This review aims to increase awareness and improve understanding, diagnosis, and management of fibromyalgia – a complex, distressing health challenge that significantly impacts people’s lives due to its variable nature and lack of clear diagnostic markers. Healthcare professionals must assist those with this condition and improve their general quality of life. Further, they can do a lot to improve the lives of people with Fibromyalgia by resolving diagnostic hurdles, promoting collaboration, supporting patient advocacy, advancing medical technology, and adopting novel approaches.
Fibromyalgia is a composite chronic pain disorder that afflicts millions of people worldwide, causing widespread physical pain, soreness, and exhaustion; furthermore, it frequently presents sleep problems and cognitive challenges. Tender spots are often used to diagnose the condition, but focusing solely on tender areas may lead to a misdiagnosis. Fibromyalgia primarily affects women, with 90% of diagnosed patients being female. It affects 3-6% of the world’s population and coexists with other illnesses like depression, chronic fatigue, and irritable bowel syndrome. The pathophysiology of fibromyalgia is complex, involving genetic, environmental, and neurological factors. Its management typically involves a multidisciplinary approach, combining pharmacological interventions, physical therapy, cognitive-behavioral therapy, and lifestyle modifications. Pain relief and better sleep quality may be achieved using medications such as antidepressants, analgesics, and antiepileptics. Muscle strength, flexibility, and general health can all be enhanced with physical therapy and exercise catered to a person’s ability 1-6.
The search strategy follows Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) criteria 7 to evaluate the present fibromyalgia narrative review. The inclusion criteria were based on the databases PubMed, Medline, and Web of Sciences were the databases which were exhaustively searched for ten years (2014-2023) of English-language publications. In the same way, we explored the papers’ reference lists for more pertinent information. There were several key phrases in the study, including “pain”, “fibromyalgia”, “current research”, and “future research direction.” Applied filters: Abstract, Full text, Meta-Analysis, Systematic Review, ten years.
There were 614 papers in the first search result. However, only 74 articles were included after screening and quality assessment based on abstract and full-text documents (Fig. 1).
Fibromyalgia is a condition with no known cure, but a multimodal approach involving symptom management, lifestyle modifications, and psychological well-being can significantly improve quality of life 8. Below are some suggestions:
- consult a medical expert for a personalized treatment plan, including medications, physical therapies, and self-care management;
- physical therapy techniques can help with pain relief and sleep improvement;
- regularly assess and modify medications with healthcare professionals to ensure optimal symptom control 9. The most commonly used medications with their pharmacological classification and details are listed in Table I, while some common combinations of drugs that may be used for the treatment of fibromyalgia are represented in Table II;
- use self-care techniques to control symptoms and enhance well-being, including regular exercise to maintain joint flexibility and engage in low-impact aerobics activities like swimming, walking, or biking 10;
- eating a balanced diet rich in whole grains, lean meats, fruits, and vegetables will help to promote general health 11;
- try relaxation techniques, deep breathing, yoga, or meditation to release tension and promote relaxation;
- enhance sleep quality by creating a relaxing sleeping environment and sticking to a regular sleep pattern 12.
It is critical to address the psychosocial effects of fibromyalgia, such as psychotherapy or counseling 13. Cognitive behavioral therapy (CBT) can enhance coping mechanisms, lessen stress, and help manage pain 14. Furthermore, join support groups online to meet struggling people and offer coping mechanisms. Mindfulness and meditation can also aid pain management, mood enhancement, and general well-being 15.
Changing a healthy routine can help relieve symptoms by avoiding overexertion and pacing yourself throughout activities to stave off flare-ups and save energy. Furthermore, adjust to manage symptoms while retaining productivity, such as ergonomic alterations and flexible schedules 16. Investigate complementary alternative remedies to conventional therapies, such as acupuncture 17 and massage therapies 18 to relieve pain and exhaustion.
Stay informed about fibromyalgia, learn from reputable sources, and set realistic goals for managing symptoms and overall well-being. Regular examinations and adaptable treatment are essential for self-progress and treatment adjustments.
Research advances in fibromyalgia
A comprehensive fibromyalgia management requires addressing sleep issues, fatigue, anxiety, and depression, so researchers are concentrating on patient-reported outcomes to evaluate the efficacy of therapies other than pain relief. Since fibromyalgia symptoms can manifest in various ways, experts are looking into individualized treatment plans.
Table II represents some common combinations of drugs may be used for the treatment of fibromyalgia.
A more successful and focused approach to management may result from interventions shaped by a patient’s unique symptom profile, genetic predisposition, and therapeutic response 19.
Fibromyalgia research has advanced significantly over time, revealing light on numerous facets of the illness and raising hopes for better detection and care. The most recent interventions depicted in Figure 2 and Table III represent the characteristics and findings of intervention-based studies included in this review 20-70.
