Manual Therapy, Posturology & Rehabilitation Journal
Manual Therapy, Posturology & Rehabilitation Journal

Use of physiotherapy resources for patients with fibromyalgia

Nóbrega, Antonio José Sarmento da; Barros, Maria de Fátima Alcântara; Carvalho, Antonio Geraldo Cidrão de; Araújo, Maria das Graças Rodrigues; Lucena, Neide Maria Gomes de

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Introduction: Fibromyalgia is a non-inflammatory rheumatic syndrome of unknown etiology manifested in the musculoskeletal system through diffuse and chronic pain and presence of tender points, which may be associated with fatigue, anxiety, muscle stiffness, skin sensitivity, pain after exercise, functional impairment and sleep disorders. Objective: This study aimed to perform a systematic literature review in order to check which physiotherapy resources are mostly used today and what are the most significant results in the treatment of fibromyalgia. Method: An integrative literature review was conducted by searching electronic databases of indexed data such as Latin American and Caribbean Health Sciences (LILACS), MEDLINE/ PubMed and Scientific Electronic Library Online (SCIELO). Randomized clinical trials were selected in the period from January 2001 to June 2013 published in Portuguese, English and Spanish. Methodological quality was assessed using the Jadad Quality Scale. Results: Overall, 522 studies were reviewed in full and only 13 were included after application of the exclusion criteria. Among these, articles that addressed the use of electrotherapic resources (n = 4), hydrotherapy (n = 3), conventional therapy (n = 3), physical exercise (n = 2) and multidisciplinary treatment (n = 1) were identified, with diversified results, protocols and application times of each methodology. Conclusion: It has been found that there are a small number of studies with scientific relevance published in the last 10 years evidencing techniques that have obtained better results in the treatment of patients with fibromyalgia. Further studies with better design aimed at obtaining more conclusive results should be conducted.


Fibromyalgia, Physiotherapy, Physiotherapy resources.


1. Martinez JE, Panossian C, Gaviolli F. Estudo comparativo das características clínicas e abordagem de pacientes com fibromialgia atendidas em serviço público de reumatologia e em consultórios particulares. Rev Bras Reumat. 2006;46(1):32-6.

2. Queiroz LP. Worldwide epidemiology of fibromyalgia. Curr Pain Headache Rep. 2013;17(8):356.

3. Senna ER, Barros AL, Silva EO, Costa IF, Pereira LV, Ciconelli RM, et al. Prevalence of Rheumatic Diseases in Brazil: A Study Using the COPCORD Approach J Rheumatol. 2004;31(3):594-7.

4. Santos AM, Burti JS, Lopes JB, Scazufca M, Marques AP, Pereira RM. Prevalence of fibromyalgia and chronic widespread pain in community- dwelling elderly subjects living in São Paulo, Brazil. Maturitas. 2010;67(3):251-5.

5. Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, et al. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Arthritis & Rheumatism. 1990;33(2):160-72.

6. Wolfe F, Clauw DJ, Fitzcharles M, Goldenberg DL, Katz RS, Mease P, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res. 2010;62(5):600-10.

7. Wolfe F, Clauw DJ, Fitzcharles M, Goldenberg DL, Hauser H, Katz RS, et al. Fibromyalgia criteria and severity scales for clinical and epidemiological studies: a modification of the ACR preliminary diagnostic criteria for fibromyalgia. J Rheumatol. 2011;38(6);1113-22.

8. Ozgocmen S, Ozyurt H, Sogut S, Akyol O. Current concepts in the pathophysiology of fibromyalgia: the potential role of oxidative stress and nitric oxide. Rheumt Inter. 2006;26(7):585-97.

9. Arnold IM, Fan J, Russell IJ, Yunus MB, Khan MA, Kushner I, et al. The Fibromyalgia Family Study. A Genome-Wide Linkage Scan Study. Arthritis & Rheumatism. 2013;65(4):1122-8.

10. Bellato E, Marini E, Castoldi F, Barbasetti N, Mattei I, Bonasia DE, et al. Fibromyalgia Syndrome: Etiology, Pathogenesis, Diagnosis, and Treatment. Pain Research and Treatment. 2013;2013:960270.

11. Thompson ME, Barkhuizen A. Fibromyalgia, Hepatitis C Infection, and the Cytokine Connection. Current Pain and Headache Reports. 2003;7(5):342-7.

12. Berber JSS, Kuper E, Berber SC. Prevalence of depression and its relationship with quality of life in patients with fibromyalgia syndrome. Rev Bras Reumatol. 2005;45(2):47-54.

13. Mease P. Fibromyalgia Syndrome: Review of Clinical Presentation, Pathogenesis, Outcome Measures, and Treatment J Rheumatol. 2005;32(10 Sup):2063.

14. Velly AM, Look JO, Schiffman E, Lenton PA, Kang W, Messner RP, et al. The Effect of Fibromyalgia and Widespread Pain on the Clinically Significant Temporomandibular Muscle and Joint Pain Disorders - A Prospective 18-Month Cohort Study. J Pain, 2010;11(11):1155-64.

15. Barros MFA, Silva IMM, Nascimento JA, Oliveira EA, Cardia MCG, Lucena NMG, et al. A percepção da qualidade de vida de pacientes fibromiálgicas submetidas à intervenção fisioterapêutica. R Bras Ci Saúde. 2012;16(Sup 2):3-10.

