Does addition of ‘mud-pack and hot pool treatment’ to patient education make a difference in fibromyalgia patients? A randomized controlled single blind study Balneotherapy for fibromyalgia at the Dead Sea The effects of balneotherapy on fibromyalgia patients Management of patients with fibromyalgia using biofeedback: a randomized control trial. Effects of mud-bath treatment on fibromyalgia patients: a randomized clinical trial Assessment of the effects of aquatic therapy on global symptomatology in patients with fibromyalgia syndrome: a randomized controlled trial. Balneotherapy in fibromyalgia: a single blind randomized controlled clinical study A pragmatic community-based intervention of multimodal physiotherapy plus deep water running (DWR) for fibromyalgia syndrome: a pilot study Effectiveness of high-frequency transcutaneous electrical nerve stimulation at tender points as adjuvant therapy for patients with fibromyalgia. SPA therapy in fibromyalgia: a randomised controlled clinic study Efficacy of the "body movement and perception" method in the treatment of fibromyalgia syndrome: an open pilot study. Static magnetic fields for treatment of fibromyalgia: a randomized controlled trial. [Comparison between aquatic-biodanza and stretching for improving quality of life and pain in patients with fibromyalgia]. Effects of unilateral repetitive transcranial magnetic stimulation of the motor cortex on chronic widespread pain in fibromyalgia. Investigation of the effects of pool-based exercise on fibromyalgia syndrome [Medicinal baths for treatment of generalized fibromyalgia]. The efficacy of the Rességuier method in the treatment of fibromyalgia syndrome: a randomized controlled trial.
The aim of this r and omized controlled single-blind study is to explore whether addition of mud-pack and hot pool treatments to patient education make a significant difference in short and mild term outcomes of the patients with fibromyalgia . Seventy women with fibromyalgia syndrome were r and omly assigned to either balneotherapy with mud-pack and hot pool treatments ( 35 ) or control ( 35 ) groups . After r and omization , five patients from  balneotherapy group and five patients from control group were dropped out from the study with different excuses . All patients had 6-h patient education programme about fibromyalgia syndrome and were given a home exercise programme . The patients in balneotherapy group had heated pool treatment at 38 ° C for 20 min a day , and mud-pack treatment afterwards on back region at 45 ° C . Balneotherapy was applied on weekdays for 2 weeks . All patients continued to take their medical treatment . An investigator who was blinded to the intervention assessed all the patients before and after the treatment , at the first and the third months of follow-up . Outcome measures were FIQ , BDI and both patient ’s and physician ’s global assessment s.  Balneotherapy group was significantly better than control group at after the treatment and at the end of the first month follow-up assessment s in terms of patient ’s and physician ’s global assessment , total FIQ score , and pain intensity , fatigue , non-refreshed awaking , stiffness , anxiety and depression subscales of FIQ . No significant difference was found between the groups in terms of BDI scores . It is concluded that patient education combined with 2 weeks balneotherapy application has more beneficial effects in patients with fibromyalgia syndrome as compared to patient education alone Abstract . The aim of this study was to evaluate the effectiveness of balneotherapy on patients with fibromyalgia ( FM ) at the Dead Sea . Forty-eight patients with FM were r and omly assigned to a treatment group receiving sulfur baths and a control group .  All participants stayed for 10 days at a Dead Sea spa .  Physical functioning , FM-related symptoms , and tenderness measurements ( point count and dolorimetry ) were assessed at four time points : prior to arrival at the Dead Sea , after 10 days of treatment , and 1 and 3 months after leaving the spa . Physical functioning and tenderness moderately improved in both groups . With the exception of tenderness threshold , the improvement was especially notable in the treatment group and it persisted even after 3 months . Relief in the severity of FM-related symptoms ( pain , fatigue , stiffness , and anxiety ) and reduced frequency of symptoms ( headache , sleep problems , and subjective joint swelling ) were reported in both groups but lasted longer in the treatment group . In conclusion , treatment of FM at the Dead Sea is effective and safe and may become an additional therapeutic