Effects of Physical-Agent Pain Relief Modalities for Fibromyalgia Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

We conducted a systematic review and meta-analysis to investigate the effects of the following physical-agent modalities for pain relief in fibromyalgia (FM) patients.We identified randomized controlled studies of adults with FM in the MEDLINE, CINAHL, and PEDro databases. The primary outcome measure was pain relief measured by a visual analogue scale (VAS), and the secondary outcome measures of interest were subjective improvements in the number of tender points, Fibromyalgia Impact Questionnaire (FIQ), and quality of life (QOL) scores.Eleven studies were included in our review. The studies' physical-agent modalities were low-level laser therapy (LLLT), thermal therapy, electromagnetic field therapy, and transcutaneous electrical nerve stimulation (TENS). LLLT did not reduce VAS scores, but it significantly reduced both the number of tender points and FIQ score. Thermal therapy was associated with significantly reduced VAS scores, tender points, and FIQ scores. Electromagnetic field therapy was associated with significantly reduced VAS score and FIQ score. TENS significantly reduced VAS scores.Our analyses revealed that thermal therapy and LLLT had a partial effect on pain relief in FM patients, and this beneficial effect may have a positive influence on FM patients' health status.