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Acupuncture and Fibromyalgia

Three Part Question

In [adults with Fibromyalgia] does [acupuncture] have an effect on [reducing pain].

Clinical Scenario

A 42-year-old female with a diagnosis of fibromyalgia is assessed by a physiotherapist in an out-patient department. The patient is presenting with widespread pain, which is impairing her function. You wonder whether acupuncture is an effective treatment to use with your patient to decrease pain.

Search Strategy

MEDLINE 1946-06/16, EMBASE 1974-06/16.

[Exp. Acupuncture] and [Exp. Fibromyalgia].

Search Outcome

Five hundred and fifty-six articles were retrieved. One Cochrane review has been included with completed search up to 2012. Subsequent publications were included as five additional papers

Relevant Paper(s)

Author, date and country Patient group Study type (level of evidence) Outcomes Key results Study Weaknesses
Deare et al
Systematic Cochrane reviewSystematic review of randomised and quasi-randomised studies evaluating any type of invasive acupuncture for fibromyalgiaFOR PAIN Acupuncture versus non-acupuncture treatment Acupuncture versus placebo or sham acupuncture Acupuncture versus medication Acupuncture as an adjunct therapy Deep needling with stimulation (T/S) versus deep needling without stimulationFavours acupuncture (N=13)

No significant difference (N=286)

Favours acupuncture (N=38) Favours acupuncture as an adjunct (N=58) No significant difference (N=41)
Extensive search of many databases including Chinese. No language restrictions
Casanueva et al
120 patients with fibromyalgiaOpen-label randomised controlled trial (RCT): six sessions of weekly dry needling, 1 h per week+standard treatment (N=60) versus Standard treatment (N=60)Visual analogue score for pain post-treatmentDry needling 6.5 (2.1) Standard care 8.0 (1.3) p=0.002Multiple outcomes assessed Open label
Collazo et al
99 patients with fibromyalgiaRCT Acupuncture versus moxibustion versus scalp acupuncturePain ScalePain scale showed the most improvement by 6 months in the scalp acupuncture groupThis is a report from the abstract. It was not possible to source the paper No details given on the type of pain scale, the outcome data or statistical comparisons
Khabbazi et al
90 patients with fibromyalgiaRCT: Acupuncture versus acupuncture+fluoxetine versus fluoxetineFibromyalgia Impact QuestionnaireTotal number of symptoms were lowest in the acupuncture and the acupuncture+fluoxetine groups (p<0.0001)Did not measure pain alone as an outcome Conference abstract only
Stival et al
36 patients with fibromyalgia from a rheumatology clinicRCT: Acupuncture versus sham acupunctureMean change in visual analogue scale for pain (0–10) from before to after one session of treatmentAcupuncture −1.70±1.55 Sham −4.36±3.23Small sample
Dias et al
30 women with fibromyalgia from a pain clinicOpen-label RCT: Randomised to acupuncture versus electroacupuncture versus moxibustionWong-Baker Faces Pain Scale Number of tender points with pain-pressure threshold <4 kg/cm2No difference between modalities in either outcomesSmall sample size No placebo or sham therapy

Clinical Bottom Line

Acupuncture may reduce pain in fibromyalgia syndrome. Most studies do not report on long-term pain outcomes and there are no large-scale studies.


  1. Deare JC , Zheng Z , Xue CCL , et al . Acupuncture for treating fibromyalgia. Cochrane Database Syst Rev 2013:(5):Art. No.: CD007070.
  2. Casanueva B , Rivas P , Rodero B , et al . Short-term improvement following dry needle stimulation of tender points in fibromyalgia. Rheumatol Int 2014;34:861–6.
  3. Collazo E , Munoz R , Aragones MA , et al . A Randomized prospective study to assess the effectiveness of several therapeutic procedures of traditional Chinese medicine in alleviation of pain and improvement in the standard of living in patien ts with fibromyalgia.Revista Internacional de Acupuntura 2014:8:21–128.
  4. Khabbazi A , Kolahi S , Tabatabaee M , et al . Acupuncture and fluoxetine versus fluoxetine in fibromyalgia. Conference: 16th Asia Pacific League of Associations for Rheumatology Congress Cebu City Philippines . Conference Publication International Journal of Rheumatic Diseases. 2014;17:115.
  5. Stival RS , Cavalheiroa PR , Stasiaka CE , et al . [Acupuncture in fibromyalgia: a randomized, controlled study addressing the immediate pain response] Rev Bras Reumatol 2014;54:431–6.
  6. Dias PA , Guimarães AB , Albuquerque Ade O , et al . Short-term complementary and alternative medicine on quality of life in women with fibromyalgia. J Integr Med 2016;4:29–35.