modality in FM . Future studies should address the outcome and possible mechanisms of this treatment in FM patients Abstract . Fibromyalgia syndrome ( FMS ) is a very common rheumatological diagnosis . There are various treatment modalities . This study was planned to investigate the effects of balneotherapy in the treatment of FMS . A total of 42 primary fibromyalgia patients diagnosed according to American College of Rheumatology criteria were included in the study . Their ages ranged between 30 and 55 years . Patients were r and omly assigned to two groups . None of them had had a cardiovascular disease before . Group 1 ( n=22 ) received 20-min bathing , once a day and five times per week . Patients participated in the study for 3 weeks ( total of 15 sessions ) . Group 2 ( n=20 ) was accepted as the control group . Patients were evaluated by the number of tender points , Visual Analogue Scale for pain , Beck 's Depression Index for depression , and Fibromyalgia Impact Question naire for functional capacity . Measurements were assessed initially , after the therapy , and at the end of the 6th month . In group 1 , there were statistically significant differences in numbers of tender points , Visual Analogue scores , Beck 's Depression Index , and Fibromyalgia Impact Question naire scores after the therapy program ( P<0.001 ) . Also , 6 months later in group 1 , there was still an improvement in the number of tender points ( P<0.001 ) , Visual Analogue scores , and Fibromyalgia Impact Question naire ( P<0.005 ) . But there was not a statistical difference in Beck 's Depression Index scores compared to the control group ( P>0.05 ) . Patients with FMS mostly complain about pain , anxiety , and the difficulty in daily living activities . This study shows that balneotherapy is effective and may be an alternative method in treating fibromyalgia patients OBJECTIVE Fibromyalgia syndrome ( FMS ) is a chronic rheumatological condition which could be characterized by generalized pain and fatigue . Cognitive and behavioral therapy has been found to be a suitable technique in the management of FMS . This study intends to evaluate the efficacy of electromyography ( EMG ) biofeedback to reduce pain in patients with FMS . MATERIAL S AND METHODS A r and omized controlled trial involving two groups of FMS patients , one receiving EMG biofeedback and the other a sham biofeedback  , was carried out . The assessment tools included in the study were fibromyalgia impact question naire ( FIQ ) , visual analogue scale ( VAS ) , six-minute walk test ( SMWT ) and number of tender points ; and tenderness of each tender point was done for both the groups . STATISTICS A Student 's ' t ' test was used to study the test for significance . RESULTS After using biofeedback , the mean VAS scores and the mean number of tender points were found to be 3 out of 10 and 6 out of 18 respectively . Subjective analysis from both groups showed improvement in physical and psychological realms . Statistical significance . CONCLUSION Biofeedback as a treatment modality reduces pain in patients with FMS , along with improvements in FIQ , SMWT and the number of tender points The efficacy of balneotherapy in fibromyalgia syndrome ( FS ) has been well demonstrated , while controlled studies using mud packs are lacking . We performed a r and omized clinical trial to evaluate the effects and the tolerability of mud-bath treatment in FS patients , who are poor responders to pharmacological therapy . Eighty patients with primary FS , according to ACR criteria , were r and omly allocated to two groups : 40 were su bmi tted to a cycle of 12 mud packs and thermal baths  , and 40 were considered as controls .  At baseline , after thermal treatment and after 16 weeks , patients were evaluated by FIQ , tender points count , VAS for “ minor ” symptoms , AIMS 1 and HAQ . Control patients were assessed at the same time periods . A significant improvement of all evaluation parameters after mud-bath therapy and after 16 weeks was observed . Mud packs were well tolerated and no drop-outs were recorded . Our results suggest the efficacy and the tolerability of mud-bath treatment in primary FS OBJECTIVES To evaluate the effects of a 16-week exercise therapy in a chest-high pool of warm water through applicable tests in the clinical practice on the global symptomatology of women with fibromyalgia ( FM ) and to determine exercise adherence levels . DESIGN A r and omized controlled trial . SETTING Testing and training were completed at the university . PARTICIPANTS Middle-aged women with FM ( n=60 ) and healthy women ( n=25 ) . INTERVENTION A 16-week aquatic