Treatment of pain due to fibromyalgia with topical capsaicin: A pilot study

BackgroundFibromyalgia (FM) is a chronic, debilitating pain disorder. Dissatisfaction with conventional medicine can lead people with FM to turn to complementary and alternative medicine (CAM). Two previous overviews of systematic reviews of CAM for FM have been published, but they did not assessed for risk of bias in the review process.MethodsFive databases Medline, Embase, AMED (via OVID), Web of Science and Central were searched from their inception to December 2015. Reference lists were hand-searched. We had two aims: the first was to provide an up-to-date and rigorously conducted synthesis of systematic reviews of CAM literature on FM; the second was to evaluate the quality of the available systematic review evidence using two different tools: AMSTAR (Shea et al. BMC Med Res Methodol 15; 7:10, 2007) and a more recently developed tool ROBIS (Whiting et al. J Clin Epidemiol 69:225-34, 2016) specifically designed to assess risk of bias in systematic reviews. Any review that assessed one of eight CAM therapies for participants diagnosed with FM was considered. The individual studies had to be randomised controlled trials where the intervention was compared to placebo, treatment as usual or waitlist controls to be included. The primary outcome measure was pain, and the secondary outcome measure was adverse events.ResultsWe identified 15 reviews that met inclusion criteria. There was low-quality evidence that acupuncture improves pain compared to no treatment or standard treatment, but good evidence that it is no better than sham acupuncture. The evidence for homoeopathy, spinal manipulation and herbal medicine was limited.ConclusionsOverall, five reviews scored 6 or above using the AMSTAR scale and the inter-rater agreement was good (83.6%), whereas seven reviews achieved a low risk of bias rating using ROBIS and the inter-rater agreement was fair (60.0%). No firm conclusions were drawn for efficacy of either spinal manipulation or homoeopathy for FM. There is limited evidence for topical Capsicum, but further research is required. There is some evidence to support the effectiveness of acupuncture for FM, but further high-quality trials are needed to investigate its benefits, harms and mechanisms of action, compared with no or standard treatment.Systematic review registrationPROSPERO CRD42016035846.

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“…Another study [77] found an improvement in sensitivity and pain. Size of effects/ P values were not reported in either study.…”

Section: Resultsmentioning

confidence: 99%

An overview of systematic reviews of complementary and alternative therapies for fibromyalgia using both AMSTAR and ROBIS as quality assessment tools

et al. 2017

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“…Five interventions were administered orally [17, 18, 20–22] and three topically [15, 16, 19]. The duration of study varied from one day to twelve weeks, one to four times per day.…”

Section: Resultsmentioning

confidence: 99%

“…Three studies [20–22] reported using a random number table, one study [15] reported using a computer-generated random-number table, another [16] reported using newspaper advertisements and internet communication to FM support groups, and three studies [17–19] used no allocation concealment and thus presented a high risk of selection bias.…”

Section: Resultsmentioning

confidence: 99%

Efficacy and Safety of Medicinal Plants or Related Natural Products for Fibromyalgia: A Systematic Review

Nascimento

DeSantana

Nampo

et al. 2013

Evidence-Based Complementary and Alternative Medicine

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To assess the effects of medicinal plants (MPs) or related natural products (RNPs) on fibromyalgia (FM) patients, we evaluate the possible benefits and advantages of MP or RNP for the treatment of FM based on eight randomized placebo-controlled trials (RCTs) involving 475 patients. The methodological quality of all studies included was determined according to JADAD and “Risk of Bias” with the criteria in the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0. Evidence suggests significant benefits of MP or RNP in sleep disruption, pain, depression, joint stiffness, anxiety, physical function, and quality of life. Our results demonstrated that MP or RNP had significant effects on improving the symptoms of FM compared to conventional drug or placebo; longer tests are required to determine the duration of the treatment and characterize the long-term safety of using MP, thus suggesting effective alternative therapies in the treatment of pain with minimized side effects.

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“…Lokal kapsaisinin tedavide etkinliğini araştıran bir çalışmada ağrı ve uyku kalitesi üzerine etkili bulunmazken lokal hassasiyette belirgin düzelme sağladığı bildirilmektedir 92 .…”

Section: Kapsaisinunclassified

Fibromiyaljide Farmakolojik Tedavi

Aşkın

Özkan

2017

Arşiv Kaynak Tarama Dergisi

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Fibromyalgia is a multisystem disorder characterized by widespread pain. Although there is no known cure for fibromyalgia, multidisciplinary team efforts using combined treatment approaches, including patient education, aerobic exercise, cognitive behavioral therapy, and pharmacologic therapies (serotonin norepinephrine reuptake inhibitors [eg, duloxetine, milnacipran] and alpha 2-delta receptor ligands [eg, pregabalin]) may improve symptoms as well as function of patients with fibromyalgia. Some success has been shown with dopamine agonists (pramipexole), tramadol, other opioids and cannabinoids (nabilone). Further evidence-based trials using complementary treatments are needed.

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Treatment of pain due to fibromyalgia with topical capsaicin: A pilot study

Cited by 36 publications

References 14 publications

An overview of systematic reviews of complementary and alternative therapies for fibromyalgia using both AMSTAR and ROBIS as quality assessment tools

An overview of systematic reviews of complementary and alternative therapies for fibromyalgia using both AMSTAR and ROBIS as quality assessment tools

Efficacy and Safety of Medicinal Plants or Related Natural Products for Fibromyalgia: A Systematic Review

Fibromiyaljide Farmakolojik Tedavi

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