Fibromyalgia: In Depth

from the National Center for Complementary and Integrative Health
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What’s the Bottom Line?

What do we know about the effectiveness of complementary health approaches for fibromyalgia?

  • Although some studies of tai chi, yoga, mindfulness meditation, and biofeedback for fibromyalgia have had promising results, the evidence is too limited to allow definite conclusions to be reached about whether these approaches are helpful.
  • It’s uncertain whether acupuncture is helpful for fibromyalgia pain.
  • Vitamin D supplements may reduce pain in people with fibromyalgia who are deficient in this vitamin.
  • Some preliminary research on transcranial magnetic stimulation (TMS) for fibromyalgia symptoms has had promising results. 

What do we know about the safety of complementary health approaches for fibromyalgia?

  • The mind and body approaches discussed here generally have good safety records. However, some may need to be adapted to make them safe and comfortable for people with fibromyalgia.
  • Some of the natural products that have been studied for fibromyalgia may have side effects or interact with medications.
  • Headaches sometimes occur as a side effect ofTMS for fibromyalgia. TMS and other procedures involving magnets may not be safe for people who have metal implants or medical devices such as pacemakers in their bodies.

What Is Fibromyalgia?

Fibromyalgia is a common disorder that involves widespread pain, tenderness, fatigue, and other symptoms. It’s not a form of arthritis, but like arthritis, it can interfere with a person’s ability to perform everyday activities. An estimated 5 million American adults have fibromyalgia. Between 80 and 90 percent of people with fibromyalgia are women, but men and children can also have this condition.

More About Fibromyalgia

For more information about fibromyalgia, visit the National Institute of Arthritis and Musculoskeletal and Skin Diseases Web site.

What the Science Says About Complementary Health Approaches for Fibromyalgia

Mind and Body Practices 

  • Acupuncture
  • Biofeedback
  • Guided Imagery
  • Massage Therapy
  • Meditative Movement Practices (Tai Chi, Qi Gong, and Yoga)
  • Mindfulness Meditation
  • Other Mind and Body Practices 

Natural Products

  • It has been suggested that deficiencies in vitamin D might worsen fibromyalgia symptoms. In one study of women with fibromyalgia who had low vitamin D levels, 20 weeks of vitamin D supplementation led to a reduction in pain.
  • Researchers are investigating whether low magnesium levels contribute to fibromyalgia and if magnesium supplements might help to reduce symptoms.
  • Other natural products that have been studied for fibromyalgia include dietary supplements such as soy, S-adenosyl-L-methionine (SAMe), and creatine, and topical products containing capsaicin (the substance that gives chili peppers their heat). There’s not enough evidence to determine whether these products are helpful.
  • “Natural” doesn’t necessarily mean “safe.” Natural products can have side effects, and some may interact with medications. Even vitamins and minerals (including vitamin D and magnesium) can be harmful if taken in excessive amounts. 

Other Complementary Approaches

  • Balneotherapy
  • Homeopathy
  • Magnetic Therapies
  • Reiki

NCCIH-Funded Research

Recent NCCIH-sponsored studies have been investigating various aspects of complementary and integrative interventions for fibromyalgia, including:

  • The effectiveness of traditional Chinese medicine for treating fibromyalgia
  • How tai chi compares to aerobic exercise as an adjunctive treatment for fibromyalgia symptoms
  • Whether brain responses to placebos differ between people with fibromyalgia and healthy people.

More to Consider

  • Be aware that some complementary health approaches—particularly dietary supplements—may interact with conventional medical treatments. To learn more about using dietary supplements, see the NCCIH fact sheet Using Dietary Supplements Wisely and the NCCIH interactive module Understanding Drug-Supplement Interactions.
  • If you’re considering a practitioner-provided complementary health approach such as acupuncture, check with your insurer to see if the services will be covered, and ask a trusted source (like your fibromyalgia health care provider or a nearby hospital or medical school) to recommend a practitioner.
  • Tell all your health care providers about any complementary or integrative health approaches you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

For More Information

NCCIH Clearinghouse

The NCCIH Clearinghouse provides information on NCCIH and complementary and integrative health approaches, including publications and searches of Federal databases of scientific and medical literature. The Clearinghouse does not provide medical advice, treatment recommendations, or referrals to practitioners.

Toll-free in the U.S.:  1-888-644-6226

TTY (for deaf and hard-of-hearing callers):  1-866-464-3615

Website: nccih.nih.gov

Email: info@nccih.nih.gov (link sends e-mail)

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)

The mission of NIAMS is to support research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases; the training of basic and clinical scientists to carry out this research; and the dissemination of information on research progress in these diseases.

