[Digital treatment of fibromyalgia]

Fibromyalgia is a chronic pain syndrome associated with a substantial physical and psychological burden. The effectiveness of pharmacological treatment is limited, whereas nonpharmacological self-management strategies, such as exercise, cognitive behavioral therapy (CBT) and mindfulness-based approaches, are recommended. These can increasingly be delivered as online programs and significantly improve access to these forms of treatment.

Based on the current evidence, the aim of this article is to review how self-management approaches for fibromyalgia are digitally implemented via apps and how these could be further developed using, for example, wearables, artificial intelligence (AI) models and chatbots.

Existing digital applications for fibromyalgia and novel concepts were evaluated. As an example, the authors' own app, the patient organiser and companion system (POCOS), with and without an AI-based chatbot, was discussed in patient focus groups.

Increasingly available digital apps for fibromyalgia currently focus primarily on psychoeducational content, whereas exercise programs and multimodal concepts are less frequently integrated, despite their evidence base and patient demand. Clinical trials have demonstrated positive effects for certain online programs. Focus groups emphasized the need for personalized, low threshold and user-friendly app designs. The use of AI-powered chatbots in this context is both feasible and desired but requires well-defined content and regulatory frameworks. On a diagnostic level, machine learning can be used to identify distinct fibromyalgia types, which can support personalized treatment.

The digital treatment of fibromyalgia is both feasible and effective but requires consistent evidence-based implementation, active participation of people with fibromyalgia, technical interoperability and a sensitive design approach tailored to this heterogeneous patient population.