Núria Sempere-Rubio, Sara Mollà-Casanova, Elena Muñoz-Gómez and Ferran Cuenca-Martínez*

Sempere-Rubio et al. J Clin Transl Res 2023; 9(6):23-00108

Published online: November 9, 2023


Background: Fibromyalgia syndrome (FMS) is characterized by chronic widespread pain that is accompanied by emotional distress, fatigue, tender points of pain, sympathetic nervous system disturbances and alterations in the quality of sleep.
Aim: The main aim of this umbrella review was to assess the effectiveness of health education interventions (HEI) in patients with FMS.
Methods: We searched in PubMed, PEDro, EMBASE, CINAHL, Psicodoc and Google Scholar (August 6th, 2022). The outcomes measures were pain intensity, quality of life, functionality, anxiety, and pain catastrophizing. This review was previously registered in the international prospective register of systematic reviews PROSPERO (CRD42022368068). Methodological quality was analyzed using AMSTAR and ROBIS scale, and the strength of evidence was established according to the guidelines advisory committee grading criteria.
Results: Five systematic reviews with and without meta-analysis were included. The results were pooled to assess the effects of HEI in isolation, and to assess the effects of HEI in combination with other interventions (multicomponent approach based on therapeutic exercise or pharmacological). The results showed that HEI combined with other interventions were effective in improving pain intensity, quality of life, functionality, and anxiety compared to minimal intervention/usual care or no intervention, although mixed evidence was found improving pain catastrophizing, all with a limited quality of evidence. Regarding HEI in isolation, contradictory evidence was found for pain intensity and quality of life variables with a limited quality of evidence. Finally, no significant results were found in improving functionality, anxiety, and pain catastrophizing variables also with a limited quality of evidence.
Conclusions: Overall, it seems that the addition of HEI to other interventions, mostly therapeutic exercise although we could refer to it in terms of a multimodal approach, leads to greater clinical improvements than HEI in isolation. We have seen this especially in some clinical variables of interest such as pain intensity or quality of life. It seems that the main strength of the HEI is the interaction with other interventions to enhance its efficacy with respect to the outcomes assessed. Further research is needed especially ensuring the correct comparison when combining HEI with other interventions in order to obtain more consistent results.
Relevance for patients: Adding therapeutic education programs to the management of patients with FMS seems to have a clinically important effect. However, the application of therapeutic education in isolation does not appear to be effective in the management of these patients. More research is needed in this field.


DOI: http://dx.doi.org/10.18053/jctres.09.202306.23-00108

Author affiliations

Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, c/ Gascó Oliag nº5, 46010, Valencia, Spain

*Corresponding author
Ferran Cuenca-Martínez
Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, c/ Gascó Oliag nº5, 46010, Valencia, Spain.
Email: Ferran.Cuenca@uv.es

Handling editor:
Michal Heger
Department of Pharmaceutics, Utrecht University, the Netherlands
Department of Chemistry, Utrecht University, Utrecht, the Netherlands
Department of Pathology, Erasmus Medical Center, the Netherlands
Department of Pharmaceutics, Jiaxing University Medical College, Zhejiang, China


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