These interventions include: drug therapies, psycho-immunology-based treatments, and homeopathy. Further interventions include occupational therapy, exercise-based interventions, music-based therapies, massage-based techniques, whole-body vibration, acupuncture, and Tai Chi. Nutritional interventions, such as dietary supplements, vitamin D supplementation, vegan diets, and probiotics are commonly also used. E-Health therapeutic interventions, such as body awareness therapy, mind-fulfillment and acceptance-based approaches, and resistance training are increasingly used for patients with fibromyalgia Understanding fibromyalgia biomarkers and self-care techniques can improve treatment plans, alleviate pain, reduce stress, and improve well-being. By examining blood indicators, genetic variants, and neuroimaging, researchers can develop specialized therapies targeting fundamental processes, minimizing misdiagnosis, and directing individualized treatment strategies.
Obstacles and prospects
The worldwide health issues of fibromyalgia impact people from various cultures and geographical areas. For all affected people, it is critical to recognize cultural variances in symptom expression, access to care, and treatment preferences to get inclusive and equitable care. Although this has been better understood and treated, several obstacles still remain to overcome, and the following
Fibromyalgia continues to be under diagnosed or misdiagnosed as its symptoms overlap with those of other illnesses. Diagnostic delays result from deficiencies in medical training and understanding by healthcare professionals. Faster and more accurate diagnoses could occur with improved medical education and public awareness 71.
Due to the absence of objective physical symptoms, fibromyalgia patients may encounter stigma and mistrust. Raising awareness, reducing stigma and ensuring that patients receive appropriate care and support depends largely on advocacy organizations and patient-focused efforts 72.
While immediate pain relief is essential, long-term treatment plans that address the chronic aspect of fibromyalgia are also important. Patients can improve their quality of life by emphasizing behavioral changes, psychosocial support, and long-term pain management8.
Effective management of fibromyalgia requires multidisciplinary collaboration between different healthcare specialties, in order to provide comprehensive care that meets the needs of each patient by collaborating with rheumatologists, pain experts, psychologists, physiotherapists and nutritionists. However, research funding is needed to advance new methods of treating fibromyalgia 73-74.
Greater understanding of the problem and better treatment options will come from researching new therapies, examining cutting-edge technologies, and improving current approaches.
This review examines several social, emotional, and behavioral fibromyalgia-related contributing elements, will help to improve symptom management and overall health of the patients. By supporting self-care, using digital health, and using a patient-centered approach, healthcare professionals can better manage fibromyalgia.
Conflicts of interest statement
The authors declare no conflict of interest.
This study did not receive funds either locally or internationally.
AZW: design, write, and finalize the manuscript writeup; AMHM: data collection and critical reading; AHM: data collection and proofreading; MH: critical evaluation and proofreading. HA: Basic drafting of the manuscript. AGM: supervision & corresponding author.
Figures and tables
|Medications most often used in fibromyalgia||Drug Class||Mechanism of action||Side effects||Authors/year|
|Amitriptyline and nortriptyline||Tricyclic antidepressants (TCAs)||TCAs treat depression, anxiety, chronic pain, and fibromyalgia by increasing serotonin and norepinephrine levels.||Dry mouth, constipation, and dizziness.||Alberti et al., 2022 20; Farag et al., 2022 21; Moore et al., 2015 22|
|Duloxetine, venlafaxine and milnacipran||Serotonin-norepinephrine reuptake inhibitors (SNRIs)||SNRIs/SSRIs treat depression, anxiety, chronic pain, and fibromyalgia by increasing neurotransmitter levels.||Nausea, dizziness, and headache.||Migliorini et al., 2023 23; Alberti et al., 2022 20; Lian et al., 2020 24 Derry et al., 2015 25; Walitt et al., 2015 26; VanderWeide et al., 2015 27; Hauser et al., 2013 28; Lee et al., 2016 29.|
|Pregabalin, gabapentin and topiramate||Anticonvulsant/ Antiepileptic drugs||Anticonvulsant drugs treat neuropathic pain and Fibromyalgia by modulating neurotransmitter release.||Dizziness, drowsiness, and weight gain.||Egunsola et al., 2019 30; Wiffen et al., 2013 31; Cording et al., 2015 32; Moore et al., 2015 22; Cooper et al., 2016 33.|
