Review of randomized controlled trials on complementary and alternative medicine in fibromyalgia

Rheumatol Int. 2009 Aug 12. [Epub ahead of print]

Qualitative systemic review of randomized controlled trials on complementary and alternative medicine treatments in fibromyalgia.

Baranowsky J, Klose P, Musial F, Haeuser W, Dobos G, Langhorst J. Department of Internal Medicine, Complementary and Integrative Medicine, Kliniken Essen-Mitte, University Duisburg-Essen, Essen, Germany.

The objectives of the study were identification, quality evaluation and summary of RCTs on complementary and alternative medicine as defined by the National Institute of Health with the exception of dietary and nutritional supplements. A computerized search of databases from 1990 (year of publication of the ACR criteria for fibromyalgia) to July 2007 was performed. The RCTs were assessed by a methodological quality score. A total of 23 RCTs issued from 1992 to 2007 on acupuncture, balneotherapy, thermotherapy, magnetic therapy, homeopathy, manual manipulation, mind-body medicine, diet therapy and music therapy were identified. The RCTs had an average group size of 25 with the number of groups ranging from two to four. The quality score assessment of the RCTs yielded a mean score of 51 out of 100. The average methodological quality of the identified studies was fairly low. Best evidence was found for balneotherapy/hydrotherapy in multiple studies. Positive results were also noted for homeopathy and mild infrared hyperthermia in 1 RCT in each field. Mindfulness meditation showed mostly positive results in two trials and acupuncture mixed results in multiple trials with a tendency toward positive results. Tendencies for improvement were furthermore noted in single trials of the Mesendieck system, connective tissue massage and to some degree for osteopathy and magnet therapy. No positive evidence could be identified for Qi Gong, biofeedback, and body awareness therapy.

PMID: 19672601 [PubMed - as supplied by publisher]

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written by Maff, August 19, 2009

So in a review of randomized-controlled trials (RCTs), the "gold standard" of medical research, we have researchers concluding that homeopathy, mild infrared hyperthermia, mindfulness meditation, and acupuncture are effective, or somewhat effective for the treatment of fibromyalgia.

Unfortunately the quality of the studies the researchers reviewed was of fairly low quality, the number of studies was low, and the studies included only small numbers participants. These are important factors that make the conclusions questionable. Still, it is good to see a review such as this finding positive results for a number of complementary and alternative therapies. More studies with larger numbers of participants and better design to investigate the usefullness of these therapies to fibromyalgia patients is now required.