Effect of Acupuncture on Pain, Fatigue, Sleep, Physical Function, Stiffness, Well-Being, and Safety in Fibromyalgia: A Systematic Review and Meta-Analysis

Purpose: Fibromyalgia (FM) is a syndrome characterized by widespread pain, which caused huge economic and social burden. Acupuncture is often used to manage chronic pain. However, the efficacy of acupuncture in FM is still controversial. This study aimed to systematically review the effects of acupuncture on pain, fatigue, sleep quality, physical function, stiffness, well-being, and safety in FM. Methods: We searched databases including PubMed, Embase, the Cochrane Library, Wanfang Database, Chongqing Weipu, and the China National Knowledge Infrastructure from inception to September 2021. Eligible studies included randomized or quasi randomized controlled studies of acupuncture in patients with FM. Quantitative analysis was conducted using RevMan 5.3 software, and risk assessment was performed according to the Cochrane collaboration tool. Safety was quantitatively analyzed. Results: A total of 13 articles were searched, of which 12 were analyzed quantitatively. Our meta-analysis found that acupuncture could alleviate pain (SMD: -0.42, 95% CI, -0.66, -0.17, P<0.001, I-2=58%) and improve well-being (SMD: -0.86, 95% CI, -1.49, 0.24, P=0.007, I-2=85%) at post-treatment. In addition, acupuncture showed long-term effects on reducing pain (P=0.03) and improving well-being (P<0.001). No evidence that acupuncture works on fatigue, sleep quality, physical function, or stiffness was found. No serious adverse events were detected in acupuncture treatment. Conclusion: Moderate quality of evidence supports acupuncture in reducing pain in patients with FM. Therefore, acupuncture is recommended as a treatment for FM.