Clinical Benefits of Current Therapies in Improving Quality of Life and Physical-Psychological Symptoms in Women with Fibromyalgia: An Integrative Review
DOI:
https://doi.org/10.36489/saudecoletiva.2025v16i99p17028-17053Keywords:
Fibromyalgia, Therapeutics, Quality of Life, WomenAbstract
Fibromyalgia is a chronic syndrome characterized by diffuse musculoskeletal pain, fatigue, sleep disturbances, and psychological symptoms, predominantly affecting women. This study evaluated, through an integrative review using Scielo, Lilacs, and PubMed, the effects of pharmacological and non-pharmacological therapies on pain, fatigue, and depression, focusing on improving the quality of life in individuals with fibromyalgia. Classical treatment approaches using tricyclic antidepressants and anticonvulsants showed some efficacy, although limited by side effects and treatment discontinuation. In contrast, non-pharmacological treatments are emerging as promising alternatives or complements. Interventions such as kinesiotherapy, Pilates, aquatic exercises, and multicomponent programs (such as FIBROWALK) demonstrated significant symptom improvement, while vitamin D supplementation and cannabidiol use still lack robust evidence. It is concluded that these approaches, especially physical and psychosocial ones, outperform isolated pharmacological treatments in terms of therapeutic scope.
References
Cristiane Vitaliano Graminha, Juliana Martins Pinto, Shamyr Sulyvan de Castro. Fatores relacionados a qualidade de vida autorrelatada em mulheres com fibromialgia de acordo com a Classificação Internacional de Funcionalidade. BrJP. 2021.
Rodríguez-Almagro D, Del Moral-García M, López-Ruiz MDC, Cortés-Pérez I, Obrero-Gaitán E, Lomas-Vega R. Optimal dose and type of exercise to reduce pain, anxiety and increase quality of life in patients with fibromyalgia. A systematic review with meta-analysis. Front Physiol. 2023; 14:1170621
Alberti FF, Becker MW, Blatt CR, Ziegelmann PK, da Silva Dal Pizzol T, Pilger D. Comparative efficacy of amitriptyline, duloxetine and pregabalin for treating fibromyalgia in adults: an overview with network meta-analysis. Clin Rheumatol. 2022; 41(7):1965-1978.
Farag HM, Yunusa I, Goswami H, Sultan I, Doucette JA, Eguale T. Comparison of Amitriptyline and US Food and Drug Administration-Approved Treatments for Fibromyalgia: A Systematic Review and Network Meta-analysis. JAMA Netw Open. 2022; 2;5(5):e2212939.
Böhm R, Westermann P, Gleim M, Cascorbi I, Gruenewald M, Herdegen T, Ohnesorge H. High-dose spironolactone lacks effectiveness in treatment of fibromyalgia (RCT). Eur J Pain. 2021; 25(8):1739-1750.
Karin Due Bruun, Robin Christensen, Kirstine Amris, Henrik Bjarke Vaegter, Morten Rune Blichfeldt-Eckhardt, Lars Bye-Møller, Anders Holsgaard-Larsen, Palle Toft, Naltrexone 6 mg once daily versus placebo in women with fibromyalgia: a randomised, double-blind, placebo-controlled trial, The Lancet Rheumatology, Volume 6, Issue 1, 2024.
Paula TMH, Castro MS, Medeiros LF, Paludo RH, Couto FF, Costa TRD, Fortes JP, Salbego MO, Behnck GS, Moura TAM, Tarouco ML, Caumo W, Souza A. Association of low-dose naltrexone and transcranial direct current stimulation in fibromyalgia: a randomized, double-blinded, parallel clinical trial. Braz J Anesthesiol. 2023; 73(4):409-417..
Chaves C, Bittencourt PCT, Pelegrini A. Ingestion of a THC-Rich Cannabis Oil in People with Fibromyalgia: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial. Pain Med. 2020; 21(10):2212-2218.
Qu, K., Li, M. X., Zhou, Y. L., Yu, P., & Dong, M. (2022). The efficacy of vitamin D in treatment of fibromyalgia: a meta-analysis of randomized controlled studies and systematic review. Expert Review of Clinical Pharmacology. 2022;15(4): 433–44.