|Oxycodone and tramadol||Opioid analgesics||Opioid analgesics reduce pain perception by binding to brain and spinal cord receptors.||Constipation, nausea, and respiratory depression.||Gaskell et al., 2016 34; Rocha et al., 2020 35; Sola et al., 2020 36.|
|Mirtazapine, quetiapine agomelatine, trazodone and amisulpride||Atypical antidepressants||Atypical antidepressants treat depression, anxiety, and sleep disorders in fibromyalgia.||Drowsiness, weight gain, and dry mouth.||Welsch et al., 2017 37; Migliorini et al., 2023 23; Ottman et al., 2018 38.|
|Cannabis||Cannabis and Cannabinoids||Plant-based substances reduce pain and inflammation and treat chronic pain conditions.||Dry mouth, dizziness, and impaired coordination.||Strand et al., 2023 39; Kurlyandchik et al., 2021 40; Mücke et al., 2018 41; Hauser et al., 2016 42; Fitzcharles et al., 2016 43.|
|NSAIDs and lidocaine||Non-opioid analgesics||Non-opioid analgesics treat fibromyalgia by blocking prostaglandin production and reducing pain.||Stomach upset, headache, and dizziness.||Derry et al., 2016 44; de Carvalho et al., 2022 45.|
|Olanzapine quetiapine Acetyl-L-carnitine||Antipsychotic drugs||Antipsychotic drugs are not the primary treatment for fibromyalgia, but atypical drugs like quetiapine can be used off-label for specific symptoms like sleep disturbances and anxiety.||Healthcare professionals must closely monitor antipsychotic drug use for fibromyalgia treatment to avoid adverse effects and drug interactions.||Walitt et al., 2016 46; Jimenez et al 2018 47; Calandre et al., 2014 48.|
|1||Antidepressants (such as TCAs or SNRIs)||&||Anticonvulsants (such as gabapentin or pregabalin)|
|2||Opioid analgesics (such as oxycodone or tramadol)||&||Nonsteroidal anti-inflammatory drugs (NSAIDs)|
|3||Antidepressants (such as TCAs or SNRIs)||&||Sleep aids (such as zolpidem or trazodone)|
|4||Antidepressants (such as TCAs or SNRIs)||&||Muscle relaxants (such as cyclobenzaprine or tizanidine)|
|Interventions||Types||Study design||Findings||Authors, year|
|Pharmacological interventions||Pharmacological interventions||Meta-analysis||This meta-analysis investigates the efficacy of pharmaceutical and non-pharmacological therapies and summarizes evidence on fibromyalgia response classifications. Results indicate that there is not enough information to establish firm conclusions, although circumstantial evidence points to the possibility of improvement with SNRI, NRI, and multimodal treatment.||Papadopoulou et al., 2016 50|
|Drug therapies||Meta-analysis of RCT||The most potent painkillers were milnacipran, pregabalin, and duloxetine in 100/200, 300 and 60 mg, respectively. The placebo group had a lower probability of withdrawal due to adverse effects.||Lee et al., 2020 29|
|Psycho-immunology based||Systematic review||This comprehensive review assesses psychoneuroimmunology-based therapies to slow the progression of the disease and its adverse effects. In a review of 42 studies, it was discovered that practices like yoga, meditation, tai chi, acupuncture, mindfulness, and cognitive behavior therapy lowered the levels of the stress hormones cortisol, epinephrine, and norepinephrine. Only one study, though, found a substantial impact on the development of the illness.||Moraes et al., 2018 51|
|Inflammatory biomarkers||Systematic review||This review examines non-pharmacological therapies’ effects on inflammatory biomarkers in fibromyalgia patients. Results show decreased interleukin, IL-8, IL-6, and insulin-like growth factor 1 levels. However, neuropeptide and CRP levels remain conflicting. Further study is needed.||Sanada et al., 2015 52|
|Homeopathy||Literature-review and meta-analysis||Homeopathy has shown potential advantages for managing fibromyalgia symptoms, with meta-analyses showing effects on tender point count, pain severity, and exhaustion compared to placebo. This review explores the use of homeopathy in treating FMS.||Boehm et al., 2014 53|
|Electrical interventions neuromodulation & central sensitization||Repetitive transcranial magnetic stimulation||A systematic review and meta-analysis||The evaluation of 10-Hz rTMS for treating fibromyalgia found that it significantly reduced pain and improved quality of life compared to sham stimulation. However, it did not reduce depression. No significant difference was found in pain subgroup analysis..||Zhu et al., 2023 54|
|Electrical neuromodulation||Systematic review and meta-analysis of RCT||Electrical neuromodulation significantly improved pain, depression, and functioning in fibromyalgia patients, with active transcranial direct current stimulation affecting pain, depression, and functioning. Age-related depression effects suggest efficient treatment programs.||Cheng et al., 2023 55|
