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Acute Pain | Chronic Pain | General

Pharmacological and non-pharmacological treatments for fibromyalgia

Clinical bottom line: Information from this systematic review does not enable assessment of the efficacy of treatments for fibromyalgia.

Fibromyalgia syndrome (FMS) is not well understood, but symptoms include sleep disturbance, fatigue, pain (especially at tender points), impairment in daily functioning, and often emotional distress. Prevalence in the general population is estimated to be 3.4% for women and 0.5% for men.

Systematic review

Rossy LA, Buckelew SP, Dorr N et al . A meta-analysis of fibromyalgia treatment interventions. Ann Behav Med 1999; 21((2)):180-91.

Date review completed: November 1996

Number of trials included: 49

Control group: active, placebo, no treatment, none

Main outcomes: physical status, self-report of FMS symptoms, psychological status, daily functioning

Inclusion criteria were controlled and uncontrolled trials of fibromyalgia treatments; adult patients; outcomes included physical status, self-report of symptoms, psychological status and/or daily functioning; sufficient information to enable calculation of effect size.

Reviewers did not discriminate between randomised and non-randomised trials, between controlled and uncontrolled trials, or between blind and non-blind trials. Reviewers calculated effect size (with 95% confidence interval) using the difference between the mean divided by pooled standard deviation. If the confidence interval included zero, intervention was regarded as not significantly different to control.


It is difficult to make sense of effect sizes, or to compare effect sizes across such methodologically diverse trials. Reviewers do not provide information on trial methodology (e.g. blinding, randomisation, duration and dose of treatment. It is therefore difficult to interpret findings from individual trials or pooled data. Reviewers do not indicate type of control (active or placebo) for the included trials, so it is not possible to provide a vote-count of positive versus negative treatments.

Adverse effects

Reviewers do not report on adverse effects

Further reading

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