Effectiveness of acupuncture on clinical outcomes in patients with fibromyalgia: An overview of systematic reviews and meta-analyses

Abstract

Background

Acupuncture, a traditional oriental therapy, is increasingly being adopted globally as a method of complementary intervention for pain relief in patients with fibromyalgia (FM). The aim of this study was to evaluate the effectiveness of acupuncture compared to placebo, pharmacotherapy, or physiotherapy in reducing pain and improving function in patients with FM.

Methods

An electronic search was performed in the MEDLINE, Web of Science, CENTRAL, EMBASE, LILACS, CINAHL, PEDro, and SPORTDiscus databases. The eligibility criteria were systematic reviews of clinical trials that compared acupuncture versus control interventions for pain intensity and other clinical outcomes in women with FM.

Results

A total of 10 systematic reviews met the eligibility criteria for the quantitative synthesis. For pain intensity, the mean difference (MD) was −1.30 cm (95% CI = -1.85 to 0.76, p < 0.001). For functional status, the MD was −10.18 points (95% CI = -13.56 to −6.79, p < 0.001). For sleep quality, the MD was 0.46 points 95% CI = -1.85 to 0.76, p < 0.001). For fatigue, the standard mean difference (SMD) was −0.18 (95% CI = -0.86 to 0.51, p = 0.55). For depression, the MD was −6.28 points (95% CI = -9.80 to −2.76, p = 0.0005). Most of the differences were in favor of acupuncture, except for sleep quality.

Conclusion

Compared to pharmacotherapy and physiotherapy interventions, acupuncture showed statistically significant differences in pain intensity, functional status, and depression symptoms; however, all differences did not reach the minimum threshold to be considered clinically important in patients with FM. The quality of evidence was low to very low according to GRADE ratings.