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Fibromyalgia and Complementary Health Approaches

On this page:

  • Key Points
  • About Fibromyalgia
  • What the Science Says
  • NCCAM-Funded Research
  • If You Are Considering Complementary Health Approaches for Fibromyalgia
  • Key References
  • For More Information

Introduction

Fibromyalgia is a disorder that causes muscle pain and fatigue. Researchers are evaluating a variety of complementary health approaches as possible additions to conventional treatment for fibromyalgia. This fact sheet provides basic information about fibromyalgia, summarizes scientific research on complementary approaches for fibromyalgia, and suggests sources for additional information.

Key Points

  • Some mind and body practices, such as tai chi, qi gong, and massage therapy, may be helpful for fibromyalgia symptoms.
  • There is not enough evidence to support the use of natural products, such as topical creams containing capsaicin or dietary supplements like S-adenosyl-L-methionine (SAMe), soy, or magnesium, for fibromyalgia.
  • Be aware that some complementary approaches—particularly dietary supplements—may interact with conventional medical treatments. Although many dietary supplements (and some prescription drugs) come from natural sources, “natural” does not always mean “safe.”
  • Tell all your health care providers about any complementary health approaches you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

About Fibromyalgia

People with fibromyalgia have widespread pain and “tender points” on their bodies that hurt when slight pressure is put on them. People with fibromyalgia may also have other problems, such as:

  • Trouble sleeping
  • Morning stiffness
  • Headaches
  • Painful menstrual periods
  • Tingling or numbness in hands or feet
  • Problems with thinking and memory (sometimes called “fibro fog”).

Fibromyalgia may also be associated with depression and anxiety.

The causes of fibromyalgia are unknown, but current research is looking at how different parts of the nervous system may contribute to fibromyalgia pain.

It is estimated that fibromyalgia affects 5 million American adults. Most people with fibromyalgia—between 80 and 90 percent—are women. However, men and children also can have the disorder.

A person with fibromyalgia may have other, coexisting chronic pain conditions. Such conditions may include chronic fatigue syndrome, endometriosis, interstitial cystitis (painful bladder syndrome), irritable bowel syndrome, temporomandibular joint dysfunction, and vulvodynia (chronic vulvar pain). It is not known whether these disorders share a common cause.

To find out more about fibromyalgia and related conditions, visit the National Institute of Arthritis and Musculoskeletal and Skin Diseases Web.

About Scientific Evidence on Complementary Health Approaches

Scientific evidence on complementary health approaches includes results from laboratory research as well as clinical trials (studies in people). It provides information on whether an approach is helpful and safe. Scientific journals publish study results, as well as review articles that evaluate the evidence as it accumulates; fact sheets from the National Center for Complementary and Alternative Medicine (NCCAM)—like this one—base information about research findings primarily on the most rigorous review articles, known as systematic reviews and meta-analyses.

What the Science Says

Much of the research on complementary health approaches for fibromyalgia is still preliminary, and evidence of effectiveness is limited. However, some studies have shown that practices such as tai chi, qi gong, and massage therapy may help relieve fibromyalgia symptoms.

