ORIGINAL ARTICLE An overview of systematic reviews of complementary and alternative medicine for fibromyalgia Rohini Terry & Rachel Perry & Edzard Ernst Received: 19 September 2010 / Revised: 13 April 2011 / Accepted: 16 May 2011 / Published online: 26 May 2011 # Clinical Rheumatology 2011 Abstract Fibromyalgia (FM) is a chronic pain condition which is difficult to diagnose and to treat. Most individuals suffering from FM use a variety of complementary or alternative medicine (CAM) interventions to treat and manage their symptoms. The aim of this overview was to critically evaluate all systematic reviews of single CAM interventions for the treatment of FM. Five systematic reviews met the inclusion criteria, evaluating the effective- ness of homoeopathy, chiropractic, acupuncture, hydrother- apy and massage. The reviews found some evidence of beneficial effects arising from acupuncture, homoeopathy, hydrotherapy and massage, whilst no evidence for thera- peutic effects from chiropractic interventions for the treatment of FM symptoms was found. The implications of these findings and future directions for the application of CAM in chronic pain conditions, as well as for CAM research, are discussed. Keywords Complementary/alternative medicine (CAM) . Fibromyalgia . Systematic review Introduction Fibromyalgia (FM) is a chronic pain disorder characterised by widespread pain and often accompanied by other symptoms including sleep disruption and chronic fatigue. Affecting between 1% and 4% of the population [1], it is also associated with other syndromes such as irritable bowel syndrome and depression. As the pathophysiology of FM remains unclear, neither diagnosis nor treatment is straightforward [2–8]. Integrated, multidisciplinary care programmes are generally offered conventionally to man- age FM symptoms, which take into account the complex interactions between physical, psychological and social factors that shape responses to the pain and other symptoms of FM [4–6]. Recent evidence-based guidelines for the management of FM [7–9] have proposed multidisciplinary, tailored approaches to the management of FM symptoms, recommending non-pharmacological and pharmacological interventions. However, clear evidence of the benefits of these remains elusive; reports of symptom reduction are mixed, and adverse effects of medication are frequently experienced [7–11]. Moreover, a recent review of these guidelines highlighted a number of inconsistencies between the guidelines’ recommendations which may be attributable to the study inclusion criteria, weighting systems and composition of the panels [10]. Prior research has found that around 90% of individuals suffering from FM use or have used at least one form of complementary or alternative medicine (CAM) to manage their symptoms [12–15]. CAM has been defined as “a group of diverse medical and health care systems, practices and products that are not generally considered part of conventional medicine” [16]. That which may be considered to be CAM is influenced by political, social and cultural issues and the dominant health care system. The definition of CAM is therefore fluid, evolving and often contested, and the boundaries between CAM and conventional medicine are often not clear-cut. The preva- lence of CAM use in the general population is generally much lower than amongst FM sufferers, currently around 30–40% in the UK. A growing literature has indicated a variety of ‘push’ and ‘pull’ factors influencing patients’ R. Terry (*) : R. Perry : E. Ernst Complementary Medicine, Peninsula Medical School, University of Exeter, Exeter, UK e-mail: rohini.terry@pms.ac.uk Clin Rheumatol (2012) 31:55–66 DOI 10.1007/s10067-011-1783-5