393 Acupuncture may be effective for fibromyalgia

July 10, 2013

PEARLS 393, June 2013, written by Brian R McAvoy

Clinical question
How effective is acupuncture for treating fibromyalgia?

Bottom line
There was low to moderate-level evidence that, compared with no treatment and standard therapy, acupuncture improved pain and stiffness in people with fibromyalgia.

There was moderate-level evidence that the effect of acupuncture did not differ from sham acupuncture in reducing pain or fatigue, or improving sleep or global wellbeing.
The same level of evidence supported acupuncture as an adjunct therapy to medication and exercise or acupuncture when compared with a medication and exercise control.
Electroacupuncture was probably better than manual acupuncture for pain and stiffness reduction and improvement of global wellbeing, sleep and fatigue.
Evidence suggested treatment sessions should be twice per week, over 4 weeks, with each session lasting for 25 minutes. The effect lasted up to 1 month, but was not maintained at 6 months follow-up.

Acupuncture appeared safe.

Caveat
The small sample size, scarcity of studies for each comparison and lack of ideal sham acupuncture weakened the level of evidence and its clinical implications. Larger studies are warranted.

Context
Fibromyalgia is a musculoskeletal disorder characterised by widespread chronic pain and any number of comorbidities, such as sleep disturbance, fatigue, stiffness, irritable bowel syndrome, headaches and mood disorders. It affects over 2% of the population and occurs predominantly in females.1 One in 5 individuals with fibromyalgia use acupuncture treatment within 2 years of diagnosis.

Cochrane Systematic Review
Deare JC et al. Acupuncture for treating fibromyalgia.
Cochrane Reviews, 2013, Issue 5. Art. No.: CD007070.DOI: 10.1002/14651858. CD007070.pub2.
This review contains 9 studies involving 395 participants.

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.