Primary studies included in this systematic review

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Effects of acupuncture to treat fibromyalgia: a preliminary randomised controlled trial.

Authors Itoh K , Kitakoji H
Journal Chinese medicine
Year 2010
Links Pubmed DOI PubMed Central

This article is included in 4 Systematic reviews Systematic reviews (4 references)

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Background Acupuncture is often used to treat fibromyalgia (FM), but it remains unclear whether acupuncture is effective. This study aims to evaluate the effects of acupuncture on pain and quality of life (QoL) in FM patients. Methods Sixteen patients (13 women and 3 men aged 25-63 years) suffering from FM were randomised into two groups: group A (n = 8) received five acupuncture treatments after the fifth week and group B received ten acupuncture treatments. Outcome measures used in this study were pain intensity (visual analogue scale, VAS) and the fibromyalgia impact questionnaire (FIQ). Results After the fifth week, pain intensity (U = 25.0; P = 0.022) in group B decreased and QoL (U = 24.5; P = 0.026) improved compared to group A. Conclusion The present study suggests that acupuncture treatment is effective to relieve pain for FM patients in terms of QoL and FIQ.

Primary study

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A randomized controlled trial of acupuncture added to usual treatment for fibromyalgia.

Journal Journal of rehabilitation medicine : official journal of the UEMS European Board of Physical and Rehabilitation Medicine
Year 2008
Links Pubmed DOI

This article is included in 3 Systematic reviews Systematic reviews (3 references)

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OBJECTIVE: To evaluate the effectiveness of acupuncture for fibromyalgia. METHODS: Fifty-eight women with fibromyalgia were allocated randomly to receive either acupuncture together with tricyclic antidepressants and exercise (n=34), or tricyclic antidepressants and exercise only (n=24). Patients rated their pain on a visual analogue scale. A blinded assessor evaluated both the mean pressure pain threshold value over all 18 fibromyalgia points and quality of life using SF-36. RESULTS: At the end of 20 sessions, patients who received acupuncture were significantly better than the control group in all measures of pain and in 5 of the SF-36 subscales. After 6 months, the acupuncture group was significantly better than the control group in numbers of tender points, mean pressure pain threshold at the 18 tender points and 3 subscales of SF-36. After one year, the acupuncture group showed significance in one subscale of the SF-36; at 2 years there were no significant differences in any outcome measures. CONCLUSION: Addition of acupuncture to usual treatments for fibromyalgia may be beneficial for pain and quality of life for 3 months after the end of treatment. Future research is needed to evaluate the specific effects of acupuncture for fibromyalgia.

Primary study

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Dynamic levels of glutamate within the insula are associated with improvements in multiple pain domains in fibromyalgia.

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Journal Arthritis and rheumatism
Year 2008
Links Pubmed DOI

This article is included in 2 Systematic reviews Systematic reviews (2 references)

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OBJECTIVE: Fibromyalgia (FM) is a chronic widespread pain condition that is thought to arise from augmentation of central neural activity. Glutamate (Glu) is an excitatory neurotransmitter that functions in pain-processing pathways. This study was carried out to investigate the relationship between changing levels of Glu within the insula and changes in multiple pain domains in patients with FM. METHODS: Ten patients with FM underwent 2 sessions of proton magnetic resonance spectroscopy (H-MRS) and 2 sessions of functional magnetic resonance imaging (FMRI), each conducted before and after a nonpharmacologic intervention to reduce pain. During H-MRS, the anterior and posterior insular regions were examined separately using single-voxel spectroscopy. The levels of Glu and other metabolites were estimated relative to levels of creatine (Cr) (e.g., the Glu/Cr ratio). During FMRI, painful pressures were applied to the thumbnail to elicit neuronal activation. Experimental pressure-evoked pain thresholds and clinical pain ratings (on the Short Form of the McGill Pain Questionnaire [SF-MPQ]) were also assessed prior to each imaging session RESULTS: Both experimental pain (P = 0.047 versus pretreatment) and SF-MPQ-rated clinical pain (P = 0.043 versus pretreatment) were reduced following treatment. Changes from pre- to posttreatment in Glu/Cr were negatively correlated with changes in experimental pain thresholds (r = -0.95, P < 0.001) and positively correlated with changes in clinical pain (r = 0.85, P = 0.002). Changes in the FMRI-determined blood oxygenation level-dependent effect (a measure of neural activation) were positively correlated with changes in Glu/Cr within the contralateral insula (r = 0.81, P = 0.002). CONCLUSION: Changes in Glu levels within the insula are associated with changes in multiple pain domains in patients with FM. Thus, H-MRS data may serve as a useful biomarker and surrogate end point for clinical trials of FM.

