7. Conclusion

FM is a common musculo-skeletal disorder and is otherwise known by unexplained chronic widespread pain, a lower pain threshold, high tender point count (tenderness on examination at specific, predictable anatomic sites known as tender points), sleep disturbances, fatigue, headache, irritable bowel syndrome, morning stiffness, paresthesia of the extremities, frequent psychological distress, and depressed mood [98]. For these reasons, FM has a negative effect on work capacity, family life, social functions, and life quality [7]. Typically, management of fibromyalgia is multidisciplinary. Furthermore, the treatment of the patients must be organized individually after the detailed examination. There are many nonpharmacologic treatment options available in the treatment of fibromyalgia. When this disease is thought to last for a lifetime, increasing the quality of life of patients should be the primary goal. It should concentrate first on nonpharmacologic modalities. This is in view of accessibility, cost, safety and patient preference. It is considered that in addition to the existing standard treatment modality of the patient, the treatment may be more efficient and the burden of medication might be reduced with the selection of the best nonpharmacologic treatment option for the patient.

Among these nonpharmocologic treatment methods, exercise therapy, balneotherapy, cognitive behavioral therapies, acupuncture, and meditative movement/mindfulness/mind-body therapies are more effective treatment methods according to the evidence-based medicine approach. These are summarized in Table 1. In case of severe disability, combination therapies should be performed.


\*According to the evidence-based results of guidelines, systematic reviews and meta-analyses.

Table 1. Most effective\* nonpharmacological therapies for fibromiyalgia.
