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Meta-Analysis
. 2014 Feb 20;9(2):e89304.
doi: 10.1371/journal.pone.0089304. eCollection 2014.

Massage therapy for fibromyalgia: a systematic review and meta-analysis of randomized controlled trials

Yan-hui Li  1 , Feng-yun Wang  1 , Chun-qing Feng  1 , Xia-feng Yang  1 , Yi-hua Sun  1
Affiliations
Meta-Analysis

Massage therapy for fibromyalgia: a systematic review and meta-analysis of randomized controlled trials

Yan-hui Li et al. PLoS One. .

Abstract

Background: Although some studies evaluated the effectiveness of massage therapy for fibromyalgia (FM), the role of massage therapy in the management of FM remained controversial.

Objective: The purpose of this systematic review is to evaluate the evidence of massage therapy for patients with FM.

Methods: Electronic databases (up to June 2013) were searched to identify relevant studies. The main outcome measures were pain, anxiety, depression, and sleep disturbance. Two reviewers independently abstracted data and appraised risk of bias. The risk of bias of eligible studies was assessed based on Cochrane tools. Standardised mean difference (SMD) and 95% confidence intervals (CI) were calculated by more conservative random-effects model. And heterogeneity was assessed based on the I(2) statistic.

Results: Nine randomized controlled trials involving 404 patients met the inclusion criteria. The meta-analyses showed that massage therapy with duration ≥ 5 weeks significantly improved pain (SMD, 0.62; 95% CI 0.05 to 1.20; p = 0.03), anxiety (SMD, 0.44; 95% CI 0.09 to 0.78; p = 0.01), and depression (SMD, 0.49; 95% CI 0.15 to 0.84; p = 0.005) in patients with FM, but not on sleep disturbance (SMD, 0.19; 95% CI -0.38 to 0.75; p = 0.52).

Conclusion: Massage therapy with duration ≥ 5 weeks had beneficial immediate effects on improving pain, anxiety, and depression in patients with FM. Massage therapy should be one of the viable complementary and alternative treatments for FM. However, given fewer eligible studies in subgroup meta-analyses and no evidence on follow-up effects, large-scale randomized controlled trials with long follow-up are warrant to confirm the current findings.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Flow chart for this meta-analysis. RCTs: randomized controlled trials; FM: fibromyalgia.
Figure 2
Figure 2. Risk of bias. Red (−): high risk of bias; Yellow (?): unknown risk of bias; Green (+): low risk of bias.
Figure 3
Figure 3. Forest plot showing the effect of massage therapy on pain, anxiety, depression, and sleep disturbance in patients of fibromyalgia.
Figure 4
Figure 4. Forest plot of the subgroup analyses of massage therapy on pain in patients of fibromyalgia.
Figure 5
Figure 5. Forest plot of the subgroup analyses of massage therapy on anxiety in patients of fibromyalgia.
Figure 6
Figure 6. Forest plot of the subgroup analyses of massage therapy on depression in patients of fibromyalgia.
Figure 7
Figure 7. Forest plot of the subgroup analyses of massage therapy on sleep disturbance in patients of fibromyalgia.
Figure 8
Figure 8. Funnel plot for pain, anxiety, depression, and sleep disturbance. Ernst E, Pittler MH (1997) Alternative therapy bias. Nature 385∶480.
See this image and copyright information in PMC

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