Primary study

Unclassified

Improvement in fibromyalgia symptoms with acupuncture: results of a randomized controlled trial.

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Journal Mayo Clinic proceedings. Mayo Clinic
Year 2006
Links Pubmed DOI

This article is included in 11 Systematic reviews Systematic reviews (11 references)

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OBJECTIVE: To test the hypothesis that acupuncture improves symptoms of fibromyalgia. PATIENTS AND METHODS: We conducted a prospective, partially blinded, controlled, randomized clinical trial of patients receiving true acupuncture compared with a control group of patients who received simulated acupuncture. All patients met American College of Rheumatology criteria for fibromyalgia and had tried conservative symptomatic treatments other than acupuncture. We measured symptoms with the Fibromyalgia Impact Questionnaire (FIQ) and the Multidimensional Pain Inventory at baseline, immediately after treatment, and at 1 month and 7 months after treatment. The trial was conducted from May 28, 2002, to August 18, 2003. RESULTS: Fifty patients participated in the study: 25 in the acupuncture group and 25 in the control group. Total fibromyalgia symptoms, as measured by the FIQ, were significantly improved in the acupuncture group compared with the control group during the study period (P = .01). The largest difference in mean FIQ total scores was observed at 1 month (42.2 vs 34.8 in the control and acupuncture groups, respectively; P = .007). Fatigue and anxiety were the most significantly improved symptoms during the follow-up period. However, activity and physical function levels did not change. Acupuncture was well tolerated, with minimal adverse effects. CONCLUSION: This study paradigm allows for controlled and blinded clinical trials of acupuncture. We found that acupuncture significantly improved symptoms of fibromyalgia. Symptomatic improvement was not restricted to pain relief and was most significant for fatigue and anxiety.

Primary study

Unclassified

A randomized clinical trial of acupuncture compared with sham acupuncture in fibromyalgia.

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Journal Annals of internal medicine
Year 2005
Links Pubmed DOI

This article is included in 10 Systematic reviews Systematic reviews (10 references)

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<b>BACKGROUND: </b>Fibromyalgia is a common chronic pain condition for which patients frequently use acupuncture.<b>OBJECTIVE: </b>To determine whether acupuncture relieves pain in fibromyalgia.<b>DESIGN: </b>Randomized, sham-controlled trial in which participants, data collection staff, and data analysts were blinded to treatment group.<b>SETTING: </b>Private acupuncture offices in the greater Seattle, Washington, metropolitan area.<b>PATIENTS: </b>100 adults with fibromyalgia.<b>Intervention: </b>Twice-weekly treatment for 12 weeks with an acupuncture program that was specifically designed to treat fibromyalgia, or 1 of 3 sham acupuncture treatments: acupuncture for an unrelated condition, needle insertion at nonacupoint locations, or noninsertive simulated acupuncture.<b>Measurements: </b>The primary outcome was subjective pain as measured by a 10-cm visual analogue scale ranging from 0 (no pain) to 10 (worst pain ever). Measurements were obtained at baseline; 1, 4, 8, and 12 weeks of treatment; and 3 and 6 months after completion of treatment. Participant blinding and adverse effects were ascertained by self-report. The primary outcomes were evaluated by pooling the 3 sham-control groups and comparing them with the group that received acupuncture to treat fibromyalgia.<b>RESULTS: </b>The mean subjective pain rating among patients who received acupuncture for fibromyalgia did not differ from that in the pooled sham acupuncture group (mean between-group difference, 0.5 cm [95% CI, -0.3 cm to 1.2 cm]). Participant blinding was adequate throughout the trial, and no serious adverse effects were noted.<b>Limitations: </b>A prescription of acupuncture at fixed points may differ from acupuncture administered in clinical settings, in which therapy is individualized and often combined with herbal supplementation and other adjunctive measures. A usual-care comparison group was not studied.<b>CONCLUSION: </b>Acupuncture was no better than sham acupuncture at relieving pain in fibromyalgia.

