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Qualitative systemic review of randomized controlled trials on complementary and alternative medicine treatments in fibromyalgia
Rheumatology International, 08/20/09

Baranowsky J et al. – Authors conclude that many of the studies on complementary and alternative medicine (CAM) for fibromyalgia suffered from methodological shortcomings and worked with small study samples. Thus, only moderate evidence for aerobic exercise approaches could be found. Best evidence was noted for acupuncture and some herbal and nutritional supplements. However, since then some new clinical trials have appeared that make a new review on randomized controlled trials (RCTs) in fibromyalgia necessary.

Methods

Objectives of the study were identification, quality evaluation and summary of RCTs on CAM with the exception of dietary and nutritional supplements
A computerized search of databases from 1990 to July 2007 was performed
The RCTs were assessed by a methodological quality score

Results

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
RCTs had an average group size of 25 with the number of groups ranging from 2–4
Quality score assessment of the RCTs yielded a mean score of 51 out of 100
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 2 trials
Acupuncture showed 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