A pilot study of complementary and alternative medicine use in patients with fibromyalgia syndrome

  • Geoffrey C. Wall
  • Linda L. Krypel
  • Michael J. Miller
  • Derek M. Rees
Keywords: Fibromyalgia, Complementary Therapies, United Stated


Fibromyalgia syndrome (FMS) is a complex disorder, with primary symptoms of sleep disturbances, pain, and fatigue. FMS is one of the most common reasons for patient visits to a rheumatologist. Previous studies have suggested that complementary and alternative medicine (CAM) use in patients with rheumatic diseases is common, but such data specific to FMS patients is limited.

Objective: The following study sought to describe the prevalence of CAM use in a primary care practice of patients with FMS and assess whether these patients discuss CAM use with their physician, physician-extender, and/or pharmacist.

Methods: A one-group cross-sectional survey design was implemented in a large, community-based, private physician practice of patients diagnosed with FMS.  A self-administered questionnaire was distributed during clinic visits. It solicited information related to demographic characteristics; FMS-specific health background; whether CAM use had been discussed with a health care provider; and the “ever-use” of common types of CAM. Respondents returned the questionnaire via US mail in a postage-paid, self-addressed envelope.

Results: A total of 115 surveys were distributed with 54 returned for analysis (47% completion rate). The sample was predominantly female, well educated and had a mean age of 55.6 years. All respondents were White. Most respondents (92.6%) reported using some type of CAM. Exercise (92.2%), chiropractic treatment (48.1%), lifestyle and diet (45.8%), relaxation therapy (44.9%), and dietary and herbal supplements (36.5%) were most commonly reported CAM therapies “ever-used” by respondents. Dietary and herbal supplements with the highest prevalence of “ever-use” were magnesium (19.2%), guaifenesin (11.5%), and methylsulfonylmethane (MSM) (9.6%). Respondents most commonly discussed CAM with the clinic rheumatologist and the primary care physician (53.7% and 38.9%, respectively). Only 14.8% of respondents discussed CAM with a pharmacist. However, a significantly higher proportion of respondents who “ever-used” dietary and herbal supplements discussed CAM with a pharmacist compared to those who never used dietary and herbal supplements [chi square=6.03, p=0.014].

Conclusion:  This pilot study suggests that CAM use is common in patients diagnosed with FMS. Compared to other healthcare providers, respondents were least likely to discuss CAM with a pharmacist.  However, respondents who used dietary and herbal supplements were more likely to discuss CAM with a pharmacist compared to those who did not, suggesting the potential influence of pharmacist intervention.


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1. Doron Y, Peleg R, Peleg A, Neumann L, Buskila D. The clinical and economic burden of fibromyalgia compared with diabetes mellitus and hypertension among Bedouin women in the Negev. Fam Pract. 2004; 21:415-9.

2 Robinson RL, Birnbaum HG, Morley MA, Sisitsky T, Greenberg PE, Claxton AJ. Economic cost and epidemiological characteristics of patients with fibromyalgia claims. J Rheumatol. 2003;30:1318-25.

3 Solomon DH, Liang MH. Fibromyalgia: scourge of humankind or bane of a rheumatologist's existence? Arthritis Rheum. 1997 ;40:1553-5.

4 Littlejohn GO, Walker J. A realistic approach to managing patients with fibromyalgia. Curr Rheumatol Rep. 2002 ;4:286-92.

5 Rao JK, Mihaliak K, Kroenke K, Bradley J, Tierney WM, Weinberger M. Use of Complementary Therapies for Arthritis among Patients of Rheumatologists Ann Intern Med. 1999;131:409-416.

6 Mannel M. Drug Interactions with St John's Wort : Mechanisms and Clinical Implications. Drug Saf. 2004;27:773-97.

7 Barbour C. Use of complementary and alternative treatments by individuals with fibromyalgia syndrome. J Am Acad Nurse Pract. 2000;12:311-6.

8 StataCorp. (2003). Stata Statistical Software: Release 8.0. College Station, TX: Stata Corporation.

9 Wahner-Roedler DL, Elkin PL, Vincent A, Thompson JM, Oh TH, Loehrer LL, et al. Use of complementary and alternative medical therapies by patients referred to a fibromyalgia treatment program at a tertiary care center. Mayo Clin Proc. 2005 Jan;80(1):55-60.

10 Sarac AJ, Gur A. Complementary and alternative therapies in fibromyalgia. Curr Pharm Des. 2006;12:47-57.

11 Russell IJ, Michalek JE, Flechas JD, Abraham GE. Treatment of fibromyalgia syndrome with Super Malic: a randomized, double blind, placebo controlled, crossover pilot study. J Rheumatol. 1995;22:953-8.

12 Bennett RM, DeGarmo P, Clark SR A 1 year double blind placebo-controlled study of guaifenesin in fibromyalgia". Arthritis and Rheumatism 1996;39: S212.

13 Rao JK, Mihaliak K, Kroenke K, Bradley J, et al. Use of complementary therapies for arthritis among patients of rheumatologists. Ann Intern Med. 1999;131:409-16.

14 Visser GJ, Peters L, Rasker JJ. Rheumatologists and their patients who seek alternative care: an agreement to disagree. Br J Rheumatol. 1992;31:485-90.

15 Vecchio PC. Attitudes to alternative medicine by rheumatology outpatient attenders. J Rheumatol. 1994;21:145-7.
How to Cite
Wall GC, Krypel LL, Miller MJ, Rees DM. A pilot study of complementary and alternative medicine use in patients with fibromyalgia syndrome. Pharm Pract (Granada) [Internet]. 2007Nov.22 [cited 2020Jul.10];5(4):185-90. Available from: https://pharmacypractice.org/journal/index.php/pp/article/view/242
Original Research