training program , including strength training , aerobic training , and relaxation exercises . MAIN OUTCOME MEASURES Tender point count ( syringe calibrated ) , health status ( Fibromyalgia Impact Question naire ) ; sleep quality ( Pittsburgh Sleep Quality Index ) ; physical ( endurance strength to low loads tests ) , psychologic ( State Anxiety Inventory ) , and cognitive function ( Paced Auditory Serial Addition Task ) ; and adherence 12 months after the completion of the study . RESULTS For all the measurements , the patients showed significant deficiencies compared with the healthy subjects . Efficacy analysis ( n=29 ) and intent-to-treat analysis ( n=34 ) of the exercise therapy was effective in decreasing the tender point count and improving sleep quality , cognitive function , and physical function . Anxiety remained unchanged during the follow-up . The exercise group had a significant improvement of health status , not associated exclusively with the exercise intervention . There were no changes in the control group . Twenty-three patients in the exercise group were exercising regularly 12 months after completing the program . CONCLUSIONS An exercise therapy 3 times a week for 16 weeks in a warm pool could improve most of the symptoms of FM and cause a high adherence to exercise in unfit women with heightened FM symptomatology . The therapeutic intervention 's effects can be assessed through applicable tests in the clinical practice We aim ed to evaluate the effectiveness of balneotherapy in  fibromyalgia management .  Fifty women with fibromyalgia under pharmacological treatment were r and omly assigned to either the balneotherapy ( 25 ) or the control ( 25 ) group . Four patients from the balneotherapy group and one patient from the control group left the study after r and omization . The patients in the balneotherapy group ( 21 ) had 2 thermomineral water baths daily for 2 weeks in Tuzla Spa Center . The patients in the control group ( 24 ) continued to have their medical treatment and routine daily life . An investigator who was blinded to the study arms assessed the patients . All patients were assessed four times ; at the beginning of the study , at the end of the 2nd week , the 1st month , and the 3rd month after balneotherapy . Outcome measures of the study were pain intensity , Fibromyalgia Impact Question naire ( FIQ ) , Beck Depression Inventory ( BDI ) , patient ’s global assessment , investigator ’s global assessment , SF-36 scores , and tender point count .  Balneotherapy was found to be superior at the end of the cure period in terms of pain intensity , FIQ , Beck Depression Inventory , patient ’s global assessment , investigator ’s global assessment scores , and tender point count as compared to the control group . The superiority of balneotherapy lasted up to the end of the 3rd month , except for the Beck Depression Inventory score and the investigator ’s global assessment score . Significant improvements were observed in PF , GH , and MH subscales of SF-36 during the study period in the balneotherapy group ; however , no such improvement was observed in the control group . Balneotherapy was superior only in VT subscale at the end of therapy and at the end of the third month after the therapy as compared to the controls . It was concluded that balneotherapy provides beneficial effects in patients with fibromyalgia Evidence -based recommendations support the use of multimodal therapy and hydrotherapy for fibromyalgia syndrome ; however , there is little st and ardisation of such programmes . The aim of the study was to assess the effectiveness of a pool-based exercise using deep water running ( DWR ) as part of a multimodal physiotherapy programme for patients with fibromyalgia syndrome . For a non-r and omised clinical study , 44 patients diagnosed with fibromyalgia were recruited from primary care . Patients in the experimental group received a multimodal programme incorporating pool-based exercise using DWR three times a week for an 8-week period . The control group received a leaflet containing advice and continued with normal activities . Patients were evaluated for physical function ( Fibromyalgia Impact Question naire , FIQ ) , pain , general health ( Short Form-12 Health Survey ) and quality of life ( European Quality of Life Scale-5D ) pre- and post intervention . Statistically significant results were found for the experimental group for FIQ total score , incorporating physical function , pain , fatigue , stiffness and psychological variables ( p < 0.05 ) . Statistically significant differences between the experimental group and control were also found