Essay: Fibromyalgia Is a Common Cause

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[. . .] EULAR gave randomized controlled trials greater importance, and hence, a higher level of evidence. (Hauser, Thieme & Turk, 2010)

Both APS and AWMF gave the greatest amount of credit to aerobic exersize, cognitive-behavioral therapy, amitriptyline, and multicomponent treatment. The level of evidence for each of these modalities was based on level A A modality was given a level A evidence when there was evidence of type I, or consistent evidences of type II, III, or IV from multiple studies. Chiropractic manipulations and massage therapy were also recommended based on level B Modalities were described as level B if evidence of type II, III or IV were generally consistent. (Hauser, Thieme & Turk, 2010)

On the other hand, EULAR assigned the highest level of evidence to pharmacologic treatment and evidence for CBT and physical therapy were at level D The effectiveness of CBT in the management of fibromyalgia patients may be of benefit. According to the EULAR, this effect is based merely on expert opinions, rather than being backed up by credible evidence. When analyzing the level of evidence for CBT, only two studies were identified. Neither of the studies had a control group and in both researches, patients were allowed to continue their usual medication. Only one of the two studies used only one of the EULAR predetermined outcome measures. Based on these deficiencies, both the studies were described to be of poor quality and hence, the outcomes could not be incorporated into a definitive treatment modality. According to the EULAR, the poor quality of trials was masked by what experts believed to be a 'realistic reflection of possible benefits.' Even though the EULAR did recognize a reportable evidence of CBT benefit in fibromyalgia patients from systemic reviews and meta-analysis, very few studies were included. Also the scarcity of researches on the topic was another factor that made this modality less popular in the recommendations presented by the EULAR. (Carville et al., 2007)

Other therapies, such as physiotherapy, relaxation, chiropractic and massage therapies were recommended based on individual needs and satisfaction. Such modalities were also based on expert opinion mostly, but some experimental evidence from reviews did exist regarding its benefits in fibromyalgia. Clinical trial evidence were, however, absent. Two studies were identified regarding physiotherapy that met the EULAR criterion. These were of moderate quality. Another study was identified for connective tissue massage. This study compared its effects to a control group. There were considerable benefits in pain relief and function, when compared to the control group. (Carville et al., 2007)


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Fibromyalgia Is a Common Cause.  (2012, July 17).  Retrieved July 23, 2019, from

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"Fibromyalgia Is a Common Cause."  17 July 2012.  Web.  23 July 2019. <>.

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"Fibromyalgia Is a Common Cause."  July 17, 2012.  Accessed July 23, 2019.