  • Research suggests that tai chi—a practice originating in China that involves moving the body slowly, gently, and with awareness—may provide a benefit to patients with fibromyalgia. A 2010 NCCAM-funded study compared the effects of a tai chi program with a wellness education and stretching program for managing fibromyalgia over a 12-week period. The researchers found that the participants in the tai chi group had significant improvements in symptoms such as pain, sleep quality, depression, and quality of life, and maintained these benefits for up to 24 weeks. A larger followup study of tai chi for fibromyalgia is underway. A 2009 review examined the use of qi gong—another Chinese practice involving physical movement, mental focus, and breathing techniques—for fibromyalgia. The reviewers found that qi gong may improve symptoms related to fibromyalgia.
  • A 2009 study compared the effects of manual lymph drainage therapy (a massage technique used to move fluid away from areas where lymph vessels are blocked or damaged) and connective tissue massage in women with fibromyalgia. The researchers found that both types of massage helped to reduce pain, improve quality of life, and increase the pain pressure threshold. Manual lymph drainage therapy had a greater effect on the participants’ overall health.
  • A 2010 systematic review of acupuncture for fibromyalgia concluded that acupuncture had a small pain-relieving effect. However, this effect might have been due to biases in the acupuncture studies.
  • Studies have examined the use of balneotherapy—bath therapy for health purposes—for fibromyalgia. A 2009 systematic review found that balneotherapy may provide some benefit to patients with fibromyalgia, particularly for improving pain. However, because of variations in the study designs and small sample sizes, definite conclusions about the value of balneotherapy cannot be reached based on the current evidence.
  • Researchers have looked at whether various types of biofeedback may be helpful for fibromyalgia. However, because studies have been small and because not all studies used rigorous methods (such as comparing true and simulated [sham] biofeedback), it is not yet possible to reach definite conclusions.
  • A 2010 systematic review concluded that homeopathy has not been proven beneficial in relieving fibromyalgia symptoms. For more information on homeopathy, see the NCCAM fact sheet Homeopathy: An Introduction.
  • Small studies have examined various natural products—such as topical creams containing capsaicin (the substance that gives chili peppers their heat) or dietary supplements like S-adenosyl-L-methionine (SAMe) or soy—for fibromyalgia. A 2010 systematic review concluded that there is not enough evidence to determine whether these products provide a health benefit. Researchers are investigating whether low magnesium levels contribute to fibromyalgia and if magnesium supplements might help to reduce symptoms.
  • An NCCAM-funded study examined the use of Reiki, a practice based on an Eastern idea that an energy supports the body’s natural healing abilities, for fibromyalgia-related pain. The study showed no effect of Reiki on pain or any of the other outcomes measured in the study (physical and mental functioning, medication use, and visits to health care providers).
  • Research evidence is insufficient to draw conclusions about the effectiveness of chiropractic care, hypnosis, or magnet therapy for fibromyalgia.

NCCAM-Funded Research

Recent NCCAM-sponsored studies have been investigating:

  • The effectiveness of traditional Chinese medicine for treating fibromyalgia
  • The mechanisms of fibromyalgia pain, as revealed by brain-imaging techniques
  • The effectiveness of a form of electroencephalograph (EEG) biofeedback in addressing fibromyalgia symptoms.

If You Are Considering Complementary Health Approaches for Fibromyalgia

  • Be aware that some complementary health approaches—particularly dietary supplements—may interact with conventional medical treatments. To learn more about using dietary supplements, see the NCCAM fact sheet Using Dietary Supplements Wisely.
  • If you are considering a practitioner-provided complementary health approach such as acupuncture, check with your insurer to see if the services will be covered, and ask a trusted source (like your fibromyalgia health care provider or a nearby hospital or medical school) to recommend a practitioner. In addition, you can find professional organizations for complementary health practitioners by searching the National Library of Medicine’s Directory of Health Organizations Online. Some professions may be represented by more than one organization.
  • Tell all your health care providers about any complementary health approaches you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care. For tips about talking with your health care providers about complementary health approaches, see NCCAM’s Time to Talk campaign.

For More Information

NCCAM Clearinghouse

The NCCAM Clearinghouse provides information on NCCAM and complementary health approaches, including publications and searches of Federal databases of scientific and medical literature. The Clearinghouse does not provide medical advice, treatment recommendations, or referrals to practitioners.

Toll-free in the U.S.:
1-888-644-6226
TTY (for deaf and hard-of-hearing callers):
1-866-464-3615
Web site:
nccam.nih.gov
E-mail:
info@nccam.nih.gov

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)

The mission of NIAMS is to support research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases; the training of basic and clinical scientists to carry out this research; and the dissemination of information on research progress in these diseases.

Toll-free in the U.S.:
1-877-22-NIAMS
Web site:
www.niams.nih.gov

PubMed®

A service of the National Library of Medicine (NLM), PubMed® contains publication information and (in most cases) brief summaries of articles from scientific and medical journals.

