People with chronic health conditions such as fibromyalgia often turn to some form of complementary and alternative medicine (CAM)—a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine. This fact sheet provides basic information of fibromyalgia and “what the science says” about the effectiveness of CAM practices that many people with fibromyalgia use.
If you are considering a CAM therapy for fibromyalgia, this information can help you talk to your health care provider about it.
About Fibromyalgia
Fibromyalgia is a disorder that causes muscle pain and fatigue. People with
fibromyalgia have chronic widespread pain, as well as “tender points” on the
neck, shoulders, back, hips, arms, and legs, which hurt when slight pressure
(about 9 pounds) is applied.
People with fibromyalgia may also have other symptoms, such as:
• Trouble sleeping
• Morning stiffness
• Headaches
• Problems with thinking and memory (sometimes called “fibro fog”)
• Irritable bowel syndrome.
Women with fibromyalgia may also have painful menstrual periods.
Fibromyalgia may also be associated with depression.
The causes of fibromyalgia are unknown, but problems with the nervous system
could be involved. It is estimated that fibromyalgia affects as many as 1 in 50
Americans. Most people with fibromyalgia are women, and most are diagnosed
during middle age. However, men and children also can have the disorder.
CAM Practices Used for Fibromyalgia
Conventional therapies for fibromyalgia are limited, and research shows that
about 90 percent of people with fibromyalgia use some form of CAM. CAM
practices used by people with fibromyalgia include:
• Acupuncture
• Biofeedback
• Chiropractic care
NCCAM-2
• Hypnosis
• Magnesium supplements
• Magnet therapy
• Massage therapy
• SAMe (S-Adenosyl-L-Methionine)
• Tai chi.
What the Science Says About CAM and Fibromyalgia
According to reviewers who have assessed the research on CAM and fibromyalgia, much of the
research is still preliminary, and evidence of effectiveness for the various therapies used is limited.
• Research on acupuncture—stimulation of anatomical points with thin metallic needles—
for fibromyalgia has produced mixed results. One review article notes that three studies
found some evidence to support the use of electroacupuncture (in which the needles are
pulsed with electric current). However, the effects of electroacupuncture in these studies
were mostly short lived, and two studies of traditional acupuncture had negative results.
• Some researchers believe that low levels of magnesium may contribute to fibromyalgia.
However, there is no conclusive scientific evidence that magnesium supplements relieve
fibromyalgia symptoms. Two small studies had conflicting results.
• A review of the research on massage therapy for fibromyalgia notes only modest,
preliminary support. Two studies had some positive findings, but two others found either
no benefits or only short-term improvements.
• Supplements containing the amino acid derivative SAMe are used for a variety of conditions.
Although several small studies of SAMe for fibromyalgia have had mixed results, there is some
evidence of a benefit. Reviewers conclude that more research is needed.
•
Finally, according to reviewers, research evidence is insufficient to draw conclusions about
the effectiveness of other CAM treatments—biofeedback, chiropractic care, hypnosis, and
magnet therapy—used for fibromyalgia.
NCCAM Research on Fibromyalgia
The National Center for Complementary and Alternative Medicine (NCCAM) funds clinical
trials that look at CAM for fibromyalgia. Recent projects include studies of:
• The effects of tai chi on fibromyalgia patients’ musculoskeletal pain, fatigue, sleep
quality, psychological distress, physical performance, and health status
• Brain-imaging techniques for determining whether acupuncture relieves pain due
to fibromyalgia
• The effectiveness of a form of electroencephalograph (EEG) biofeedback in
treating fibromyalgia.
NCCAM-3
If You Are Considering CAM for Fibromyalgia
• Talk to your health care providers. Tell them about the therapy you are considering and
ask any questions you may have. They may know about the therapy and be able to advise
you on its safety, use, and likely effectiveness in relieving your fibromyalgia symptoms.
