Lynchburg Journal of Medical Science

Lynchburg Journal of Medical Science


Family Practice


Dr. Thomas Colletti, DHSc, PA-C, DFAAPA




The objective of this systemic review is to get a better understanding of the best treatment option for pain associated with fibromyalgia (FM) in the primary care setting for adults.


This is a systemic review of multiple randomized trials and meta-analysis associated with the study of FDA approved medications for FM; pregabalin, duloxetine, milnacipran, and a non-pharmaceutical treatment option of acupuncture vs sham to identify the best treatment option for pain associated with FM. Searches for appropriate articles produced three articles dealing with FDA approved pharmaceutical treatment and three were associated with acupuncture vs sham treatments.


All studies noted an improvement of pain vs baseline with duloxetine as a favorite FDA choice over Pregabalin or Milnacipran and actual acupuncture over sham acupuncture. It was difficult to address the treatment of choice over duloxetine vs actual acupuncture secondary to not having comparable statistics. However, an overview of all the contributing factors such as adverse effects (AEs), tolerability, and safety; acupuncture is a better choice in the treatment of pain in FM patients.


As a major issue in FM patients, the treatment options for pain are plentiful but not all treatments are created equal. This paper shows several options for the treatment of pain in patients with FM and though most show improvements of pain there are some clear winners.


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