Massage therapy for fibromyalgia: a systematic review and meta-analysis of randomized controlled trials

Yan-hui Li, Feng-yun Wang, Chun-qing Feng, Xia-feng Yang, Yi-hua Sun, Yan-hui Li, Feng-yun Wang, Chun-qing Feng, Xia-feng Yang, Yi-hua Sun

Abstract

Background: Although some studies evaluated the effectiveness of massage therapy for fibromyalgia (FM), the role of massage therapy in the management of FM remained controversial.

Objective: The purpose of this systematic review is to evaluate the evidence of massage therapy for patients with FM.

Methods: Electronic databases (up to June 2013) 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. Standardised mean difference (SMD) and 95% confidence intervals (CI) were calculated by more conservative random-effects model. And heterogeneity was assessed based on the I(2) statistic.

Results: Nine randomized controlled trials involving 404 patients met the inclusion criteria. The meta-analyses showed that massage therapy with duration ≥ 5 weeks significantly improved pain (SMD, 0.62; 95% CI 0.05 to 1.20; p = 0.03), anxiety (SMD, 0.44; 95% CI 0.09 to 0.78; p = 0.01), and depression (SMD, 0.49; 95% CI 0.15 to 0.84; p = 0.005) in patients with FM, but not on sleep disturbance (SMD, 0.19; 95% CI -0.38 to 0.75; p = 0.52).

Conclusion: 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.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. Flow chart for this meta-analysis.…
Figure 1. Flow chart for this meta-analysis. RCTs: randomized controlled trials; FM: fibromyalgia.
Figure 2. Risk of bias. Red (−):…
Figure 2. Risk of bias. Red (−): high risk of bias; Yellow (?): unknown risk of bias; Green (+): low risk of bias.
Figure 3. Forest plot showing the effect…
Figure 3. Forest plot showing the effect of massage therapy on pain, anxiety, depression, and sleep disturbance in patients of fibromyalgia.
Figure 4. Forest plot of the subgroup…
Figure 4. Forest plot of the subgroup analyses of massage therapy on pain in patients of fibromyalgia.
Figure 5. Forest plot of the subgroup…
Figure 5. Forest plot of the subgroup analyses of massage therapy on anxiety in patients of fibromyalgia.
Figure 6. Forest plot of the subgroup…
Figure 6. Forest plot of the subgroup analyses of massage therapy on depression in patients of fibromyalgia.
Figure 7. Forest plot of the subgroup…
Figure 7. Forest plot of the subgroup analyses of massage therapy on sleep disturbance in patients of fibromyalgia.
Figure 8. Funnel plot for pain, anxiety,…
Figure 8. Funnel plot for pain, anxiety, depression, and sleep disturbance. Ernst E, Pittler MH (1997) Alternative therapy bias. Nature 385∶480.