• If you are considering a practitioner-provided CAM therapy such as acupuncture, check
with your insurer to see if the services will be covered, and ask a trusted source (such as
your fibromyalgia doctor or a nearby hospital or medical school) to recommend a
practitioner. Although acupuncture treatment is generally safe, complications can result if
needles are not adequately sterilized or if the treatment is not properly delivered.
• If you are considering dietary supplements, keep in mind that they can act in the same
way as drugs. They can cause medical problems if not used correctly or if used in large
amounts, and some may interact with medications you may take. The health care
providers you see about your fibromyalgia can advise you.
• Tell all your health care providers about any complementary and alternative practices you
use. Give them a full picture of what you do to manage your health. This will help ensure
coordinated and safe care.
Selected References
Arnold LM. Biology and therapy of fibromyalgia: new therapies in fibromyalgia. Arthritis Research and Therapy. 2006;8(4):212.
Clauw DJ, Crofford LJ. Chronic widespread pain and fibromyalgia: what we know, and what we need to know. Best
Practice and Research Clinical Rheumatology. 2003;17(4):685-701.
Fibromyalgia and related conditions: levels of scientific evidence for specific therapies. Natural Standard Database
Web site. Accessed at http://www.naturalstandard.com on December 17, 2007.
Goldenberg DL, Burckhardt C, Crofford L. Management of fibromyalgia syndrome. Journal of the American Medical
Association. 2004;292(19):2388-2395.
Harris RE, Clauw DJ. How do we know that the pain in fibromyalgia is “real”? Current Pain and Headache Reports. 2006;10(6):403-407.
Holdcraft LC, Assefi N, Buchwald D. Complementary and alternative medicine in fibromyalgia and related syndromes.
Best Practice and Research Clinical Rheumatology. 2003;17(4):667-683.
Mayhew E, Ernst E. Acupuncture for fibromyalgia: a systematic review of randomized clinical trials.
Rheumatology. 2007;46:801-804.
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
http://www.niams.nih.gov/health_info/fibromyalgia/default.asp on March 14, 2008.
Natural medicines in clinical management of fibromyalgia: clinical management series. Natural Medicines Comprehensive
Database Web site. Accessed at http://www.naturaldatabase.com on December 13, 2007.
Sarac AJ, Gur A. Complementary and alternative medical therapies in fibromyalgia. Current Pharmaceutical
Design. 2006;12(1):47-57.
Sim J, Adams N. Systematic review of randomized controlled trials of nonpharmacological interventions in
fibromyalgia. The Clinical Journal of Pain. 2002;18(5):324-336.
Tsao JC. Effectiveness of massage therapy for chronic, non-malignant pain: a review. Evidence-Based Complementary and
Alternative Medicine. 2007;4(2):165-179.
Wolfe F, Smythe HA, Yunus MB, et al. The American College of Rheumatology 1990 criteria for the classification of
fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis and Rheumatism. 1990;33(2):160-172.
D413
Created July 2008
*D413*
For More Information
Visit the NCCAM Web site (nccam.nih.gov) for more information about the CAM therapies
discussed in this fact sheet (including clinical trials), as well as important tips for being an
informed consumer of CAM services and products.
NCCAM Clearinghouse
The NCCAM Clearinghouse provides information on CAM and NCCAM, 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
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. CAM on
PubMed, developed jointly by NCCAM and NLM, is a subset of the PubMed system and focuses
on the topic of CAM.
Web site: www.ncbi.nlm.nih.gov/sites/entrez
CAM on PubMed: nccam.nih.gov/camonpubmed/
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
NIAMS supports research into the causes, treatment, and prevention of arthritis and musculoskeletal
and skin diseases; the training of scientists; and the sharing of research-based information.
Web site: www.niams.nih.gov
NIH National Library of Medicine’s MedlinePlus
Fibromyalgia listing: www.nlm.nih.gov/medlineplus/fibromyalgia.html
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.
National Institutes of Health
♦♦♦
U.S. Department of Health and Human Services