Complementary and alternative medicine in fibromyalgia: a practical clinical debate of agreements and contrasts

Fibromyalgia (FM) is currently classified as a chronic pain syndrome. Its main features are chronic widespread pain in the presence of tender points (TPs) upon physical examination, sleep disturbances and fatigue, although patients also report a variety of other complaints. Many therapies have been proposed over recent years with mixed results, including various pharmacological therapies for the treatment of symptoms; but there is still no effective drug treatment for the syndrome itself. Non-pharmacological therapies are an important part of the treatment, and there is evidence supporting a number of interventions, including aerobic exercise, strength and stretching training, cognitive-behavioural therapy, and patient education. Complementary and alternative medicine (CAM) techniques have not yet been fully acknowledged by scientific medicine because little is known about their mechanisms of action and usefulness. The aim of this wide-ranging review of the literature is to analyse the types of CAM techniques used to treat FM and their effectiveness, highlighting the disagreements among the authors of more specialised reviews.