for general health ( p < 0.05 ) and quality of life ( p < 0.05 ) . The results of this pilot study and the high level of compliance and adherence and low level of attrition suggest that this multimodal programme incorporating DWR is a safe and effective intervention for fibromyalgia syndrome that is acceptable to patients BACKGROUND Fibromyalgia is a chronic pain syndrome associated with sleep disorders , fatigue and psychological symptoms . Combinations therapies , such as electrotherapy and therapeutic exercises have been used in the clinical practice . AIM To assess the efficacy of high-frequency transcutaneous electrical nerve stimulation ( TENS ) as an adjuvant therapy to aerobic and stretching exercises , for the treatment of fibromyalgia . DESIGN Controlled clinical trial . SETTING Unit of rehabilitation of a public hospital . POPULATION Twenty-eight women aged 52.4±7.5 years , with fibromyalgia . METHODS A visual analogue scale measured pain intensity ; tender points pain threshold , by dolorimetry ; and quality of life , by the Fibromyalgia Impact Question naire . All subjects participated in an eight-week program consisting of aerobic exercises , followed by static stretching of muscle chains . In TENS group , high-frequency ( 150 Hz ) was applied on bilateral tender points of trapezium and supraspinatus . RESULTS TENS group had a greater pain reduction ( mean change score=-2.0±2.9 cm ) compared to Without TENS group ( -0.7±3.7 cm ) . There was a difference between mean change scores of each group for pain threshold ( right trapezium : 0.2±1 kg/cm² in TENS group and -0.2±1.2 kg/cm² in Without TENS group ) . In the evaluation of clinical ly important changes , patients receiving TENS had relevant improvement of pain , work performance , fatigue , stiffness , anxiety and depression compared to those not receiving TENS . CONCLUSION It has suggested that high-frequency TENS as an adjuvant therapy is effective in relieving pain , anxiety , fatigue , stiffness , and in improving ability to work of patients with fibromyalgia . CLINICAL REHABILITATION IMPACT High-frequency TENS may be used as a short-term complementary treatment of fibromyalgia Objective : The aim of the present study is to evaluate the effectiveness of spa therapy in the management of  fibromyalgia .  Methods : Thirty women with fibromyalgia were r and omly assigned to either a spa therapy group or a control group . The spa therapy group ( n = 16 ) had spa treatment for 2 weeks in addition to their medical treatment . The control group ( n = 14 ) continued to have their medical treatment and /or daily exercises . An investigator who was blinded for the intervention assessed all the patients for 9 months . Improvements in Fibromyalgia Impact Question naire ( FIQ ) , pain and number of tender points were primary outcomes . Secondary outcome measures were improvement in sleep disturbance , fatigue , gastrointestinal symptoms , anxiety , Beck Depression Inventory and patient ’s global evaluation . Results : the spa group was found to be superior to the control group at the end of intervention in terms of FIQ , pain , tender point count , fatigue and patients ’ global assessment . This superiority remained for 6 months in FIQ , 1 month in pain and tender point count . Conclusion : It was concluded that the addition of spa therapy to medical therapy has both short- and long-term beneficial effects in female patients with fibromyalgia OBJECTIVES Group exercises may be useful in fibromyalgia syndrome ( FMS ) .  The ' Body movement and perception ' ( BMP ) method is based on low impact exercises , awareness of body perception and relaxation , aim ed at treating small groups of patients following the Resseguier method ( RM ) and integrating RM with exercises derived from soft gymnastics . We assessed the effects of BMP method on FMS . METHODS 40 women with FMS ( age and disease duration : 51.7±7.2 and 4.9±3.8 years ) participated in an open pilot study . BMP sessions were performer twice a week ( 50 minutes each ) for 8 weeks . Patients were assessed at enrolment ( T0 ) and at the end of the study ( T1 ) by a self-administered question naire ( temporal characteristics of pain , pain interference in working and recreational activities and in night-time rest , awareness of pain , fatigue , irritability , well-being , quality of movement , ability to focus on perception and to perceive whole body , postural selfcontrol , ability to relax ) and a clinical evaluation ( tender points , assumption of analgesics/NSAIDs , distribution of pain , pain in sitting and st and ing position , pain during postural passages and gait , postural