Web site:
www.ncbi.nlm.nih.gov/pubmed

NIH National Library of Medicine’s MedlinePlus

To provide resources that help answer health questions, MedlinePlus brings together authoritative information from the National Institutes of Health as well as other Government agencies and health-related organizations.

Web site: www.medlineplus.gov
Information on fibromyalgia: www.nlm.nih.gov/medlineplus/fibromyalgia.html

 

Key References

  • Baranowsky J, Klose P, Musial F, et al. Qualitative systemic review of randomized controlled trials on complementary and alternative medicine treatments in fibromyalgia. Rheumatology International. 2009;30(1):1–21.
  • De Silva V, El-Metwally A, Ernst E, et al. Evidence for the efficacy of complementary and alternative medicines in the management of fibromyalgia: a systematic review. Rheumatology. 2010;49(6):1063–1068.
  • Ekici G, Bakar Y, Akbayrak T, et al. Comparison of manual lymph drainage therapy and connective tissue massage in women with fibromyalgia: a randomized controlled trial. Journal of Manipulative and Physiological Therapeutics. 2009;32(2):127–133.
  • Hassett AL, Gevirtz RN. Nonpharmacologic treatment for fibromyalgia: patient education, cognitive-behavioral therapy, relaxation techniques, and complementary and alternative medicine. Rheumatic Diseases Clinics of North America. 2009;35(2):393–407.
  • Langhorst J, Klose P, Musial F, et al. Efficacy of acupuncture in fibromyalgia syndrome—a systematic review with a meta-analysis of controlled clinical trials. Rheumatology. 2010;49(4):778–788.
  • National Institute of Arthritis and Musculoskeletal and Skin Diseases. Questions and Answers About Fibromyalgia. National Institute of Arthritis and Musculoskeletal and Skin Diseases Web site. Accessed at niams.nih.gov/health_info/fibromyalgia/ on April 3, 2012.
  • Perry R, Terry R, Ernst E. A systematic review of homoeopathy for the treatment of fibromyalgia. Clinical Rheumatology. 2010;29(5):457–464.
  • Porter NS, Jason LA, Boulton A, et al. Alternative medical interventions used in the treatment and management of myalgic encephalomyelitis/chronic fatigue syndrome and fibromyalgia. Journal of Alternative and Complementary Medicine. 2010;16(3):235–249.
  • Sarac AJ, Gur A. Complementary and alternative medical therapies in fibromyalgia. Current Pharmaceutical Design. 2006;12(1):47–57.
  • Schneider M, Vernon H, Ko G, et al. Chiropractic management of fibromyalgia syndrome: a systematic review of the literature. Journal of Manipulative and Physiological Therapeutics. 2009;32(1):25–40.
  • Tsao JC. Effectiveness of massage therapy for chronic, non-malignant pain: a review. Evidence-Based Complementary and Alternative Medicine. 2007;4(2):165–179.
  • Wang C, Schmid CH, Rones R, et al. A randomized trial of tai chi for fibromyalgia. New England Journal of Medicine. 2010;363(8):743–754.

 

Acknowledgments

NCCAM thanks the following people for their technical expertise and review of the update of this publication: Richard Harris, Ph.D., University of Michigan Health System; David V. Nelson, Ph.D., Sam Houston State University; and Carol Pontzer, Ph.D., and John (Jack) Killen, Jr., M.D., NCCAM.

This publication is not copyrighted and is in the public domain. Duplication is encouraged.

NCCAM has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your primary health care provider. We encourage you to discuss any decisions about treatment or care with your health care provider. The mention of any product, service, or therapy is not an endorsement by NCCAM.
NCCAM Pub No.:
D413
Date Created:
July 2008
Last Updated:
August 2013
Copyright
Content is in the public domain and may be reprinted, except if marked as copyrighted (©). Please credit the National Center for Complementary and Alternative Medicine as the source. All copyrighted material is the property of its respective owners and may not be reprinted without their permission.

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