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Does physical therapy improve symptoms of fibromyalgia?

Article Excerpt
* EVIDENCE-BASED ANSWER

Physical therapy is minimally effective in the treatment of fibromyalgia, with immediate post-treatment improvement in pain and tender points, and both short- and longer-term improved self-efficacy (confidence in performing tasks) (strength of recommendation [SOR]: B, 1 small, high-quality randomized controlled trial, 4 additional small randomized controlled trials).

Multidisciplinary rehabilitation is probably not effective for this disorder but warrants future research, as trial quality is poor (SOR: B, systematic review of 4 small or low-quality and 3 additional randomized controlled trials on widespread pain conditions).

* EVIDENCE SUMMARY

The goal of physical therapy is to maximize function and reduce impairment to limit disability in patients with musculoskeletal conditions. (1) Based on a British study, physical therapists most commonly use exercise, education about correct posture and functional activity, relaxation, and energy conservation and fatigue management. (2) For this review, physical therapy is defined as a treatment program that includes patient education and supervised exercise.

In the highest-quality trial, Buckelew and colleagues (3) randomized 119 subjects to 1 of 4 groups: biofeedback and relaxation training, exercise training, combination treatment, and an education and attention control program. Individuals were evaluated on measures of pain, function, disease impact, and...