SYSTEMATIC REVIEW article
Front. Med.
Sec. Rheumatology
This article is part of the Research TopicTherapeutic Strategies: Rehabilitation, Complementary and Alternative Therapies for Musculoskeletal DiseasesView all 7 articles
Acupuncture for fibromyalgia syndrome: An overview of systematic reviews and meta-analyses
Provisionally accepted
- Korea Institute of Oriental Medicine (KIOM), Daejeon, Republic of Korea
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Objective: Numerous systematic reviews (SRs) and meta-analyses (MAs) have investigated the clinical effectiveness of acupuncture therapy (AT) for fibromyalgia syndrome (FMS). This study aimed to evaluate the methodological quality and strength of evidence in published SRs and MAs on the efficacy and safety of AT for FMS. Methods: A comprehensive literature search was conducted in 11 databases up to May 2025. Two reviewers independently selected studies, extracted data, and assessed methodological quality using A MeaSurement Tool to Assess systematic Reviews-2 (AMSTAR-2), reporting quality via Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 and certainty of evidence with Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Results: Thirteen SRs and MAs were included. According to AMSTAR-2, only one SR and MA was rated high quality, three were moderate, and eight were low or critically low, respectively. Following the PRISMA guidelines, five SRs demonstrated compliance >85%. No high-quality evidence with GRADE assessment was found. The overall quality of evidence in the included SRs ranged from “very low” to “moderate.” AT was found to be superior to sham AT or standard pharmacological therapies (SPT) in treating FMS and pain. Evidence from 10 SRs (collectively reporting on 63 outcomes) indicated that AT provided superior pain relief than sham AT or medication. AT was more effective than sham AT (Visual Analog Scale; mean difference [MD] -1.04 [-1.70, -0.38], p = 0.002) and SPT (MD -1.77 [-2.10, -1.44], p < 0.00001) in reducing pain. It also showed significantly better long-term pain relief (standard mean difference [SMD] 0.40 [-0.77, -0.03], p = 0.03), lower Fibromyalgia Impact Questionnaire scores (SMD -0.69 [-0.91, -0.47], p < 0.00001), reduced fatigue (SMD -0.03 [-0.42, 0.35], p = 0.87), reduced number of tender points (SMD -2.38 [-3.40, -1.37], p < 0.00001), and increased pain pressure threshold (SMD 0.31 [0.02, 0.61], p = 0.04). No adverse effects attributed to AT were reported. Conclusion: The current SRs and MAs provide low-quality evidence for the effectiveness of AT in treating FMS. Robust and well-designed studies using standardized methods are needed to provide more reliable and convincing evidence. Registration: PROSPERO (CRD42024536968)
Keywords: Acupuncture therapy (AT), Fibromyalgia syndrome (FMS), pain relief, GRADE assessment, Systematic review, Meta-analysis
Received: 24 Sep 2025; Accepted: 21 Nov 2025.
Copyright: © 2025 Choi, Jun, Lee and Lee. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Tae Young Choi, superoung@gmail.com
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