{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T22:41:27Z","timestamp":1792190487595,"version":"4.4.0"},"reference-count":61,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2022,9,24]],"date-time":"2022-09-24T00:00:00Z","timestamp":1663977600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Fibromyalgia (FM) is a disease characterized by widespread musculoskeletal chronic pain that impairs the patient\u2019s quality of life and is considered a somatization disorder. The symptoms of the disease also affect the patient mentally, mainly since invisible pain is the only thing that indicates its existence. A typical symptom that characterizes FM patients is the lack of acceptance of the disease since its pathophysiology is not elucidated, hence the deficiencies in its management, or rather, cognitively, the belief that there is no disease to manage. The current paper aims to shed light on the new treatment methods at a holistic level, that is, cognitive, physical, and pharmacological therapies. Method: A literature review was carried out that discusses treatment methods that help alleviate the pain, accept it, and manage the symptoms of the disease. Results: FM symptoms can be treated by taking a broad view of treatment that will include a response to the mind through pain management, response to the body through physical activity, and response to the pain through pharmacological treatment. Conclusions: Today, there is an evolutionary view that accepts FM and chronic pain diseases as syndromes in which the pain is the disease; therefore, the response to this disease can be applied through three channels: physical, bodily, and mental.<\/jats:p>","DOI":"10.3390\/ijerph191912106","type":"journal-article","created":{"date-parts":[[2022,9,25]],"date-time":"2022-09-25T23:13:27Z","timestamp":1664147607000},"page":"12106","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Review of Fibromyalgia (FM) Syndrome Treatments"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5750-5585","authenticated-orcid":false,"given":"Liraz","family":"Cohen-Biton","sequence":"first","affiliation":[{"name":"Ariel University in Samaria, Ariel 4076414, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Buskila","sequence":"additional","affiliation":[{"name":"Ben-Gurion University of the Negev, Beer Sheva 8443944, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4014-2874","authenticated-orcid":false,"given":"Rachel","family":"Nissanholtz-Gannot","sequence":"additional","affiliation":[{"name":"Ariel University in Samaria, Ariel 4076414, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,24]]},"reference":[{"key":"ref_1","first-page":"62","article-title":"Facts and Myths Pertaining to Fibromyalgia","volume":"20","author":"Fitzcharles","year":"2018","journal-title":"Dialogues Clin. Neurosci."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1016\/B978-0-7020-4086-3.00033-3","article-title":"Fibromyalgia","volume":"119","author":"Sumpton","year":"2014","journal-title":"Handb. Clin. Neurol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"ITC33","DOI":"10.7326\/AITC202003030","article-title":"Fibromyalgia","volume":"172","author":"Bair","year":"2020","journal-title":"Ann. Intern. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1097\/MJT.0b013e3181df8e1b","article-title":"Fibromyalgia Syndrome: A Discussion of the Syndrome and Pharmacotherapy","volume":"17","author":"Smith","year":"2010","journal-title":"Am. J. Ther."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1007\/s12016-015-8509-4","article-title":"Fibromyalgia: A Critical and Comprehensive Review","volume":"49","author":"Borchers","year":"2015","journal-title":"Clin. Rev. Allergy Immunol."},{"key":"ref_6","unstructured":"Chaitow, L. (2010). Fibromyalgia Syndrome: A Practitioner\u2019s Guide to Treatment, Churchill Livingstone. [3rd ed.]."},{"key":"ref_7","first-page":"1143","article-title":"The Correlation between Problem-Oriented Coping and a Sense of Coherence among Fibromyalgia Patients Who Underwent the Fibrotherapy Model Intervention Program","volume":"40","author":"Buskila","year":"2022","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1097\/RHU.0000000000001866","article-title":"The Effect of the Fibrotherapy Intervention Program on the Coping Patterns of Fibromyalgia Patients","volume":"28","author":"Buskila","year":"2022","journal-title":"J. Clin. Rheumatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1097\/j.pain.0000000000001384","article-title":"Chronic Pain as a Symptom or a Disease: The IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11)","volume":"160","author":"Treede","year":"2019","journal-title":"Pain"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.55563\/clinexprheumatol\/gz4i3i","article-title":"One Year in Review 2021: Fibromyalgia","volume":"39","author":"Alciati","year":"2021","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"6541798","DOI":"10.1155\/2020\/6541798","article-title":"Current and Emerging Pharmacotherapy for Fibromyalgia","volume":"2020","author":"Tzadok","year":"2020","journal-title":"Pain Res. Manag."