Primary study

Unclassified

Treatment of Fibromyalgia with Formula Acupuncture: Investigation of Needle Placement, Needle Stimulation, and Treatment Frequency.

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Journal Journal of alternative and complementary medicine (New York, N.Y.)
Year 2005
Links Pubmed DOI

This article is included in 10 Systematic reviews Systematic reviews (10 references)

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OBJECTIVES: The objective of this study was to investigate whether typical acupuncture methods such as needle placement, needle stimulation, and treatment frequency were important factors in fibromyalgia symptom improvement. Design/settings/subjects: A single-site, single-blind, randomized trial of 14 participants diagnosed with fibromyalgia for at least 1 year was performed. Intervention: Participants were randomized to one of four treatment groups: (1) T/S needles placed in traditional sites with manual needle stimulation (n = 29): (2) T/0 traditional needle location without stimulation (n = 30); (3) N/S needles inserted in nontraditional locations that were not thought to be acupuncture sites, with stimulation (n = 28); and (4) N/0 nontraditional needle location without stimulation (n = 27). All groups received treatment once weekly, followed by twice weekly, and finally three times weekly, for a total of 18 treatments. Each increase in frequency was separated by a 2-week washout period. Outcome measures: Pain was assessed by a numerical rating scale, fatigue by the Multi-dimensional Fatigue Inventory, and physical function by the Short Form-36. RESULTS: Overall pain improvement was noted with 25%-35% of subjects having a clinically significant decrease in pain; however this was not dependent upon "correct" needle stimulation (t = 1.03; p = 0.307) or location (t = 0.76; p = 0.450). An overall dose effect of treatment was observed, with three sessions weekly providing more analgesia than sessions once weekly (t = 2.10; p = 0.039). Among treatment responders, improvements in pain, fatigue, and physical function were highly codependent (all p ≤ 0.002). CONCLUSIONS: Although needle insertion led to analgesia and improvement in other somatic symptoms, correct needle location and stimulation were not crucial. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Primary study

Unclassified

[Clinical study on treatment of fibromyalgia syndrome with penetration needling at the back].

Authors Guo Y , Sun YZ
Journal Zhongguo zhen jiu = Chinese acupuncture & moxibustion
Year 2005
Links Pubmed

This article is included in 2 Systematic reviews Systematic reviews (2 references)

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OBJECTIVE: To compare therapeutic effects of penetration needling at the back and western medicine on fibromyalgia syndrome (FS). METHODS: Thirty-eight cases were randomly divided into the observation group treated with penetration needling at the first and second lines of The Bladder Meridian of Foot-Taiyang and Governor Vessel, and the control group treated mainly with oral administration of amitriptyline, 19 cases in each group. RESULTS: There were significant differences in the cured-markedly effective rate and the results of follow-up for 6 months for the cured-markedly effective cases between the observation group and the control group (all P < 0.01). CONCLUSION: Penetration needling therapy in the therapeutic effect on fibromyalgia syndrome is better than the medical treatment.

Primary study

Unclassified

Electroacupuncture in fibromyalgia: results of a controlled trial.

blocked
Journal BMJ (Clinical research ed.)
Year 1992
Links Pubmed DOI PubMed Central

This article is included in 15 Systematic reviews Systematic reviews (15 references)

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OBJECTIVE: To determine the efficacy of electroacupuncture in patients with fibromyalgia, a syndrome of unknown origin causing diffuse musculoskeletal pain. DESIGN: Three weeks' randomised study with blinded patients and evaluating physician. SETTING: University divisions of physical medicine and rehabilitation and rheumatology, Geneva. PATIENTS: 70 patients (54 women) referred to the division for fibromyalgia as defined by the American College of Rheumatology. INTERVENTIONS: Patients were randomised to electroacupuncture (n = 36) or a sham procedure (n = 34) by means of an electronic numbers generator. MAIN OUTCOME MEASURES: Pain threshold, number of analgesic tablets used, regional pain score, pain recorded on visual analogue scale, sleep quality, morning stiffness, and patient's and evaluating physician's appreciation. RESULTS: Seven of the eight outcome parameters showed a significant improvement in the active treatment group whereas none were improved in the sham treatment group. Differences between the groups were significant for five of the eight outcome measures after treatment. CONCLUSIONS: Electroacupuncture is effective in relieving symptoms of fibromyalgia. Its potential in long term management should now be studied.