body alignment , muscular contractures ) . RESULTS At T1 , FMS patients significantly improved with respect to T0 in pain , fatigue , irritability , well-being , quality of movement , postural self-control , ability to relax mind and body , movement perception , tender point scores , assumption of analgesic/NSAIDs , body alignment and muscle contractures ( p<0.05 for all the comparisons T1 versus T0 ) . CONCLUSIONS In FMS patients , rehabilitation with BMP  improves pain and well being , reduces the number of tender points and muscle contractures , thus it is useful in FMS management OBJECTIVE To test effectiveness of static magnetic fields of two different configurations , produced by magnetic sleep pads , as adjunctive therapies in decreasing patient pain perception and improving functional status in individuals with fibromyalgia . DESIGN R and omized , placebo-controlled , 6-month trial conducted from November 1997 through December 1998 . SETTING AND SUBJECTS Adults who met the 1990 American College of Rheumatology criteria for fibromyalgia were recruited through clinical referral and media announcements and evaluated at a university-based clinic . INTERVENTIONS Subjects in Functional Pad A group used a pad for 6 months that provided whole-body exposure to a low , uniform static magnetic field of negative polarity . Subjects in the Functional Pad B group used a pad for 6 months that exposed them to a low static magnetic field that varied spatially and in polarity . Subjects in two Sham groups used pads that were identical in appearance and texture to the functional pads but contained inactive magnets ; these groups were combined for analysis . Subjects in the Usual Care group continued with their established treatment regimens . OUTCOME MEASURES Primary outcomes were the change scores at 6 months in the following measures : functional status ( Fibromyalgia Impact Question naire ) , pain intensity ratings , tender point count , and a tender point pain intensity score . RESULTS There was a significant difference among groups in pain intensity ratings ( p = 0.03 ) , with Functional Pad A group showing the greatest reduction from baseline at 6 months . All four groups showed a decline in number of tender points , but differences among the groups were not significant ( p = 0.72 ) . The functional pad groups showed the largest decline in total tender point pain intensity , but overall differences were not significant ( p = 0.25 ) . Improvement in functional status was greatest in the functional pad groups , but differences among groups were not significant ( p = 0.23 ) . CONCLUSIONS Although the functional pad groups showed improvements in functional status , pain intensity level , tender point count , and tender point intensity after 6 months of treatment , with the exception of pain intensity level these improvements did not differ significantly from changes in the Sham group or in the Usual Care group OBJECTIVE To determine the level of improvement , as regards pain , impact on fibromyalgia and depression , achieved by patients with fibromyalgia by comparing aquatic biodanza and stretching exercises . DESIGN R and omised controlled trial with two intervention groups . LOCATION Five health centres ( Almeria ) . PATIENTS A total of 82 fibromyalgia patients between 18 and 65 years old , diagnosed by American College of Rheumatology criteria , were included , with 12 patients declining to take part in the study . The 70 remaining patients were r and omly assigned to two groups of 35 patients each : aquatic biodanza and stretching exercises .  Those who did not attend in at least 14 sessions or changed their treatment during the studio were excluded . The final sample consisted of 19 patients in aquatic biodanza group and 20 in stretching group . The limitations of the study included , the open evaluation design and a sample size reduced by defaults . MAIN MEASURES The outcome measures were sociodemographic data , quality of life ( Fibromyalgia Impact Question naire ) , pain ( McGill-Melzack question naire ; and Visual Analogue Scale ) , pressure algometry ( Wagner FPI10 algometer ) and depression ( Beck Inventory ) . These were carried out before and after a 12-week therapy . RESULTS The mean age of the sample was 55.41 years . The mean period from diagnosis was 13.44 years . The sample consisted mainly of housewives . There were significant differences ( P<.05 ) between groups , in pain ( P<.01 ) , fibromyalgia impact ( P<.01 ) , and depression ( P<.04 ) after the treatment . CONCLUSIONS The biodanza aquatic exercises improve pain and quality of life in fibromyalgia patients Non-invasive