Andrade CP, Zamunér AR, Forti M, Tamburús NY, Silva E. Efeitos do treinamento aquático e do destreinamento em mulheres com fibromialgia: ensaio clínico randomizado controlado. Eur J Phys Rehabil Med. 2019; 55(1):79-88.
Medeiros SA, de Almeida Silva HJ, do Nascimento RM, da Silva Maia JB, de Almeida Lins CA, de Souza MC. Mat Pilates is as effective as aquatic aerobic exercise in treating women with fibromyalgia: a clinical, randomized and blind trial. Adv Rheumatol. 2020; 60(1):21.
Matei D, Trăistaru R, Pădureanu V, Avramescu TE, Neagoe D, Genunche A, Amzolini A. The Efficiency of Kinesiotherapy versus Physical Modalities on Pain and Other Common Complaints in Fibromyalgia. Life (Basel). 2024; 14(5):604.
Izquierdo-Alventosa R, Inglés M, Cortés-Amador S, Gimeno-Mallench L, Chirivella-Garrido J, Kropotov J, Serra-Añó P. Low-Intensity Physical Exercise Improves Pain Catastrophizing and Other Psychological and Physical Aspects in Women with Fibromyalgia: A Randomized Controlled Trial. Int J Environ Res Public Health. 2020; 17(10):3634.
Rodríguez-Mansilla J, Mejías-Gil A, Garrido-Ardila EM, Jiménez-Palomares M, Montanero-Fernández J, González-López-Arza MV. Effects of an Exercise for Well-Being and Physical Training Programme on Muscle Strength, Range of Movement, Respiratory Capacity and Quality of Life in Women with Fibromyalgia: A Randomized Controlled Trial. J Clin Med. 2023; 12(3):774.
Cheng CA, Chiu YW, Wu D, Kuan YC, Chen SN, Tam KW. Effectiveness of Tai Chi on fibromyalgia patients: A meta-analysis of randomized controlled trials. Complement Ther Med. 2019; 46:1-8.
Aguilera M, Paz C, Salla M, Compañ V, Medina JC, Medeiros-Ferreira L, Feixas G. Cognitive-Behavioral and Personal Construct Therapies for Depression in Women with Fibromyalgia: A Randomized Controlled Trial. Int J Clin Health Psychol. 2022; 22(2):100296.
Serrat M, Ferrés S, Auer W, Almirall M, Lluch E, D'Amico F, Maes M, Lorente S, Navarrete J, Montero-Marín J, Neblett R, Nijs J, Borràs X, Luciano JV, Feliu-Soler A. Effectiveness, cost-utility and physiological underpinnings of the FIBROWALK multicomponent therapy in online and outdoor format in individuals with fibromyalgia: Study protocol of a randomized, controlled trial (On&Out study). Front Physiol. 2022; 13:1046613.
Prados G, Miró E, Martínez MP, Sánchez AI, Lami MJ, Cáliz R. Combined cognitive-behavioral therapy for fibromyalgia: Effects on polysomnographic parameters and perceived sleep quality. Int J Clin Health Psychol. 2020 ;20(3):232-242.
Nadal-Nicolás Y, Miralles-Amorós L, Martínez-Olcina M, Sánchez-Ortega M, Mora J, Martínez-Rodríguez A. Vegetarian and Vegan Diet in Fibromyalgia: A Systematic Review. Int J Environ Res Public Health. 2021 May; 18(9):4955.
Tomas-Carus P, Biehl-Printes C, Del Pozo-Cruz J, Parraca JA, Folgado H, Pérez-Sousa MÁ. Effects of respiratory muscle training on respiratory efficiency and health-related quality of life in sedentary women with fibromyalgia: a randomised controlled trial. Clin Exp Rheumatol. 2022; 40(6):1119-1126. doi: 10.55563/clinexprheumatol/0v55nh. Epub 2022 Jun 22. PMID: 35748715.








