Benefícios Clínicos das Terapêuticas Atuais na Melhora da Qualidade de Vida e dos Sintomas Físico-psicológicos nas Mulheres com Fibromialgia: Uma Revisão Integrativa

Camila Azevedo da Silva; Alinie Rogang Selenko; Cleia Aparecida Clemente Giosole; Luciano Henrique Pinto; Daniela Delwing-de Lima

doi:10.36489/saudecoletiva.2025v16i99p17028-17053

Autores/as

Camila Azevedo da Silva Graduanda em Medicina pela UNIVILLE https://orcid.org/0000-0003-0836-9761
Alinie Rogang Selenko Graduanda em Medicina pela UNIVILLE https://orcid.org/0009-0005-7195-5087
Cleia Aparecida Clemente Giosole Membro da Associação Catarinense de Fibromialgia e Amigos https://orcid.org/0000-0002-6805-6284
Luciano Henrique Pinto Docente Adjunto do Departamento de Medicina da Universidade da Região de Joinville – UNIVILLE – Joinville SC https://orcid.org/0000-0003-0250-7502
Daniela Delwing-de Lima Docente do Programa de Pós-Graduação em Saúde e Meio Ambiente da Universidade da Região de Joinville – UNIVILLE – Joinville SC https://orcid.org/0000-0001-5335-5102

DOI:

https://doi.org/10.36489/saudecoletiva.2025v16i99p17028-17053

Palabras clave:

Fibromialgia, Terapéutica, Calidad de Vida, Mujeres

Resumen

La fibromialgia es un síndrome crónico caracterizado por dolor musculoesquelético difuso, fatiga, trastornos del sueño y síntomas psicológicos, que afecta predominantemente a mujeres. Este trabajo evaluó, mediante una revisión integradora en los sitios Scielo, Lilacs y PubMed, los efectos de terapias farmacológicas y no farmacológicas sobre el dolor, la fatiga y la depresión, con enfoque en la mejora de la calidad de vida en personas con fibromialgia. Los tratamientos clásicos con antidepresivos tricíclicos y anticonvulsivantes mostraron cierta eficacia, aunque limitada por efectos secundarios y abandono del tratamiento. En cambio, las terapias no farmacológicas surgen como alternativas o complementos prometedores. Intervenciones como la cinesiterapia, el pilates, los ejercicios acuáticos y los programas multicomponentes (como FIBROWALK) demostraron mejoras significativas de los síntomas, mientras que las modalidades como la suplementación con vitamina D y el uso de cannabidiol aún carecen de evidencias sólidas. Se concluye que estos enfoques, especialmente los físicos y psicosociales, superan a los tratamientos farmacológicos aislados en cuanto a alcance terapéutico.

Citas

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.