unilateral repetitive transcranial magnetic stimulation ( rTMS ) of the motor cortex induces analgesic effects in focal chronic pain syndromes , probably by modifying central pain modulatory systems . Neuroimaging studies have shown bilateral activation of a large number of structures , including some of those involved in pain processing , suggesting that such stimulation may induce generalized analgesic effects . The goal of this study was to assess the effects of unilateral rTMS of the motor cortex on chronic widespread pain in patients with fibromyalgia . Thirty patients with fibromyalgia syndrome ( age : 52.6 + /- 7.9 ) were r and omly assigned , in a double-blind fashion , to two groups , one receiving active rTMS ( n = 15 ) and the other sham stimulation ( n = 15 ) , applied to the left primary motor cortex in 10 daily sessions . The primary outcome measure was self-reported average pain intensity over the last 24 h , measured at baseline , daily during the stimulation period and then 15 , 30 and 60 days after the first stimulation . Other outcome measures included : sensory and affective pain scores for the McGill pain Question naire , quality of life ( assessed with the pain interference items of the Brief Pain Inventory and the Fibromyalgia Impact Question naire ) , mood and anxiety ( assessed with the Hamilton Depression Rating Scale , the Beck Depression Inventory and the Hospital Anxiety and Depression Scale ) . We also assessed the effects of rTMS on the pressure pain threshold at tender points ipsi- and contralateral to stimulation . Follow-up data were obtained for all the patients on days 15 and 30 and for 26 patients ( 13 in each treatment group ) on day 60 . Active rTMS significantly reduced pain and improved several aspects of quality of life ( including fatigue , morning tiredness , general activity , walking and sleep ) for up to 2 weeks after treatment had ended . The analgesic effects were observed from the fifth stimulation onwards and were not related to changes in mood or anxiety . The effects of rTMS were more long-lasting for affective than for sensory pain , suggesting differential effects on brain structures involved in pain perception . Only few minor and transient side effects were reported during the stimulation period . Our data indicate that unilateral rTMS of the motor cortex induces a long-lasting decrease in chronic widespread pain and may therefore constitute an effective alternative analgesic treatment for fibromyalgia Objective The aim of this study was to compare pool-based exercise and balneotherapy in fibromyalgia syndrome ( FMS ) patients . Methods Fifty female patients diagnosed with FMS according to the American College of Rheumatism ( ACR ) criteria were r and omly assigned to two groups : group 1 ( n=25 ) with pool-based exercise , and in group 2 ( n=25 ) balneotherapy was applied in the same pool without any exercise for 35 min three times a week for 12 weeks . In both groups , pre- ( week 0 ) and post-treatment ( weeks 12 and 24 ) evaluation was performed by one of the authors , who was blind to the patient group . Evaluation parameters included pain , morning stiffness , sleep , tender points , global evaluation by the patient and the physician , fibromyalgia impact question naire , chair test , and Beck depression inventory . Statistical analysis was done on data collected from three evaluation stages . Results Twenty-four exercise and 22 balneotherapy patients completed the study . Pretreatment ( week 0 ) measurements did not show any difference between the groups . In group 1 , statistically significant improvement was observed in all parameters ( P<0.01 ) except for the chair test at both weeks 12 and 24 . In group 2 , week 12 measurements showed significant improvement in all parameters ( P<0.01 ) except for the chair test and Beck depression inventory . Week 24 evaluation results in group 2 showed significant improvements in pain and fatigue according to visual analogue scale ( VAS ) , 5-point scale , number of tender points , algometric and myalgic scores , and patient and physician global evaluation ( P<0.01 and P<0.05 , respectively ) , while improvements were nonsignificant in morning stiffness , sleep , fibromyalgia impact question naire ( FIQ ) , chair test , and Beck depression inventory parameters in this group . Comparison of the two groups based on the post-treatment ( weeks 12 and 24 ) percent changes and difference scores relative to pretreatment ( week 0 ) values failed to show a significant difference between the groups for any parameter except Beck depression inventory ( P<0.01 ) . Conclusion The results of