Clinical Question: What treatment m...

Clinical Question: What treatment modalities are principally effective for fibromyalgia syndrome?

Setting: Various (meta-analysis)

contemplation Design: Meta-analysis (other)

Synopsis: The authors searched multiple sources, including MEDLINE, EMBASE, Science Citation Index, and the Cochrane Collaboration, for trials upon the efficacy of fibromyalgia syndrome therapy. A total of 505 articles were reviewed and classified according to their flush of evidence. It was unclear whether the articles were reviewed independently and the potential for publication bias. was not discussed. Evidence was ranked as healthy (i.e., positive results from a meta-analysis or consistent issues from more than one randomized controll trial [RCT]) moderate (i.e., positive accrues from one RCT or for the most part positive results from multiple RCT or consistently positive rises from non-RCT studies), or weak (i.e., positive follows from descriptive and case studies, inconsistent comes from RCTs, or both).

able to endure evidence for efficacy was construct for treatment with amitriptyline, cyclobenzaprine, exercise, cognitive behavior therapy, and patient education. Moderate evidence for efficacy was construct for tramadol, various selective serotonin reuptake inhibitors, acupuncture, hypnotherapy, and biofeedback. Weak evidence for efficacy was erect for growth hormone therapy, S-adenosyl-methionine, chiropractic and massage therapy, electrotherapy, and ultrasonography. No evidence of any evaluation or effectiveness was fix for steroids, nonsteroidal anti-inflammatory unsalable articles melatonin, benzodiazepine hypnotics, or trigger point injections.

Bottom Line: Treatments for fibromyalgia syndrome with the strongest evidence for efficacy include amitriptyline, cyclobenzaprine, exercise, cognitive behavior therapy, patient education, and multidisciplinary therapy. (Level of Evidence: 1a-)

contemplation Reference: Goldenberg DL, et al. Management of fibromyalgia syndrome JAMA November 17 2004;292:2388-95

Used with permission from Slawson D Useful treatments for fibromyalgia syndrome Accessed online December 28 2004 at: http://www.InfoPOEMs.com.

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