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

Yuichiro Honda,Kyo Goto,Yasutaka Kondo,Minoru Okita,Takuya Fukushima,Jiro Nakano,Natsumi Tanaka,Satoshi Oga,Ryo Sasabe,Hideki Kataoka,Ryo Sasaki,Yohei Hamaue,Junya Sakamoto

doi:10.1155/2018/2930632

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.

Highlights

Fibromyalgia (FM) is an idiopathic, common, and complex syndrome, defined as long-lasting, widespread, and symmetrical nonarticular musculoskeletal pain with generalized tender points at specific anatomical sites [1, 2]
Our meta-analysis revealed that transcutaneous electrical nerve stimulation (TENS), electromagnetic therapy, and thermal therapy had positive effects on fibromyalgia-induced pain
Our meta-analysis showed that the level laser therapy (LLLT) and thermal therapy were effective treatments for tenderness in fibromyalgia patients

Summary

Introduction

Fibromyalgia (FM) is an idiopathic, common, and complex syndrome, defined as long-lasting, widespread, and symmetrical nonarticular musculoskeletal pain with generalized tender points at specific anatomical sites [1, 2]. The authors of a 2014 meta-analysis reported that very few drugs in well-designed clinical trials have demonstrated significant relief for multiple FM symptom domains, whereas nonpharmacologic treatments with weaker study designs have demonstrated multidimensional effects [8]. Nonpharmacological therapies such as physical exercise including strength training, aerobic training, and yoga [9, 10]. Even though several placebo-controlled trials assessing the effects of physical-agent modalities on pain, ADLs, and QOL in patients with FM have been published in recent years, some studies had small sample sizes and have presented controversial results. We conducted the present study to systematically review the effects of physical-agent modalities for the treatment of FM, especially for the improvement of pain, ADLs, and QOL

Methods

Results

Discussion

Conclusion