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"101415","DOI":"10.1016\/j.berh.2019.04.007","article-title":"New Concepts of Pain","volume":"33","author":"Trouvin","year":"2019","journal-title":"Best Pract Res. Clin. Rheumatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.jbmt.2009.08.003","article-title":"Fascia: A Missing Link in Our Understanding of the Pathology of Fibromyalgia","volume":"14","author":"Liptan","year":"2010","journal-title":"J. Bodyw. Mov. Ther."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Galosi, E., Truini, A., and di Stefano, G. (2022). A Systematic Review and Meta-Analysis of the Prevalence of Small Fibre Impairment in Patients with Fibromyalgia. Diagnostics, 12.","DOI":"10.3390\/diagnostics12051135"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"104","DOI":"10.5152\/eurjrheum.2018.17109","article-title":"Evidence of Peripheral Large Nerve Involvement in Fibromyalgia: A Retrospective Review of EMG and Nerve Conduction Findings in 55 FM Subjects","volume":"5","author":"Caro","year":"2018","journal-title":"Eur. J. Rheumatol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"744","DOI":"10.2147\/JPR.S234475","article-title":"Electrodiagnostic Abnormalities Associated with Fibromyalgia","volume":"13","author":"Hulens","year":"2020","journal-title":"J. Pain Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1016\/j.reuma.2020.04.003","article-title":"Fibromyalgia. Old Opinions versus New Knowledge","volume":"17","author":"Collado","year":"2020","journal-title":"Reumatol. Clin."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1002\/mus.26131","article-title":"Fibromyalgia Syndrome and Small Fiber, Early or Mild Sensory Polyneuropathy","volume":"58","author":"Lawson","year":"2018","journal-title":"Muscle Nerve"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1016\/j.math.2008.09.001","article-title":"The the Mechanisms of Manual Therapy in the Treatment of Musculoskeletal Pain: A Comprehensive Model","volume":"14","author":"Bialosky","year":"2009","journal-title":"Man. Ther."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Siracusa, R., di Paola, R., Cuzzocrea, S., and Impellizzeri, D. (2021). Fibromyalgia: Pathogenesis, Mechanisms, Diagnosis and Treatment Options Update. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22083891"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"461","DOI":"10.36076\/ppj.2020\/23\/461","article-title":"Efficacy of Manual Therapy on Pain, Impact of Disease, and Quality of Life in the Treatment of Fibromyalgia: A Systematic Review","volume":"23","author":"Schulze","year":"2020","journal-title":"Pain Physician"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.jbiomech.2008.09.027","article-title":"Epimuscular Myofascial Force Transmission: A Historical Review and Implications for New Research. International Society of Biomechanics Muybridge Award Lecture, Taipei, 2007","volume":"42","author":"Huijing","year":"2009","journal-title":"J. Biomech."},{"key":"ref_23","first-page":"440","article-title":"The Effectiveness of Myofascial Release Techniques in the Treatment of Myofascial Pain: A Literature Review","volume":"32","author":"Werenski","year":"2011","journal-title":"Lit. Rev."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1177\/0269215511399476","article-title":"Effects of Myofascial Release Techniques on Pain, Physical Function, and Postural Stability in Patients with Fibromyalgia: A Randomized Controlled Trial","volume":"25","year":"2011","journal-title":"Clin. Rehabil."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12913-021-06278-7","article-title":"Health Care Providers\u2019 Experiences of Pain Management and Attitudes towards Digitally Supported Self-Management Interventions for Chronic Pain: A Qualitative Study","volume":"21","author":"Varsi","year":"2021","journal-title":"BMC Health Serv. Res."},{"key":"ref_26","unstructured":"de Silva, D. (2011). Helping People Help Themselves: A Review of the Evidence Considering Whether It Is Worthwhile to Support Self-Management, The Health Foundation."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"103507","DOI":"10.1016\/j.ijnurstu.2019.103507","article-title":"The Efficacy of E-Health in the Self-Management of Chronic Low Back Pain: A Meta Analysis","volume":"106","author":"Du","year":"2020","journal-title":"Int. J. Nurs. Stud."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1002\/msc.1470","article-title":"Fibromyalgia Self-Management: Mapping the Behaviour Change Techniques Used in a Practice-Based Programme","volume":"18","author":"Pearson","year":"2020","journal-title":"Musculoskeletal. Care"},{"key":"ref_29","unstructured":"Clauss-Ehlers, C.S. (2010). Cognitive Behavioral Therapy (CBT). Educational Psychology Papers and Publications, Springer."