Fibromyalgia (FM) is a chronic condition which ruins the quality of life of many patients. It is also a domain of alternative medicine: dozens of different treatments are on offer – this is clearly a paradise for charlatans and bogus claims. So is there a treatment that is demonstrably effective? The purpose of this systematic review is to evaluate the evidence of massage therapy FM.
Electronic databases were searched to identify relevant studies. The main outcome measures were pain, anxiety, depression, and sleep disturbance. Two reviewers independently abstracted data and appraised risk of bias. The risk of bias of eligible studies was assessed based on Cochrane tools.
Nine randomized controlled trials involving 404 patients met the inclusion criteria. A meta-analyses showed that massage therapy with a duration of at least 5 weeks significantly improved pain , anxiety, and depression. Sleep disturbance was not improved by massage therapy.
The authors conclude that massage therapy with duration ≥5 weeks had beneficial immediate effects on improving pain, anxiety, and depression in patients with FM. Massage therapy should be one of the viable complementary and alternative treatments for FM. However, given fewer eligible studies in subgroup meta-analyses and no evidence on follow-up effects, large-scale randomized controlled trials with long follow-up are warrant to confirm the current findings.
To put these results into context, we need to consider the often poor methodological quality of the primary studies. It is, of course, not easy to test massage therapy in rigorous trials. For instance, there is no obvious placebo, and we can therefore not be sure whether the treatment benefits patients through a specific effect or whether non-specific effects are the cause of the improvement.
We also should be aware of the facts that for most other alternative therapies the evidence is not encouraging, and that massage therapy is relatively safe. Therefore the conclusion for those who suffer from FM might well be that massage therapy is worth a try.