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

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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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