16. Meyer BB, Lemley KJ. Utilizing exercise to affect the symptomology of fibromyalgia: a pilot study. Med Scien Sport Exer. 2000;32(10):1691-7.

17. Clark SR, Jones KD, Burckhardt CS, Bennet R. Exercises for patients with fibromyalgia: risks versus benefits. Curr Rheum Repor. 2001;3(2):135-40.

18. Brecher LS, Cymet TC. Apratical approach to fibromyalgia. J Am Osteopath Assoc. 2001;101(4 Sup 2):S12-7.

19. Reilly KA, Bird HA. Prophylactic hydrotherapy. Rheumatology. 2001;40(1):4-6.

20. Dias KSD. Melhora da qualidade da vida em pacientes fibromiálgicos tratados com hidroterapia. Rev Fisioter Brasil. 2003;4(5): 320-5.

21. Sluka KA, Walsh D. Transcutaneous electrical nerve stimulation: basic science mechanisms and clinical effectiveness. J Pain. 2003;4(3):109-21.

22. Löfgren M, Norrbrink C. Pain relief in women with fibromyalgia: a cross-over study of superficial warth stimulation and transcutaneous electrical nerve stimulation. J Rehabil Med. 2009;41(7): 557-62.

23. Mutlu B, Paker N, Bugdayci D, Tekdos D, Kesiktas N. Efficacy of supervised exercise combined with transcutaneous electrical nerve stimulation in women with fibromyalgia: a prospective controlled study. Rheumatol Int. 2013;33(3):649-55.

24. Hecker CD, Melo C, Tomazoni SS, Martins ABL, Leal Júnior ECP. Análise dos efeitos da cinesioterapia e da hidrocinesioterapia sobre a qualidade de vida de pacientes com fibromialgia - um ensaio clínico randomizado. Fisioter Mov. 2011;24(1): 57-64.

25. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJM, Gavaghan DJ, et al. Assessing the Quality of Reports of Randomized Clinical Trials: Is Blinding Necessary? Control Clin Trials. 1996;17(1):1-12.

26. Fregni F, Gimenes R, Valle AC, Ferreira MJ, Rocha RR, Natalle I, et al. A randomized, sham-controlled, proof of principle study of transcranial direct current stimulation for the treatment of pain in fibromyalgia. Arthritis Rheum. 2006;54(12):3988-98.

27. Mendonça ME, Santana MB, Baptista AF, Datta A, Bikson M, Fregni F, et al. Transcranial DC stimulation in fibromyalgia: optimized cortical target supported by high-resolution computational models. J Pain. 2011;12(5):610-7.

28. Taylor AG, Anderson JG, Riedel SL, Lewis JE, Bourguignon C. A randomized, controlled, double-blind pilot study of the effects of cranial electrical stimulation on activity in brain pain processing regions in individuals with fibromyalgia. Explore (NY). 2013;9(1):32-40.

29. Hargrove JB, Bennett RM, Yesons DG, Smith SJ, Nagpal S, Deering DE. A Randomized Placebo-Controlled Study of Noninvasive Cortical Electrostimulation in the Treatment of Fibromyalgia Patients. Pain Med. 2012;13(1):115-24.

30. Dönmez A, Karagülle MZ, Tercan N, Dinler M, Işsever H, Karagülle M, et al. SPA therapy in fibromyalgia: a randomized controlled clinic study. Rheumatol Int. 2005;26(2):168-72.

31. Evcik D, Kizilay B, Gökçen E. The effects of balneotherapy on fibromyalgia patients. Rheumatol Int. 2002;22(2):56-9.

32. Evcik D, Yigit I, Pusak H, Kavuncu V. Effectiveness of aquatic therapy in the treatment of fibromyalgia syndrome: a randomized controlled open study. Rheumatol Int. 2008;(9):885-90.

33. Vitorino DFM, Carvalho IBC, Prado GF. Hydrotherapy and conventional physiotherapy improve total sleep time and quality of life of fibromyalgia patients: Randomized clinical trial. Sleep Medicine. 2006;7(3): 293-6.

34. Tomas-Carus P, Häkkinen A, Gusi N, Leal A, Häkkinen K, Ortega-Alonso A. Aquatic training and detraining on fitness and quality of life in fibromyalgia. Med Sci Sports Exerc. 2007;39(7):1044-50.

35. Tomas-Carus P, Gusi N, Häkkinen A, Häkkinen K, Raimundo A, Ortega-Alonso A. Improvements of muscle strength predicted benefits in HRQOL and postural balance in women with fibromyalgia: an 8-month randomized controlled trial. Rheumatology (Oxford), 2009;48(9):1147-51.

36. Altan I, Korkmaz N, Bingol U, Gunay B. Effect of pilates training on people with fibromyalgia syndrome: a pilot study. Arch Phys Med Rehabil. 2009;90(12):1983-8.

37. Sañudo B, Galiano D, Carrasco I, Hoyo M, Mcveigh JG. Effects of a prolonged exercise program on key health outcomes in women with fibromyalgia: a randomized controlled trial. J Rehabil Med. 2011;43(6):521-6.

38. Casanueva-Fernández B, Ilorca J, Rubió JB, Rodero-Fernández B, González-Gay MA. Efficacy of a multidisciplinary treatment program in patients with severe fibromyalgia. Rheumatol Int. 2012;32(8):2497-502.

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