|Central sensitization||Systematic review||A study aimed to determine popular dynamic pain metrics in fibromyalgia and evaluate Central sensitization in patients using algometry. The findings showed 28 studies had low quality, three had moderate quality, and three had high quality. Further research is needed to understand the mechanics and enhance algometry protocols.||de la Coba et al., 2022 56|
|Non-pharmacological interventions||Psychotherapy §||Systematic review||Recent clinical trials on psychotherapy therapies’ effects on physical pain in fibromyalgia patients, mainly from Spain, revealed significant variations in outcomes. These differences can be attributed to psychotherapy modalities, evaluation instruments, and internal and external variables.||Gómez-de-Regil et al., 2020 57|
|*Cognitive behavioral therapy||Systematic review and meta-analysis||Review shows cognitive-behavioral treatment improves pain, anxiety, sorrow, sleep quality in fibromyalgia patients, but lacks sleep efficiency; hybrid CBT or mindfulness may help.||Climent-Sanz et al., 2022 14|
|Acupuncture||Systematic review and meta-analysis||Acupuncture effects on fibromyalgia patients’ pain, exhaustion, sleep quality, physical function, stiffness, well-being, and safety were examined in 13 publications. The outcomes demonstrated that acupuncture reduced pain and enhanced well-being following treatment, with long-term effects on both. There was no indication of weariness, poor sleep, impaired physical function, stiffness, or significant adverse effects. There is some evidence to suggest that acupuncture can treat FM.||Zheng et al., 2022 17|
|Occupational therapy||Systematic review||The efficacy of occupational therapy for fibromyalgia patients is investigated in this systematic study. The findings provide compelling support for cognitive-behavioral, stress-reduction, emotional honesty, physical activity, and interdisciplinary therapies. Self-management, however, has less empirical support, and few strategies help people sleep better.||Poole 2017 58|
|Exercise-based interventions||Mapping review with meta-analysis||In this review, the effect of EBIs on fibromyalgia patients’ sleep quality was evaluated. Meta-analysis of the nine systematic reviews found a moderate statistically significant effect. Exercises that included the body and mind and those done in combination had the biggest impacts; cardio and strength training alone had little impact. EBIs were superior to limited, no intervention, or standard treatment in terms of increasing sleep quality.||Cuenca-Martínez et al., 2023 59|
|*Music||Meta-analysis||The study examined music therapy’s impact on fibromyalgia patients’ pain, depression, and quality of life. Results showed lower scores on the Beck Depression and Pain Visual Analog Scales, but no significant differences on the McGill Pain Scale. The study concluded that music therapy is more effective than non-music therapy.||Wang et al., 2020 60|
|*Massage||Systematic review and meta-analysis of RCT||A systematic study evaluates massage therapy’s effectiveness in treating fibromyalgia, finding that five-week massage therapy reduced pain, anxiety, and depression in patients, but not insomnia. Large-scale, randomized trials are needed for verification.||Yuan et al., 2015 18|
|*Whole body vibration||Systematic review||The study evaluated evidence for whole-body vibration in managing pain, fatigue, and quality of life in fibromyalgia-affected women. Results showed ambiguous findings on pain and exhaustion, and a marginal difference in quality of life, suggesting no clinically significant benefits.||Moretti et al., 2018 61|
|*Tai Chi||Meta-analysis of RCT||This review includes six RCTs, found that Tai Chi significantly improves fibromyalgia therapy by reducing pain, exhaustion, and sleep and quality of life. Further research is needed.||Cheng et al., 2019 62|
|Nutritional interventions||Review||A multidisciplinary strategy involving olive oil, ancient grains, low-calorie diets, gluten-free options, and Mediterranean diets is essential. Further research is needed for effective management strategies.||Pagliai et al., 2020 11|
|*Dietary||Systematic review||Alternative treatments include vegan and low-FODMAP diets, supplementation with acetyl-l-carnitine, coenzyme Q10, chlorella green algae, and vitamins C and E. However, poor design, variability, small sample size, and strong bias limit interpretation.||Lowry et al., 2020 63|
|*Vitamin D||Systematic review||A review of randomized controlled trials (RCTs) found a link between vitamin D insufficiency and diffuse muscle pain in FMS and chronic widespread musculoskeletal pain (CMP). Eight studies showed pain relief, suggesting vitamin D supplementation as a potential treatment.||Lombardo et al., 2022 64|
