Therapeutic benefit of balneotherapy and hydrotherapy in the management of fibromyalgia syndrome: a qualitative systematic review and meta-analysis of randomized controlled trials

Naumann, Johannes; Sadaghiani, Catharina

doi:10.1186/ar4603

Cited by 77 publications

(60 citation statements)

References 78 publications

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“…There was a significant improvement in pain (−0.78; −1.42 to −0.13) at the end of therapy, maintained in the longer term (median 14 weeks), although the review authors noted that no trials conducted an ITT analysis. There was consistency with regard to the evidence for hydrotherapy and balneotherapy, although little evidence to suggest superiority of one over the other 77 . Hydrotherapy evaluation: weak for (93% agreement) .…”

Section: Resultsmentioning

confidence: 92%

EULAR revised recommendations for the management of fibromyalgia

et al. 2016

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Objective The original European League Against Rheumatism recommendations for managing fibromyalgia assessed evidence up to 2005. The paucity of studies meant that most recommendations were 'expert opinion'. Methods A multidisciplinary group from 12 countries assessed evidence with a focus on systematic reviews and meta-analyses concerned with pharmacological/nonpharmacological management for fibromyalgia. A review, in May 2015, identified eligible publications and key outcomes assessed were pain, fatigue, sleep and daily functioning. The Grading of Recommendations Assessment, Development and Evaluation system was used for making recommendations. Results 2979 titles were identified: from these 275 full papers were selected for review and 107 reviews (and/or meta-analyses) evaluated as eligible. Based on metaanalyses, the only 'strong for' therapy-based recommendation in the guidelines was exercise. Based on expert opinion, a graduated approach, the following four main stages are suggested underpinned by shared decision-making with patients. Initial management should involve patient education and focus on nonpharmacological therapies. In case of non-response, further therapies (all of which were evaluated as 'weak for' based on meta-analyses) should be tailored to the specific needs of the individual and may involve psychological therapies (for mood disorders and unhelpful coping strategies), pharmacotherapy (for severe pain or sleep disturbance) and/or a multimodal rehabilitation programme (for severe disability). Conclusions These recommendations are underpinned by high-quality reviews and meta-analyses. The size of effect for most treatments is relatively modest. We propose research priorities clarifying who will benefit from specific interventions, their effect in combination and organisation of healthcare systems to optimise outcome.

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Section: Resultsmentioning

confidence: 92%

EULAR revised recommendations for the management of fibromyalgia

et al. 2016

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“…36 A systematic review and meta-analysis of 8 RCTs (overall N = 462) of the therapeutic benefit of hydrotherapy (water treatments) for FM provided moderate-to-strong evidence for a small improvement in HRQoL at the end of treatment, but not in depression or tender-point count. 37 Five RCTs (overall N = 177) of balneotherapy (spa treatments in mineral/thermal water) produced moderate evidence for a moderate-to-large reduction in pain and tender-point count at the end of treatment; a smaller effect on pain was maintained at follow-up.…”

Section: Other Cam Therapiesmentioning

confidence: 96%

Current Understanding of Fibromyalgia: Diagnosis, Treatment, and Theories About Causes

HorowitzSala¹

2015

Alternative and Complementary Therapies

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Fibromyalgia (FM) is a challenge to clinicians and patients because of its constellation of symptoms that are frequently shared with other chronic pain conditions, and the lack of a definitive diagnostic test or known cause. This article reviews the epidemiology, diagnostic issues and criteria, conventional and complementary and alternative medicine (CAM) therapies used to treat FM, the evidence base for CAM therapies, and theories of the causes of this complex disorder that affects the health-related quality of life (HRQoL) of millions of patients. Historical Background and EpidemiologyDerived from the Latin term for fibrous tissue (fibro) plus the Greek terms for muscle (myo) and pain (algia), FM is a disorder of unknown etiology characterized by chronic widespread pain and fatigue. 1 Symptoms may also include sleep disturbances, morning stiffness, cognitive problems, and depression. Although FM is often considered a rheumatic condition like arthritis, FM does not cause inflammation of-or damage to-the joints, muscles, or other tissues. The syndrome was called "fibrositis" prior to the mid-1970s. 2 The first controlled clinical study validating the symptoms of FM was published in 1981. The idea that FM was interconnected with similar conditions was also proposed in the 1980s. The American College of Rheumatology (ACR) published its first diagnostic criteria for FM in 1990, which were later revised.Recent estimates put the prevalence of FM in the United States as ranging from 2% to 8% of the population, second only to osteoarthritis (OA) as the most common "rheumatic" disorder. 3 The prevalence is similar in many other countries. The majority of patients affected are women, although FM can also affect men and children. Diagnostic Issues and CriteriaThere is currently no diagnostic test specifically for FM. In addition, many patients experience symptoms that also characterize other chronic pain disorders, including chronic fatigue syndrome, irritable bowel syndrome (IBS), temporomandibular disorders, and migraine. American College of Rheumatology CriteriaThe ACR developed criteria for classifying FM in 1990; this classification focused on tenderness upon pressure in at least 11 of 18 tender-point sites, in conjunction with widespread pain-defined as pain in 3 of the 4 quadrants of the body. No distinction was found between the diagnoses of primary and secondary FM, so the use of these terms was abandoned. 4 The ACR criteria accelerated research on FM, but were revised in 2010 in response to issues raised regarding the necessity of a tender-point-examination, lack of consideration of nonpain symptoms, and the observation that FM might represent the extreme end of a pain spectrum. 5 Daniel J. Clauw, MD-a professor of anesthesiology, medicine (rheumatology), and psychiatry at the University of Michigan in Ann Arbor, and director of the university's Chronic Pain and Fatigue Research Center-is among researchers who questioned the clinical utility of the ACR's emphasis on tender points in diagnosing FM. 6 Dr. Clauw com...

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“…Various other scientific studies, mainly in people with fibromyalgia [19,20], osteoarthritis [21][22][23][24][25][26][27][28][29][30], chronic low back pain [31,32] and chronic venous insufficiency [33,34], have found that balneotherapy and undergoing such treatments resulted in an improved quality of life in regard to health.…”

Section: Discussionmentioning

confidence: 99%

Improvement in Pensioners Quality of Life after Treatment with Mineral-Rich Medicinal Waters

Maján¹

2017

J Geriatr Med Gerontol

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Introduction: Because there are mineral-rich medicinal waters in natural thermal spas. Their mechanical, thermal and psychotropic properties should be harnessed and the transmineralisation resulting from absorption through the skin of the ions they contain is fundamental. The main objective of this study was to determine whether the possible improvement in quality of life following balneotherapy can be maintained for at least two months after undergoing various thermal treatments.

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Therapeutic benefit of balneotherapy and hydrotherapy in the management of fibromyalgia syndrome: a qualitative systematic review and meta-analysis of randomized controlled trials

Cited by 77 publications

References 78 publications

EULAR revised recommendations for the management of fibromyalgia

EULAR revised recommendations for the management of fibromyalgia

Current Understanding of Fibromyalgia: Diagnosis, Treatment, and Theories About Causes

Improvement in Pensioners Quality of Life after Treatment with Mineral-Rich Medicinal Waters

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