},{"key":"ref_30","unstructured":"Hayes, S.C., and Hofmann, S.G. (2018). Introduction. Process-Based CBT: The Science and Core Clinical Competencies of Cognitive Behavioral Therapy, Context Press."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Williams, A.C.d.C., Fisher, E., Hearn, L., and Eccleston, C. (2021). Psychological Therapies for the Management of Chronic Pain (Excluding Headache) in Adults. Cochrane Database Syst. Rev., 2021.","DOI":"10.1002\/14651858.CD007407.pub4"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"357","DOI":"10.2217\/pmt-2016-0003","article-title":"Using a Biopsychosocial Perspective in the Treatment of Fibromyalgia Patients","volume":"6","author":"Turk","year":"2016","journal-title":"Pain Manag."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1111\/1756-185X.13756","article-title":"Mindfulness Is Associated with Sleep Quality among Patients with Fibromyalgia","volume":"23","author":"Park","year":"2020","journal-title":"Int. J. Rheum. Dis."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2541","DOI":"10.3389\/fpsyg.2019.02541","article-title":"Using a Mindfulness-Based Intervention to Promote Subjective Well-Being, Trait Emotional Intelligence, Mental Health, and Resilience in Women with Fibromyalgia","volume":"10","author":"Cejudo","year":"2019","journal-title":"Front. Psychol."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"P\u00e9rez-Aranda, A., D\u2019amico, F., Feliu-Soler, A., McCracken, L.M., Pe\u00f1arrubia-Mar\u00eda, M.T., Andr\u00e9s-Rodr\u00edguez, L., Angarita-Osorio, N., Knapp, M., Garc\u00eda-Campayo, J., and Luciano, J.V. (2019). Cost-Utility of Mindfulness-Based Stress Reduction for Fibromyalgia versus a Multicomponent Intervention and Usual Care: A 12-Month Randomized Controlled Trial (EUDAIMON Study). J. Clin. Med., 8.","DOI":"10.3390\/jcm8071068"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"15639","DOI":"10.1038\/s41598-019-52260-z","article-title":"Effects of Attachment-Based Compassion Therapy (ABCT) on Brain-Derived Neurotrophic Factor and Low-Grade Inflammation among Fibromyalgia Patients: A Randomized Controlled Trial","volume":"9","author":"Tops","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Sanabria-Mazo, J.P., Montero-Marin, J., Feliu-Soler, A., Gasi\u00f3n, V., Navarro-Gil, M., Morillo-Sarto, H., Colomer-Carbonell, A., Borr\u00e0s, X., Tops, M., and Luciano, J.V. (2020). Mindfulness-Based Program plus Amygdala and Insula Retraining (MAIR) for the Treatment of Women with Fibromyalgia: A Pilot Randomized Controlled Trial. J. Clin. Med., 9.","DOI":"10.3390\/jcm9103246"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1007\/s11916-011-0214-2","article-title":"Exercise Therapy for Fibromyalgia","volume":"15","author":"Busch","year":"2011","journal-title":"Curr. Pain Headache Rep."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1007\/s10067-013-2421-1","article-title":"Avoidance Behavior towards Physical Activity in Chronic Fatigue Syndrome and Fibromyalgia: The Fear for Post-Exertional Malaise","volume":"33","author":"Nijs","year":"2014","journal-title":"Clin. Rheumatol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.1002\/acr.20268","article-title":"Tailored Cognitive\u2013Behavioral Therapy and Exercise Training for High-Risk Patients with Fibromyalgia","volume":"62","author":"Kraaimaat","year":"2010","journal-title":"Arthritis Care Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1097\/AJP.0000000000001010","article-title":"Exploring the Preference for Fatigue-Avoidance Goals as a Mediator between Pain Catastrophizing, Functional Impairment, and Walking Behavior in Women with Fibromyalgia","volume":"38","author":"Velasco","year":"2022","journal-title":"Clin. J. Pain"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"105202","DOI":"10.1016\/j.jbspin.2021.105202","article-title":"Physical Activity in the Treatment of Fibromyalgia","volume":"88","author":"Masquelier","year":"2021","journal-title":"Jt. Bone Spine"},{"key":"ref_43","first-page":"548","article-title":"Effect of a Physical Activity Programme in Patients with Fibromyalgia: A Systematic Review","volume":"143","year":"2014","journal-title":"Med. Clin."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1080\/17461391.2019.1683610","article-title":"Zumba Dancing and Aerobic Exercise Can Improve Working Memory, Motor Function, and Depressive Symptoms in Female Patients with Fibromyalgia","volume":"20","author":"Norouzi","year":"2019","journal-title":"Eur. J. Sport Sci."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1080\/09593985.2019.1639229","article-title":"Effects of Aquatic Physiotherapy or Health Education Program in Women with Fibromyalgia: A Randomized Clinical Trial","volume":"37","author":"Fonseca","year":"2021","journal-title":"Physiother. Theory Pract."