Author details

studies demonstrated improvements after 6 months compared to baseline in patients with FM. However, the studies had significant methodological issues and variability [94]. Tai Chi is another mind-body technique with specific movements. A meta-analysis that included seven studies evaluated Tai Chi for FM that showed improvements in some symptoms [89, 95].

In the revised recommendations of EULAR for managing FM, there were six reviews focusing on qigong, yoga, Tai Chi, or a combination of them. However, there was inadequate evidence for individual recommendations. EULAR proposes meditative movement as weak [10].

There were 6 reviews that included 13 trials and 1209 participants about mindfulness/mindbody therapy in the EULAR revised recommendations. One recent review provided evidence that mindfulness-based stress reduction resulted in improvements in pain compared with usual care. However, these effects were considered to be biased. EULAR proposes mindfulness/

Although hypnosis is one of the oldest therapies for pain, interest in hypnosis for controlling chronic pain rose only in the last decade. Hypnosis is defined as a state of consciousness involving focused attention and reduced peripheral awareness and is characterized by an enhanced capacity for response to suggestion [96]. Imagery is defined as a dynamic, psychophysiological process in which a person imagines and experiences an internal reality in the absence of external stimuli. These images can be initiated by the patient or guided by a therapist. In a systematic review conducted on evaluating the efficacy, acceptability and safety of guided imagery/hypnosis (GI/H) in FM, randomized-controlled trials comparing GI/H with controls were analyzed. The main outcomes were ≥50% pain relief, ≥20% improvement of health-related quality of life, psychological distress, disability, acceptability and safety at the end of therapy and a 3-month follow-up. There were 7randomized controlled trials (RCTs) with 387 subjects that were included into a comparison of GI/H vs. controls. There was a benefit from GI/H compared to the controls at the end of the therapy [97]. In the revised recommendations of EULAR for

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

managing FM, hypnotherapy evaluation was considered weak [10].

mind-body therapy as weak [10].

46 Discussions of Unusual Topics in Fibromyalgia

7. Conclusion

6.4. Guided imagery/hypnotherapy

Fatmanur Aybala Koçak and Emine Eda Kurt\*

\*Address all correspondence to: eedakurt@gmail.com

Medical Faculty, Department of Physical Medicine and Rehabilitation, Ahi Evran University, Kırşehir, Turkey