|*Vegan diet||Systematic review||The systematic assessment of 88 studies found that plant-based dietary patterns improved biochemical indicators, quality of life, sleep, pain, and overall health condition. However, interpretation is constrained by poor methodology.||Nadal-Nicolás et al., 2021 65|
|*Probiotics||Systematic review||Fibromyalgia syndrome and chronic fatigue syndrome may be caused by the gut flora. Anxiety levels and fecal content were reported to be decreased by Lactobacillus casei strain Shirota after 8 weeks in a systematic assessment of probiotic therapies in patients with FMS or CFS. Inflammatory indicators were lowered by Bifidobacterium infantis. To completely understand the effects of probiotics in these situations, more experimental study is necessary.||Roman et al., 2018 66|
|E-health therapeutic interventions||Systematic review||This review reviews e-health therapies targeting psychosocial outcomes and pain-related psychological factors in chronic pain syndromes, including fibromyalgia syndrome. Twenty-six publications, mostly randomized controlled trials, focus on adult female patients. However, the literature is diverse, making it difficult to draw firm conclusions.||Donisi et al., 2023 67;|
|*Body awareness||Systematic review and meta-analysis||Fibromyalgia is a chronic illness with widespread pain and impairment. This study compares movement and body awareness (BA) therapy results for fibromyalgia patients. Results show mobility and BA treatments improve pain symptoms, but more investigation is needed to determine the mechanism of action.||Bravo et al., 2019 68|
|*Mind fullness &acceptance based||Systematic review and meta-analyses||In comparison to controls after treatment, the analyses revealed minor to moderate effects in favor of mindfulness- and acceptance-based therapies. Due to limitations in individual studies, contradictory findings, and imprecision, the effects are questionable.||Haugmark et al., 2019 15|
|*Tele-Rehabilitation therapy||Systematic review and Meta-analysis of RCT||14 RCTs found tele-rehabilitation improved fibromyalgia patients’ symptoms and quality of life, but safety remains unknown due to insufficient data. Further, well-planned experiments are needed to confirm its effectiveness.||Wu et al., 2023 69|
|*Resistance training||Systematic review and meta-analysis||15 studies found that resistance training (RT) is beneficial in reducing pain intensity, functional ability, and illness severity in women with fibromyalgia. However, more clinical studies are needed to validate these findings.||Rodríguez-Domínguez et al., 2023 70|
- Sarzi-Puttini P, Giorgi V, Marotto D, Atzeni F. Fibromyalgia: an update on clinical characteristics, aetiopathogenesis and treatment. Nat Rev Rheumatol. 2020;16:645-660. doi:https://doi.org/10.1038/s41584-020-00506-w
- Eich W, Bär K, Bernateck M. Definition, Klassifikation, klinische Diagnose und Prognose des Fibromyalgiesyndroms: Aktualisierte Leitlinie 2017 und Übersicht von systematischen Übersichtsarbeiten Definition, classification, clinical diagnosis and prognosis of fibromyalgia syndrome: Updated guidelines 2017 and overview of systematic review articles. Schmerz. 2017;31:231-238. doi:https://doi.org/10.1007/s00482-017-0200-7
- D’Onghia M, Ciaffi J, Ruscitti P. The economic burden of fibromyalgia: a systematic literature review. Semin Arthritis Rheum. 2022;56. doi:https://doi.org/10.1016/j.semarthrit.2022.152060
- Kleykamp B, Ferguson M, McNicol E. The prevalence of psychiatric and chronic pain comorbidities in fibromyalgia: an ACTTION systematic review. Semin Arthritis Rheum. 2021;51:166-174. doi:https://doi.org/10.1016/j.semarthrit.2020.10.006
- Qureshi A, Jha S, Iskander J. Diagnostic challenges and management of fibromyalgia. Cureus. 2021;13. doi:https://doi.org/10.7759/cureus.18692
- Hackshaw K. Assessing our approach to diagnosing fibromyalgia. Expert Rev Mol Diagn. 2020;20:1171-1181. doi:https://doi.org/10.1080/14737159.2020.1858054
- Moher D, Liberati A, Tetzlaff J. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg. 2010;8:336-341. doi:https://doi.org/10.1016/j.ijsu.2010.02.007
- Saracoglu I, Akin E, Aydin Dincer G. Efficacy of adding pain neuroscience education to a multimodal treatment in fibromyalgia: a systematic review and meta-analysis. Int J Rheum Dis. 2022;25:394-404. doi:https://doi.org/10.1111/1756-185X.14293
- Schulze N, Salemi M, de Alencar G. Efficacy of manual therapy on pain, impact of disease, and quality of life in the treatment of fibromyalgia: a systematic review. Pain Physician. 2020;23:461-476.
