Wednesday, June 15, 2011

CAM Therapies for Fibromyalgia Reviewed

CAM Therapies The June 2011 Clinical Digest from the U.S. National Center for Complementary and Alternative Medicine (NCCAM) offers a review and assessment of research on Complementary and Alternative Medicine (CAM) therapies for treating fibromyalgia syndrome. Much of the research on CAM for fibromyalgia is preliminary and evidence for the effectiveness of various modalities is for the most part limited.

Here is a summary of observations and opinions from NCCAM reviewers who assessed the literature…

  • Massage — only modest, preliminary support for massage therapy has been demonstrated in the research to date. Two studies had some positive findings, but 2 others found either no benefits or only short-term improvements.

  • Acupuncture — there have been mixed results of this modality for fibromyalgia, with 2 studies finding negative results. One review article notes that 3 studies found evidence in support of electroacupuncture (in which the needles are pulsed with electric current); however, benefits were short lived.

  • Tai Chi — this mind-body practice originating in China and involving moving the body slowly, gently, and with awareness may provide some benefit to patients with fibromyalgia. A 2010 NCCAM-funded study compared tai chi with a wellness education and stretching program for fibromyalgia. Participants in the tai chi group had significant improvements in pain, sleep quality, depression, and quality of life that were maintained for up to 24 weeks. However, larger, long-term studies are needed.

  • Dietary Supplements — low levels of magnesium have been thought to contribute to fibromyalgia; however, there is no conclusive evidence that magnesium supplements relieve fibromyalgia symptoms. Two small studies found conflicting results.

    Several small studies of supplements containing the amino acid derivative SAMe for fibromyalgia demonstrated mixed results; although there was some evidence of a benefit, more research is needed.

  • Other CAM Approaches — According to NCCAM reviewers, research evidence is insufficient to draw conclusions about the effectiveness of biofeedback, chiropractic care, hypnosis, or magnet therapy for fibromyalgia.

COMMENTARY: It is important to note that there is no mention in the review of any CAM therapies causing harm to any patients, even though benefits may have been lacking or disappointing in some cases. Unfortunately, the NCCAM Clinical Digest review of CAM for fibromyalgia [available here] does not explain the methodology behind their literature search, references for the examined research studies, or a grading of the quality of evidence. Therefore, the external validity of the findings noted above is unknown and the observations/conclusions should be cautiously considered.

NCCAM is one of 27 institutes and centers at the National Institutes of Health (NIH), a nationwide focal point for medical research in the United States. The mission of NCCAM is exploring complementary and alternative healing practices in the context of rigorous science, training CAM researchers, and disseminating authoritative information to the public and professionals.