A meta-analysis of fibromyalgia (FM) treatment interventions

OBJECTIVE: To evaluate and compare the efficacy of

pharmacological and nonpharmacological treatments of

fibromyalgia syndrome (FMS).

METHODS: This meta-analysis of 49

fibromyalgia treatment outcome studies assessed the efficacy

of pharmacological and nonpharmacological treatment across

four types of outcome measures-physical status, self-report of

FMS symptoms, psychological status, and daily functioning.

RESULTS: After controlling for study design, antidepressants

resulted in improvements on physical status and self-report of

FMS symptoms. All nonpharmacological treatments were

associated with significant improvements in all four

categories of outcome measures with the exception that

physically-based treatment (primarily exercise) did not

significantly improve daily functioning. When compared,

nonpharmacological treatment appears to be more efficacious in

improving self-report of FMS symptoms than pharmacological

treatment alone. A similar trend was suggested for functional


CONCLUSION: The optimal intervention for FMS would

include nonpharmacological treatments, specifically exercise

and cognitive-behavioral therapy, in addition to appropriate

medication management as needed for sleep and pain symptoms.

Rossy LA, Buckelew SP, Dorr N, Hagglund KJ, Thayer JF, McIntosh MJ,

Hewett JE, Johnson JC

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