Fibromyalgia: do I tackle you with complementary medicines?

Area of Science:

• Pain Management
• Integrative Medicine

Background:

• Fibromyalgia management guidelines emphasize graded care and integrating nonpharmacological treatments and complementary medicine (CM).
• Patients often seek CM due to medication side effects, persistent symptoms, or a perception of safety and naturalness.
• Patients frequently withhold CM use from physicians due to fear of negative reactions, leading to potential risks.

Purpose of the Study:

• To provide updated definitions of nonpharmacological treatments and CM used by fibromyalgia patients.
• To discuss the potential benefits, risks, and challenges in evaluating these complementary medicine practices.
• To propose a structured approach for healthcare providers to discuss CM with fibromyalgia patients.

Main Methods:

• This narrative review synthesizes current literature on nonpharmacological treatments and CM for fibromyalgia.
• It includes updated definitions, risk-benefit analyses, and evaluation challenges.
• A structured discussion framework for patient-provider communication is proposed.

Main Results:

• Nonpharmacological treatments and CM are widely used by fibromyalgia patients, often without physician awareness.
• These practices carry potential benefits but also significant risks, including lack of regulation and safety concerns.
• Challenges exist in evaluating the efficacy and safety of many CM modalities.

Conclusions:

• Healthcare providers should proactively discuss nonpharmacological treatments and CM with fibromyalgia patients.
• Assessing patient expectations, motivations, and prior experiences is crucial for adherence and safety.
• Identifying "red flags" and guiding patients toward qualified practitioners and safe environments is essential.