- Bidonde J, Busch A, Schachter C. Mixed exercise training for adults with fibromyalgia. Cochrane Database Syst Rev. 2019;5. doi:https://doi.org/10.1002/14651858.CD013340
- Pagliai G, Giangrandi I, Dinu M. Nutritional Interventions in the management of fibromyalgia syndrome. Nutrients. 2020;12. doi:https://doi.org/10.3390/nu12092525
- Estévez-López F, Maestre-Cascales C, Russell D. Effectiveness of exercise on fatigue and sleep quality in fibromyalgia: a systematic review and meta-analysis of randomized trials. Arch Phys Med Rehabil. 2021;102:752-761. doi:https://doi.org/10.1016/j.apmr.2020.06.019
- Gómez-de-Regil L. Psychoeducation for patients with fibromyalgia: a systematic review. Healthcare (Basel). 2021;9. doi:https://doi.org/10.3390/healthcare9060737
- Climent-Sanz C, Valenzuela-Pascual F, Martínez-Navarro O. Cognitive behavioral therapy for insomnia (CBT-i) in patients with fibromyalgia: a systematic review and meta-analysis. Disabil Rehabil. 2022;44:5770-5783. doi:https://doi.org/10.1080/09638288.2021.1954706
- Haugmark T, Hagen K, Smedslund G. Mindfulness- and acceptance-based interventions for patients with fibromyalgia - A systematic review and meta-analyses. PLoS One. 2019;14. doi:https://doi.org/10.1371/journal.pone.0221897
- Antunes M, Couto L, Gomes Bertolini S. Effectiveness of interdisciplinary health education programs for individuals with fibromyalgia: a systematic review. J Educ Health Promot. 2021;10. doi:https://doi.org/10.4103/jehp.jehp_592_20
- Zheng C, Zhou T. Effect of acupuncture on pain, fatigue, sleep, physical function, stiffness, well-being, and safety in fibromyalgia: a systematic review and meta-analysis. J Pain Res. 2022;15:315-329. doi:https://doi.org/10.2147/JPR.S351320
- Yuan S, Matsutani L, Marques A. Effectiveness of different styles of massage therapy in fibromyalgia: a systematic review and meta-analysis. Man Ther. 2015;20:257-264. doi:https://doi.org/10.1016/j.math.2014.09.003
- Galvez-Sánchez C, Montoro C. Psychoeducation for fibromyalgia syndrome: a systematic review of emotional, clinical and functional related-outcomes. Behav Sci (Basel). 2023;13. doi:https://doi.org/10.3390/bs13050415
- Alberti F, Becker M, Blatt C. Comparative efficacy of amitriptyline, duloxetine and pregabalin for treating fibromyalgia in adults: an overview with network meta-analysis. Clin Rheumatol. 2022;41:1965-1978. doi:https://doi.org/10.1007/s10067-022-06129-8
- Farag H, Yunusa I, Goswami H. Comparison of amitriptyline and us food and drug administration-approved treatments for fibromyalgia: a systematic review and network meta-analysis. JAMA Netw Open. 2022;5. doi:https://doi.org/10.1001/jamanetworkopen.2022.12939
- Moore R, Derry S, Aldington D. Amitriptyline for fibromyalgia in adults. Cochrane Database Syst Rev. 2019;5. doi:https://doi.org/10.1002/14651858.CD011824
- Migliorini F, Maffulli N, Eschweiler J. Duloxetine for fibromyalgia syndrome: a systematic review and meta-analysis. J Orthop Surg Res. 2023;18. doi:https://doi.org/10.1186/s13018-023-03995-z
- Lian Y, Wang Y, Zhang Y. Duloxetine for pain in fibromyalgia in adults: a systematic review and a meta-analysis. Int J Neurosci. 2020;130:71-82. doi:https://doi.org/10.1080/00207454.2019.1664510
- Derry S, Phillips T, Moore R. Milnacipran for neuropathic pain in adults. Cochrane Database Syst Rev. 2015;2015. doi:https://doi.org/10.1002/14651858.CD011789
- Walitt B, Urrútia G, Nishishinya M. Selective serotonin reuptake inhibitors for fibromyalgia syndrome. Cochrane Database Syst Rev. 2015;2015. doi:https://doi.org/10.1002/14651858.CD011735
- VanderWeide L, Smith S, Trinkley K. A systematic review of the efficacy of venlafaxine for the treatment of fibromyalgia. J Clin Pharm Ther. 2015;40:1-6. doi:https://doi.org/10.1111/jcpt.12216
- Häuser W, Urrútia G, Tort S. Serotonin and noradrenaline reuptake inhibitors (SNRIs) for fibromyalgia syndrome. Cochrane Database Syst Rev. 2013;(1). doi:https://doi.org/10.1002/14651858.CD010292
- Lee Y, Song G. Comparative efficacy and tolerability of duloxetine, pregabalin, and milnacipran for the treatment of fibromyalgia: a Bayesian network meta-analysis of randomized controlled trials. Rheumatol Int. 2016;36:663-672. doi:https://doi.org/10.1007/s00296-016-3468-5
- Egunsola O, Wylie C, Chitty K. Systematic Review of the efficacy and safety of gabapentin and pregabalin for pain in children and adolescents. Anesth Analg. 2019;128:811-819. doi:https://doi.org/10.1213/ANE.0000000000003936
- Wiffen P, Derry S, Lunn M. Topiramate for neuropathic pain and fibromyalgia in adults. Cochrane Database Syst Rev. 2013;2013. doi:https://doi.org/10.1002/14651858.CD008314.pub3
