title: Massage therapy for fibromyalgia: a systematic review and meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  Although some studies evaluated the effectiveness of massage therapy for fibromyalgia (FM), the role of massage therapy in the management of FM remained controversial.
  
  
  OBJECTIVE
  The purpose of this systematic review is to evaluate the evidence of massage therapy for patients with FM.
  
  
  METHODS
  Electronic databases (up to June 2013) were searched to identify relevant studies. The main outcome measures were pain, anxiety, depression, and sleep disturbance. Two reviewers independently abstracted data and appraised risk of bias. The risk of bias of eligible studies was assessed based on Cochrane tools. Standardised mean difference (SMD) and 95% confidence intervals (CI) were calculated by more conservative random-effects model. And heterogeneity was assessed based on the I(2) statistic.
  
  
  RESULTS
  Nine randomized controlled trials involving 404 patients met the inclusion criteria. The meta-analyses showed that massage therapy with duration ≥ 5 weeks significantly improved pain (SMD, 0.62; 95% CI 0.05 to 1.20; p = 0.03), anxiety (SMD, 0.44; 95% CI 0.09 to 0.78; p = 0.01), and depression (SMD, 0.49; 95% CI 0.15 to 0.84; p = 0.005) in patients with FM, but not on sleep disturbance (SMD, 0.19; 95% CI -0.38 to 0.75; p = 0.52).
  
  
  CONCLUSIONS
  Massage therapy with duration ≥ 5 weeks had beneficial immediate effects on improving pain, anxiety, and depression in patients with FM. Massage therapy should be one of the viable complementary and alternative treatments for FM. However, given fewer eligible studies in subgroup meta-analyses and no evidence on follow-up effects, large-scale randomized controlled trials with long follow-up are warrant to confirm the current findings.
authors.affiliation: Department of Rehabilitation, Liaocheng People's Hospital, Liaocheng, Shandong, China.
authors.forename: Yan-hui
authors.initials: YH
authors.lastname: Li
authors.affiliation: Department of Rehabilitation, Liaocheng People's Hospital, Liaocheng, Shandong, China.
authors.forename: Feng-yun
authors.initials: FY
authors.lastname: Wang
authors.affiliation: Department of Rehabilitation, Liaocheng People's Hospital, Liaocheng, Shandong, China.
authors.forename: Chun-qing
authors.initials: CQ
authors.lastname: Feng
authors.affiliation: Department of Rehabilitation, Liaocheng People's Hospital, Liaocheng, Shandong, China.
authors.forename: Xia-feng
authors.initials: XF
authors.lastname: Yang
authors.affiliation: Department of Rehabilitation, Liaocheng People's Hospital, Liaocheng, Shandong, China.
authors.forename: Yi-hua
authors.initials: YH
authors.lastname: Sun
mesh_terms: D000529:Complementary Therapies; D005356:Fibromyalgia / Q000517:prevention & control / Q000628:therapy*; D006801:Humans; D008405:Massage / Q000379:methods*; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic