Nonpharmacologic Treatments for Fibromyalgia: What Works for Which Symptoms?

Fibromyalgia (FM) is often viewed as primarily a pain disorder, yet usually presents with a variety of other problems.In addition to widespread pain, the most common of these FM symptoms are fatigue, sleep problems, and depression. Nonpharmacologic interventions are recommended as first-line treatment for FM and related symptoms but there are no comprehensive reviews of the literature regarding efficacy. A recent systematic literature review and meta-analysis sought to identify the most efficacious nonpharmacologic therapies for the 4 common manifestations of FM. The primary outcome measure was disease-specific quality of life (QoL), as measured by the Fibromyalgia Impact Questionnaire (FIQ). Secondary outcomes were the impact of the interventions on pain, fatigue, sleep problems, and depression, the most common complaints associated with FM. Note: Many of the studies reviewed included relatively small numbers of subjects. Of the 11 012 participants included in these trials, 88% were women, and the median age, BMI, and FIQ score were 49 years, 27.6 kg/m2, and 59.2, respectively.