Effects of Physical-Agent Pain Relief Modalities for Fibromyalgia Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

Purpose We conducted a systematic review and meta-analysis to investigate the effects of the following physical-agent modalities for pain relief in fibromyalgia (FM) patients. Methods We identified randomized controlled studies of adults with FM in the MEDLINE, CINAHL, and PEDro databases. The primary outcome measure was pain relief measured by a visual analogue scale (VAS), and the secondary outcome measures of interest were subjective improvements in the number of tender points, Fibromyalgia Impact Questionnaire (FIQ), and quality of life (QOL) scores. Results Eleven studies were included in our review. The studies' physical-agent modalities were low-level laser therapy (LLLT), thermal therapy, electromagnetic field therapy, and transcutaneous electrical nerve stimulation (TENS). LLLT did not reduce VAS scores, but it significantly reduced both the number of tender points and FIQ score. Thermal therapy was associated with significantly reduced VAS scores, tender points, and FIQ scores. Electromagnetic field therapy was associated with significantly reduced VAS score and FIQ score. TENS significantly reduced VAS scores. Conclusion Our analyses revealed that thermal therapy and LLLT had a partial effect on pain relief in FM patients, and this beneficial effect may have a positive influence on FM patients' health status.

Excessive exercise induces cardiac arrhythmia in a young fibromyalgia mouse model

“…The symptoms of FM comprise musculoskeletal pain [ 3 ], fatigue [ 4 ], sleep disorders, and mood disorders [ 4 ]. In general, medications [ 5 , 6 ], psychotherapy [ 7 ], counseling [ 8 ], cognitive behavior therapy [ 9 ], self-care instructions [ 10 , 11 ], and rehabilitation or therapeutic exercises [ 12 , 13 ] are recommended as treatments for FM patients. Underwater walking is a therapeutic exercise that has often been utilized for gait training for patients with painful diseases, such as osteoarthritis [ 14 ], rheumatoid arthritis [ 15 ], arthroplasty [ 16 ], and FM [ 17 – 20 ].…”

Juvenile primary fibromyalgia syndrome: A Review- Treatment and Prognosis

“…Transcutaneous Electrical Nerve Stimulation (TENS) is a noninvasive therapeutic method that uses low-voltage electrical current for pain relief, by activating endogenous pain inhibitory mechanisms [86]. The use of this modality for adult FM has been described in the literature [87]. It demonstrated significant improvements in movement-evoked pain, fatigue and other clinical outcomes [88].…”

Best Practices for Chiropractic Management of Patients with Chronic Musculoskeletal Pain: A Clinical Practice Guideline

“…Table 7 summarizes the articles identified after searching for each specific modality from a pool of 348 articles. There were a total of 21 articles: 5 CPGs, 14,17,29,32,33 4 RCTS, [34][35][36][37] and 12 SRs, [38][39][40][41][42][43][44][45][46][47][48][49] as shown by condition and therapy in Table 7.…”

“…Spinal manipulation 97 Myofascial release 97 Acupuncture 44 LLL therapy 43,49 c. Combined active and passive: multidisciplinary rehabilitation d. Mind-body interventions, including CBT, mindfulness meditation, yoga, and t'ai chi, qigong…”