- Derry S, Cording M, Wiffen P. Pregabalin for pain in fibromyalgia in adults. Cochrane Database Syst Rev. Published online 2016. doi:https://doi.org/10.1002/14651858.CD011790.pub2
- Cooper T, Derry S, Wiffen P. Gabapentin for fibromyalgia pain in adults. Cochrane Database Syst Rev. 2017;1. doi:https://doi.org/10.1002/14651858.CD012188.pub2
- Gaskell H, Moore R, Derry S, Stannard C. Oxycodone for pain in fibromyalgia in adults. Cochrane Database Syst Rev. 2016;9. doi:https://doi.org/10.1002/14651858.CD012329
- da Rocha A, Mizzaci C, Nunes Pinto A. Tramadol for management of fibromyalgia pain and symptoms: systematic review. Int J Clin Pract. 2020;74. doi:https://doi.org/10.1111/ijcp.13455
- De Sola H, Dueñas M, Salazar A. Prevalence of therapeutic use of opioids in chronic non-cancer pain patients and associated factors: a systematic review and meta-analysis. Front Pharmacol. 2020;11. doi:https://doi.org/10.3389/fphar.2020.564412
- Welsch P, Bernardy K, Derry S. Mirtazapine for fibromyalgia in adults. Cochrane Database Syst Rev. 2018;8. doi:https://doi.org/10.1002/14651858.CD012708.pub2
- Ottman A, Warner C, Brown J. The role of mirtazapine in patients with fibromyalgia: a systematic review. Rheumatol Int. 2018;38:2217-2224. doi:https://doi.org/10.1007/s00296-018-4068-3
- Strand N, Maloney J, Kraus M. Cannabis for the treatment of fibromyalgia: a systematic review. Biomedicines. 2023;11. doi:https://doi.org/10.3390/biomedicines11061621
- Kurlyandchik I, Tiralongo E, Schloss J. Safety and efficacy of medicinal cannabis in the treatment of fibromyalgia: a systematic review. J Altern Complement Med. 2021;27:198-213. doi:https://doi.org/10.1089/acm.2020.0331
- Mücke M, Phillips T, Radbruch L. Cannabis-based medicines for chronic neuropathic pain in adults. Cochrane Database Syst Rev. 2018;3. doi:https://doi.org/10.1002/14651858.CD012182.pub2
- Walitt B, Klose P, Fitzcharles M. Cannabinoids for fibromyalgia. Cochrane Database Syst Rev. 2016;7. doi:https://doi.org/10.1002/14651858.CD011694.pub2
- Fitzcharles M, Baerwald C, Ablin J. Efficacy, tolerability and safety of cannabinoids in chronic pain associated with rheumatic diseases (fibromyalgia syndrome, back pain, osteoarthritis, rheumatoid arthritis): a systematic review of randomized controlled trials. Schmerz. 2016;30:47-61. doi:https://doi.org/10.1007/s00482-015-0084-3
- Derry S, Wiffen P, Häuser W. Oral nonsteroidal anti-inflammatory drugs for fibromyalgia in adults. Cochrane Database Syst Rev. 2017;3. doi:https://doi.org/10.1002/14651858.CD012332.pub2
- de Carvalho J, Skare T. Lidocaine in fibromyalgia: a systematic review. World J Psychiatry. 2022;12:615-622. doi:https://doi.org/10.5498/wjp.v12.i4.615
- Walitt B, Klose P, Üçeyler N. Antipsychotics for fibromyalgia in adults. Cochrane Database Syst Rev. 2016;2016. doi:https://doi.org/10.1002/14651858.CD011804.pub2
- Jimenez X, Sundararajan T, Covington E. A Systematic review of atypical antipsychotics in chronic pain management: olanzapine demonstrates potential in central sensitization, fibromyalgia, and headache/migraine. Clin J Pain. 2018;34:585-591. doi:https://doi.org/10.1097/AJP.0000000000000567
- Calandre E, Rico-Villademoros F, Galán J. Quetiapine extended-release (Seroquel-XR) versus amitriptyline monotherapy for treating patients with fibromyalgia: a 16-week, randomized, flexible-dose, open-label trial. Psychopharmacology (Berl). 2014;231:2525-2531. doi:https://doi.org/10.1007/s00213-013-3422-0
- Thorpe J, Shum B, Moore R. Combination pharmacotherapy for the treatment of fibromyalgia in adults. Cochrane Database Syst Rev. 2018;2. doi:https://doi.org/10.1002/14651858.CD010585.pub2
- Papadopoulou D, Fassoulaki A, Tsoulas C. A meta-analysis to determine the effect of pharmacological and non-pharmacological treatments on fibromyalgia symptoms comprising OMERACT-10 response criteria. Clin Rheumatol. 2016;35:573-586. doi:https://doi.org/10.1007/s10067-015-3144-2
- Moraes L, Miranda M, Loures L. A systematic review of psychoneuroimmunology-based interventions. Psychol Health Med. 2018;23:635-652. doi:https://doi.org/10.1080/13548506.2017.1417607
- Sanada K, Díez M, Valero M. Effects of non-pharmacological interventions on inflammatory biomarker expression in patients with fibromyalgia: a systematic review. Arthritis Res Ther. 2015;17. doi:https://doi.org/10.1186/s13075-015-0789-9
- Boehm K, Raak C, Cramer H, Lauche R, Ostermann T. Homeopathy in the treatment of fibromyalgia--a comprehensive literature-review and meta-analysis. Complement Ther Med. 2014;22:731-742. doi:https://doi.org/10.1016/j.ctim.2014.06.005
- Zhu P, Xie J, Liu H. Efficacy of high-frequency repetitive transcranial magnetic stimulation at 10 Hz in fibromyalgia: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2023;104:151-159. doi:https://doi.org/10.1016/j.apmr.2022.05.006
