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Physical & other non-pharmacological interventions for fibromyalgia (FM)

  [ 45 votes ]   [ Discuss This Article ] • September 5, 1999

There is little empirical evidence for the effectiveness of
physical and other non-pharmacological approaches to the
management of fibromyalgia. Although a number of studies have
been conducted into such approaches, many of these are
uncontrolled, and relatively few randomized controlled trials
of appropriate size and methodological rigour have been
carried out. This chapter provides an overview of the evidence
available under the following headings: exercise, EMG
biofeedback training, electrotherapy and acupuncture, patient
education and self-management programmes, multimodal treatment
approaches, and other interventions. It is hard to reach firm
conclusions from the literature, owing to the variety of
interventions that have been evaluated and the varying
methodological quality of the studies concerned. Nonetheless,
in terms of specific interventions, exercise therapy has
received a moderate degree of support from the literature, and
has been subjected to more randomized studies than any other
intervention. In contrast, there is little or no evidence
available for most types of electrotherapy. In terms of
overall management strategies, a multimodal programme of
management, including physical, psychological and educational
components and delivered in a multidisciplinary setting, has
gained some support from descriptive and experimental studies,
and accords with current understanding of the aetiology and
clinical features of fibromyalgia. There is a clear need for
further systematic evaluation of the effectiveness of
non-pharmacological treatment approaches in fibromyalgia.

Sim J, Adams N

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