Fibromyalgia: Novel Therapeutic Aspects

SUMMARY

Objectives: This paper focuses on nonpharmacologic approaches to fibromyalgia treatment. Descriptions of the most well researched strategies, such as exercise, cognitive-behavioral therapy, and multidisciplinary treatment using multiple treatment components, along with novel treatments for which evidence is beginning to emerge, are compared and evaluated.

Findings: Evidence for the pain reduction benefits of moderate intensity exercise is strong. Both cognitive-behavioral therapy as a stand-alone treatment and multicomponent strategies that incorporate exercise and cognitive-behavioral or education strategies have significant benefits to patients mainly in enhanced self-efficacy and physical capacity and decreased pain. Novel therapies such as acupuncture, biofeedback, balneotherapy, therapeutic massage, movement therapy, vegetarian diets and supplements, and magnets all demonstrate therapeutic benefits in small clinical trials. There is some evidence that discernible characteristics may differentiate responders from nonresponders to many therapies.

Conclusions: Overall, there is moderate to strong evidence of the effectiveness of some nonpharmacologic approaches to fibromyalgia treatment. Novel treatments from a wide group of practitioners and health perspectives are beginning to emerge as legitimate strategies. An individualized approach that incorporates patient's abilities, preferences, physical and psychological characteristics is critical to the success of treatment.

KEYWORDS:

• Fibromyalgia
• treatment
• novel approaches
• review