Toll-free in the U.S.: 1-877-22-NIAMS

Website: www.niams.nih.gov

PubMed®

A service of the National Library of Medicine, PubMed® contains publication information and (in most cases) brief summaries of articles from scientific and medical journals. For guidance from NCCIH on using PubMed, see How To Find Information About Complementary Health Approaches on PubMed.

Website: www.ncbi.nlm.nih.gov/pubmed

MedlinePlus

To provide resources that help answer health questions, MedlinePlus (a service of the National Library of Medicine) brings together authoritative information from the National Institutes of Health as well as other Government agencies and health-related organizations. 

Website: www.medlineplus.gov

Key References

Assefi N, Bogart A, Goldberg J, et al. Reiki for the treatment of fibromyalgia: a randomized controlled trial. Journal of Alternative and Complementary Medicine. 2008;14(9):1115–1122.

Deare JC, Zheng Z, Xue CC, et al. Acupuncture for treating fibromyalgia. Cochrane Database of Systematic Reviews. 2013;(5):CD007070. Accessed at www.cochranelibrary.com on April 8, 2016.

De Silva V, El-Metwally A, Ernst E, et al. Evidence for the efficacy of complementary and alternative medicines in the management of fibromyalgia: a systematic review. Rheumatology. 2010;49(6):1063–1068.

Glombiewski JA, Bernardy K, Häuser W. Efficacy of EMG- and EEG-biofeedback in fibromyalgia syndrome: a meta-analysis and a systematic review of randomized controlled trials. Evidence-Based Complementary and Alternative Medicine: eCAM. 2013;2013:962741.

Jones KD, Sherman CA, Mist SC, et al. A randomized controlled trial of 8-form tai chi improves symptoms and functional mobility in fibromyalgia patients. Clinical Rheumatology. 2012;31(8):1205–1214.

Kalichman L. Massage therapy for fibromyalgia symptoms. Rheumatology International. 2010;30(9):1151–1157.

Langhorst J, Klose P, Dobos GJ, et al. Efficacy and safety of meditative movement therapies in fibromyalgia syndrome: a systematic review and meta-analysis of randomized controlled trials. Rheumatology International. 2013;33(1):193–207.

Lauche R, Cramer H, Dobos G, et al. A systematic review and meta-analysis of mindfulness-based stress reduction for the fibromyalgia syndrome. Journal of Psychosomatic Research. 2013;75(6):500–510.

Lauche R, Cramer H, Häuser W, et al. A systematic overview of reviews for complementary and alternative therapies in the treatment of the fibromyalgia syndrome. Evidence-Based Complementary and Alternative Medicine: eCAM. 2015;2015:610615.

Marlow NM, Bonilha HS, Short EB. Efficacy of transcranial direct current stimulation and repetitive transcranial magnetic stimulation for treating fibromyalgia syndrome: a systematic review. Pain Practice. 2013;13(2):131–145.

Meeus M, Nijs J, Vanderheiden T, et al. The effect of relaxation therapy on autonomic functioning, symptoms and daily functioning, in patients with chronic fatigue syndrome or fibromyalgia: a systematic review. Clinical Rehabilitation. 2015;29(3):221–233.

Naumann J, Sadaghiani C. Therapeutic benefit of balneotherapy and hydrotherapy in the management of fibromyalgia syndrome: a qualitative systematic review and meta-analysis of randomized controlled trials. Arthritis Research & Therapy. 2014;16(4):R141.

Perry R, Terry R, Ernst E. A systematic review of homoeopathy for the treatment of fibromyalgia. Clinical Rheumatology. 2010;29(5):457–464.

Terhorst L, Schneider MJ, Kim KH, et al. Complementary and alternative medicine in the treatment of pain in fibromyalgia: a systematic review of randomized controlled trials.Journal of Manipulative and Physiological Therapeutics. 2011;34(7):483–496.

Theadom A, Cropley M, Smith HE, et al. Mind and body therapy for fibromyalgia. Cochrane Database of Systematic Reviews. 2015;(4):CD001980. Accessed at http://www.thecochranelibrary.com (link is external) on April 8, 2016.

U.S. Food and Drug Administration, Living with Fibromyalgia, Drugs Approved to Manage Pain. U.S. Food and Drug Administration Web site. Accessed at https://www.fda.gov/forconsumers/consumerupdates/ucm107802.htm (207KB PDF) on April 8, 2016.

Wepner F, Scheuer R, Schuetz-Wieser B, et al. Effects of vitamin D on patients with fibromyalgia syndrome: a randomized placebo-controlled trial. Pain. 2014;155(2):261–268.

All Other References

This publication is not copyrighted and is in the public domain. Duplication is encouraged.

NCCIH has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your health care provider(s). We encourage you to discuss any decisions about treatment or care with your health care provider. The mention of any product, service, or therapy is not an endorsement by NCCIH.

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