References

    1. Ge HY, Wang Y, Danneskiold-Samsoe B, Graven-Nielsen T, Arendt-Nielsen L (2010) The predetermined sites of examination for tender points in fibromyalgia syndrome arefrequently associated with myofascial trigger points. J Pain 11: 644–651.
    1. Hauser W, Eich W, Herrmann M, Nutzinger DO, Schiltenwolf M, et al. (2009) The Fibromyalgia syndrome: classification, diagnosis, and treatment. Dtsch Arztebl Int 106: 383–391.
    1. Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, et al. (1990) The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. report of the multicenter criteria committee. Arthritis Rheum 33: 160–172.
    1. Bannwarth B, Blotman F, Roué-Le Lay K, Carbère JP, André E, et al. (2009) Fibromyalgia syndrome in the general population of France. A prevalence study. Joint Bone Spine 76: 184–187.
    1. Branco JC, Bannwarth B, Failde I, Abello Carbonell J, Blotman F, et al. (2009) Prevalence of fibromyalgia: a survey in five European countries. Semin Arthritis Rheum 39: 448–453.
    1. Bennett RM, Jones J, Turk DC, Russell IJ, Matallana L (2007) An internet survey of 2596 people with fibromyalgia. BMC Musculoskelet Disord 8: 27.
    1. Topbas M, Cakirbay H, Gulec H, Akgol E, Ak I, et al. (2005) The prevalence of fibromyalgia in women aged 20–64 in Turkey. Scand J Rheumatol 34: 140–144.
    1. Thompson JM, Luedtke CA, Oh TH, Shah ND, Long KH, et al. (2011) Direct medical costs in patients with fibromyalgia: cost of illness and impact of a brief multidisciplinary treatment program. Am J Phys Med Rehabil 90: 40–46.
    1. White LA, Birnbaum HG, Kaltenboeck A, Tang J, Mallett D, et al. (2008) Employees with fibromyalgia: medical comorbidity, healthcare costs, and work loss. J Occup Environ Med 50: 13–24.
    1. Terry R, Perry R, Ernst E (2012) An overview of systematic reviews of complementary and alternative medicine for fibromyalgia. Clin Rheumatol 31: 55–66.
    1. Carville SF, Arendt-Nielsen S, Bliddal H, Blotman F, Branco JC, et al. (2008) EULAR evidence-based recommendations for the management of fibromyalgia syndrome. Ann Rheum Dis 67: 536–541.
    1. Häuser W, Thieme K, Turk DC (2010) Guidelines on the management of fibromyalgia syndrome - a systematic review. Eur J Pain 14: 5–10.
    1. Wang C, Schmid CH, Rones R, Kalish R, Yinh J, et al. (2010) A randomized trial of Tai Chi for fibromyalgia. N Engl J Med 363: 743–754.
    1. Rossy LA, Buckelew SP, Dorr N, Hagglund KJ, Thayer JF, et al. (1999) A meta-analysis of fibromyalgia treatment interventions. Ann Behav Med 21: 180–191.
    1. Ernst E (2008) Complementary treatments in rheumatic diseases. Rheum Dis Clin North Am 34: 455–467.
    1. Imanura M, Furlan AD, Dryden T, Irvin EL (2012) Massage Therapy. In: Dagenais S, Haldeman S, editors. Evidence- based management of low back pain. Missouri: ELSEVIER. 216–28.
    1. Terhorst L, Schneider MJ, Kim KH, Goozdich LM, Stilley CS (2011) Complementary and alternative medicine in the treatment of pain in fibromyalgia: a systematic review of randomized controlled trials. J Manipulative Physiol Ther 34: 483–496.
    1. Bronfort G, Haas M, Evans R, Leininger B, Triano J (2010) Effectiveness of manual therapies: the UK evidence report. Chiropr Osteopat 18: 3.
    1. Winkelmann A, Häuser W, Friedel E, Mooq-Eqan M, Seeqer D, et al. (2012) Physiotherapy and physical therapies for fibromyalgia syndrome. Systematic review, meta-analysis and guideline. Schmerz 26: 276–286.
    1. Kong L, Bannuru R, Yuan W, Cheng Y, Fang M, et al... (2011) Therapeutic massage on pain relief for fibromyalgia: a systematic review and meta-analysis. Arthritis Rheum 63(Suppl 10): 1917. [abstract].
    1. Kalichman L (2010) Massage therapy for fibromyalgia symptoms. Rheumatol Int 30: 1151–1157.
    1. Higgins JPT, Douglas GA (2008) Assessing risk of bias in included studies. In: Julian PTH, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions. Chichester, UK: Wiley-Blackwell. 187–241.
    1. Sunshine W, Field TM, Quintino O, Fierro K, Kuhn C, et al. (1996) Fibromyalgia benefits from massage therapy and transcutaneous electrical stimulation. J Clin Rheumatol 2: 18–22.
    1. Brattberg G (1999) Connective tissue massage in the treatment of fibromyalgia. Eur J Pain 3: 235–245.
    1. Alnigenis MN, Bradley JD, Wallick J, Emsley CL (2001) Massage therapy in the management of fibromyalgia: a pilot study. J Musculoskelet Pain 9: 55–67.
    1. Field T, Diego M, Cullen C, Hernandez-Reif M, Sunshine W, et al. (2002) Fibromyalgia pain and substance P decrease and sleep improve after massage therapy. J Clin Rheumatol 8: 72–76.
    1. Lund I, Lundeberg T, Carleson J, Sönnerfors H, Uhrin B, et al. (2006) Corticotropin releasing factor in urine-a possible biochemical marker of fibromyalgia. Responses to massage and guided relaxation. Neurosci Lett 403: 166–171.
    1. Stiller C (2006) The effect of therapeutic touch on fibromyalgia pain and anxiety. Case Western Reserve University (Health Sciences); Available: sid = 6&Fmt = 2&clientId = 17454&RQT = 309&Vname = PQD. Accessed 12 November 2009.
    1. Ekici G, Bakar Y, Akbayrak T, Yuksel I (2009) Comparison of manual lymph drainage therapy and connective tissue massage in women with fibromyalgia: a randomized controlled trial. J Manipulative Physiol Ther 32: 127–133.
    1. Castro-Sánchez AM, Matarán-Peñarrocha GA, Granero-Molina J, Aguilera-Manrique G, Quesada-Rubio JM, et al... (2011) Benefits of massage-myofascial release therapy on pain, anxiety, quality of sleep, depression, and quality of life in patients with fibromyalgia. Evid Based Complement Alternat Med. DOI: 10.1155/2011/561753.
    1. Wang J, Gao MX, Gao LQ, Tan ZD, Pan JY (2010) Clinical observation on 31 cases of fibromyalgia treated by traditional Chinese massage. Chin J Tradit Med Sci Technol 17: 72–73.
    1. da Silva GD, Lerenzi-Fiho G, Lage LV (2007) Effects of yoga and the addition of Tui Na in patients with fibromyalgia. J Altern Complement Med 13: 1107–1113.
    1. Goats GC (1994) Massage-the scientific basis of an ancient art: Part 2. Physiological and therapeutic effects. Br J Sports Med 28: 153–156.
    1. Field TM, Sunshine W, Hernandez-Reif M, Quintino O, Schanberg S, et al. (1997) Chronic fatigue syndrome: massage therapy effects on depression and somatic symptoms in chronic fatigue syndrome. J Chronic Fatigue Syndr 3: 43–51.
    1. Citak-Karakaya I, Akbayrak T, Demirtürk F, Ekici G, Bakar Y (2009) Short and long-term results of connective tissue manipulation and combined ultrasound therapy in patients with fibromyalgia. J Manipulative Physiol Ther 29: 524–528.
    1. Sagar S, Dryden T, Wong RK (2007) Massage therapy for cancer patients: a reciprocal relationship between body and mind. Curr Oncol 14: 45–56.
    1. Goldberg J, Sullivan SJ, Seaborne DE (1992) The effect of two intensities of massage on H-reflex amplitude. Phys Ther 72: 449–457.
    1. Lidbeck J (2002) Central hyperexcitability in chronic musculoskeletal pain: a conceptual breakthrough with multiple clinical implications. Pain Res Manag 7: 81–92.
    1. Egger M, Smith GD (1998) Bias in location and selection of studies. BMJ 316: 61–66.

Source: PubMed

스폰서 및 공동 작업자

건강 상태

약물 개입

3
구독하다