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1097\/RHU.0b013e31820e7ea7","article-title":"Effects of Lifestyle Physical Activity in Adults with Fibromyalgia: Results at Follow-Up","volume":"17","author":"Fontaine","year":"2011","journal-title":"J. Clin. Rheumatol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1097\/PHM.0b013e31824faa03","article-title":"Effects of Exercise Training and Detraining in Patients with Fibromyalgia Syndrome: A 3-Yr Longitudinal Study","volume":"91","author":"Carrasco","year":"2012","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/j.semarthrit.2007.08.008","article-title":"Treatment Strategy in Fibromyalgia Syndrome: Where Are We Now?","volume":"37","author":"Buskila","year":"2008","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_49","unstructured":"Liao, S. (2022, May 08). What Medicines Treat Fibromyalgia?. Available online: https:\/\/www.webmd.com\/fibromyalgia\/guide\/medicines-to-treat-fibromyalgia."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1347","DOI":"10.1517\/14656566.2015.1047343","article-title":"An Update on Pharmacotherapy for the Treatment of Fibromyalgia","volume":"16","author":"Calandre","year":"2015","journal-title":"Expert Opin. Pharmacother."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"2525","DOI":"10.1007\/s00213-013-3422-0","article-title":"Quetiapine Extended-Release (Seroquel-XR) versus Amitriptyline Monotherapy for Treating Patients with Fibromyalgia: A 16-Week, Randomized, Flexible-Dose, Open-Label Trial","volume":"231","author":"Calandre","year":"2014","journal-title":"Psychopharmacology"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1080\/10177833.2010.11790631","article-title":"A Comparison of Reboxetine and Amitryptilline in the Treatment of Fibromyalgia Syndrome with Co-Morbid Depressive Symptoms: An Open-Label Preliminary Study","volume":"20","author":"Konuk","year":"2016","journal-title":"Klin. Psikofarmakol. B\u00fclteni-Bull. Clin. Psychopharmacol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1016\/j.bpa.2020.08.010","article-title":"Cannabis and Cannabidiol (CBD) for the Treatment of Fibromyalgia","volume":"34","author":"Berger","year":"2020","journal-title":"Best Pract. Res. Clin. Anaesthesiol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1002\/phar.2115","article-title":"Cannabis for Chronic Pain: Challenges and Considerations","volume":"38","author":"Fincham","year":"2018","journal-title":"Pharmacother. J. Hum. Pharmacol. Drug Ther."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Fiz, J., Dur\u00e1n, M., Capell\u00e0, D., Carbonell, J., and Farr\u00e9, M. (2011). Cannabis Use in Patients with Fibromyalgia: Effect on Symptoms Relief and Health-Related Quality of Life. PLoS ONE, 6.","DOI":"10.1371\/journal.pone.0018440"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"239","DOI":"10.2174\/157015906778019527","article-title":"Role of the Cannabinoid System in Pain Control and Therapeutic Implications for the Management of Acute and Chronic Pain Episodes","volume":"4","author":"Manzanares","year":"2006","journal-title":"Curr. Neuropharmacol."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Zou, S., and Kumar, U. (2018). Cannabinoid Receptors and the Endocannabinoid System: Signaling and Function in the Central Nervous System. Int. J. Mol. Sci., 19.","DOI":"10.3390\/ijms19030833"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1002\/neu.20080","article-title":"The Endogenous Cannabinoid System and Its Role in Nociceptive Behavior","volume":"61","author":"Cravatt","year":"2004","journal-title":"J. Neurobiol."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Sagy, I., Schleider, L.B.L., Abu-Shakra, M., and Novack, V. (2019). Safety and Efficacy of Medical Cannabis in Fibromyalgia. J. Clin. Med., 8.","DOI":"10.3390\/jcm8060807"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1155\/2013\/918216","article-title":"2012 Canadian Guidelines for the Diagnosis and Management of Fibromyalgia Syndrome: Executive Summary","volume":"18","author":"Fitzcharles","year":"2013","journal-title":"Pain Res. Manag."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"2003","DOI":"10.2147\/JPR.S138864","article-title":"Pain as a Disease: An Overview","volume":"10","author":"Raffaeli","year":"2017","journal-title":"J. Pain Res."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/19\/12106\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:38:54Z","timestamp":1760143134000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/19\/12106"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,24]]},"references-count":61,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2022,10]]}},"alternative-id":["ijerph191912106"],"URL":"https:\/\/doi.org\/10.3390\/ijerph191912106","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,24]]}}}