- Cheng Y, Hsiao C, Su M. Treating fibromyalgia with electrical neuromodulation: a systematic review and meta-analysis. Clin Neurophysiol. 2023;148:17-28. doi:https://doi.org/10.1016/j.clinph.2023.01.011
- de la Coba P, Montoro C, Reyes Del Paso G. Algometry for the assessment of central sensitisation to pain in fibromyalgia patients: a systematic review. Ann Med. 2022;54:1403-1422. doi:https://doi.org/10.1080/07853890.2022.2075560
- Gómez-de-Regil L, Estrella-Castillo D. Psychotherapy for physical pain in patients with fibromyalgia: a systematic review. Pain Res Manag. 2020;2020. doi:https://doi.org/10.1155/2020/3408052
- Poole J, Siegel P. Effectiveness of occupational therapy interventions for adults with fibromyalgia: a systematic review. Am J Occup Ther. 2017;71:7101180040p1-7101180040p10. doi:https://doi.org/10.5014/ajot.2017.023192
- Cuenca-Martínez F, Suso-Martí L, Fernández-Carnero J. Exercise-based interventions on sleep quality in patients with fibromyalgia syndrome: an umbrella and mapping review with meta-analysis. Semin Arthritis Rheum. 2023;61. doi:https://doi.org/10.1016/j.semarthrit.2023.152216
- Wang M, Yi G, Gao H. Music-based interventions to improve fibromyalgia syndrome: A meta-analysis. Explore (NY). 2020;16:357-362. doi:https://doi.org/10.1016/j.explore.2020.05.012
- Moretti E, Tenório A, Holanda L. Efficacy of the whole-body vibration for pain, fatigue and quality of life in women with fibromyalgia: a systematic review. Disabil Rehabil. 2018;40:988-996. doi:https://doi.org/10.1080/09638288.2017.1282989
- Cheng C, Chiu Y, Wu D. Effectiveness of Tai Chi on fibromyalgia patients: a meta-analysis of randomized controlled trials. Complement Ther Med. 2019;46:1-8. doi:https://doi.org/10.1016/j.ctim.2019.07.007
- Lowry E, Marley J, McVeigh J. Dietary Interventions in the management of fibromyalgia: a systematic review and best-evidence synthesis. Nutrients. 2020;12. doi:https://doi.org/10.3390/nu12092664
- Lombardo M, Feraco A, Ottaviani M. The Efficacy of vitamin d supplementation in the treatment of fibromyalgia syndrome and chronic musculoskeletal pain. Nutrients. 2022;14. doi:https://doi.org/10.3390/nu14153010
- Nadal-Nicolás Y, Miralles-Amorós L, Martínez-Olcina M. Vegetarian and Vegan diet in fibromyalgia: a systematic review. Int J Environ Res Public Health. 2021;18. doi:https://doi.org/10.3390/ijerph18094955
- Roman P, Carrillo-Trabalón F, Sánchez-Labraca N. Are probiotic treatments useful on fibromyalgia syndrome or chronic fatigue syndrome patients? A systematic review. Benef Microbes. 2018;9:603-611. doi:https://doi.org/10.3920/BM2017.0125
- Donisi V, De Lucia A, Pasini I. e-Health Interventions Targeting pain-related psychological variables in fibromyalgia: a systematic review. Healthcare (Basel). 2023;11. doi:https://doi.org/10.3390/healthcare11131845
- Bravo C, Skjaerven L, Guitard Sein-Echaluce L. Effectiveness of movement and body awareness therapies in patients with fibromyalgia: a systematic review and meta-analysis. Eur J Phys Rehabil Med. 2019;55:646-657. doi:https://doi.org/10.23736/S1973-9087.19.05291-2
- Wu Y, Long Y, Peng W. The efficacy and safety of telerehabilitation for fibromyalgia: systematic review and meta-analysis of randomized controlled trials. J Med Internet Res. 2023;25. doi:https://doi.org/10.2196/42090
- Rodríguez-Domínguez ÁJ, Rebollo-Salas M, Chillón-Martínez R. Clinical relevance of resistance training in women with fibromyalgia: a systematic review and meta-analysis. Eur J Pain. Published online 2023. doi:https://doi.org/10.1002/ejp.2161
- García-Ríos M, Navarro-Ledesma S, Tapia-Haro R. Effectiveness of health education in patients with fibromyalgia: a systematic review. Eur J Phys Rehabil Med. 2019;55:301-313. doi:https://doi.org/10.23736/S1973-9087.19.05524-2
- Duhn P, Wæhrens E, Pedersen M. Effectiveness of patient education as a stand-alone intervention for patients with chronic widespread pain and fibromyalgia: a systematic review and meta-analysis of randomized trials. Scand J Rheumatol. Published online 2023:1-10. doi:https://doi.org/10.1080/03009742.2023.2192450
- Martinez-Calderon J, Ho E, Ferreira P. A Call for Improving Research on Pain Neuroscience Education and Chronic Pain: An Overview of Systematic Reviews. J Orthop Sports Phys Ther. Published online 2023:1-16. doi:https://doi.org/10.2519/jospt.2023.11833
- Martínez-Navarro O, Climent-Sanz C, Lletjà-Guijarro A. Effectiveness of eHealth therapeutic education interventions in the management of fibromyalgia: protocol for a systematic review and meta-analysis. BMJ Open. 2023;13. doi:https://doi.org/10.1136/bmjopen-2022-070012
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