our study showed that pool-based exercise had a longer-lasting effect on some of the FMS symptoms , but statistical analysis failed to show a significant superiority of pool-based exercise over balneotherapy without exercise . While we believe that exercise is a gold st and ard in FMS treatment , we also suggest in light of our results that balneotherapy is among the valid treatment options in FMS , and further research regarding the type and duration of the exercise programs is necessary OBJECTIVE We studied whether whirl baths with plain water or with water containing pine oil or valerian have a different influence on  pain , disturbed sleep or tender point count . METHODS A r and omized , comparative and investigator-blinded study was performed . Out- patients with generalized fibromyalgia were r and omized into three treatment groups . INTERVENTIONS Therapy consisted of either whirl bath with plain water or with the addition of pine oil or valerian . The baths were carried out 10 times , three times a week . MAIN OUTCOME MEASURES General pain , change of pain intensity during the day , general well-being and occurrence of disturbed sleep were recorded before and after the therapy . The number of tender points was assessed by digital palpation , the pain threshold on the shinbone and the middle part of the deltoid muscle was measured by the dolorimeter of A. Fischer . The same instrument was used for recording pain threshold and pain tolerance of both trapezius muscles . The tissue compliance of these muscles was measured as well . RESULTS 30 out of 39 patients included in the study were evaluated statistically . After treatment with valerian bath ( n = 12 ) well-being and sleep were significantly improved and also the tender point count decreased significantly . Pine oil added to the bath water ( n = 7 ) result ed in a significant improvement of well-being , but unfortunately also in a significant decrease of pain threshold of the shinbone and the right deltoid muscle .  Whirl bath in plain water ( n = 11 ) reduced general and maximum pain intensity significantly . CONCLUSIONS Our cautious conclusion of this study is - with respect to the small number of treated patients - that different effects of whirl baths with or without medicinal bath oils can be detected in fibromyalgia patients .  Plain water baths modify the pain intensity , medicinal baths improve well-being and sleep OBJECTIVES In fibromyalgia syndrome ( FMS ) defined rehabilitation guidelines are yet to be vali date d. Our aim is to evaluate the efficacy of the Rességuier method ( RM ) in FMS . METHODS Forty-one patients were r and omly assigned to Interventional ( 22 pts ) and Observational ( 19 pts ) Group ( IG and OG ) . The study lasted 8 months . Patients were assessed at baseline ( T0 ) after a 2-month rehabilitation ( T1 ) and at a 6-month follow-up ( T2 ) ( only IG ) with SF-36 Physical ( PSI ) and Mental Synthetic Index ( MSI ) , Regional Pain Scale ( RPS ) , Fibromyalgia Impact Question naire ( FIQ ) , Number Rating Scales 0 - 10 to measure pain , movement quality , sleep , relax ability , analgesics number/per week . OG patients maintained their lifestyle for the duration of the study . RM aims to obtain patient awareness and control of bodily perceptions , thus reaching a modulation of responses to pain . Therapist controls patient attention and perception by verbal and manual contacts and leads them to perform bodily and respiratory active and conscious movements . RESULTS In IG , at T1 all items were improved : PSI and MSI ( p<0.001 and = 0.001 ) , FIQ ( p<0.0001 ) , RPS ( p<0.001 ) , pain ( p<0.0001 ) , movement quality ( p=0.001 ) , relax ability ( p<0.0001 ) , sleep ( p<0.001 ) ; analgesics number/per week was reduced ( p<0.001 ) . All results obtained at T1 , except FIQ , were maintained at T2 . In OG at T1 versus T0 , no difference in any of the assessed parameters was observed . CONCLUSION In FMS patients , the rehabilitation with RM  improves HRQoL , FMS-related disability and perceived pain , thus reducing the assumption of analgesics
CONCLUSION Study data confirms that spa therapy could improve the symptoms of fibromyalgia including pain , depression and minor symptoms
BACKGROUND Fibromyalgia is characterized by chronic widespread pain , tenderness at muscle and tendon insertions point when digital pressure is applied , sleep disorders , chronic fatigue , depressive episodes , anxiety , and other functional somatic syndromes .
OBJECTIVE The aim of this study was to determine whether balneotherapy with mineral waters and mineral-water containing mud is effective in the management of  fibromyalgia .