Fibromyalgia is a chronic pain condition characterised by prolonged and widespread general pain and tenderness, sleep disturbances and fatigue. The pain is felt mainly in the muscles, but also joint pain occurs. Pain sensitivity is also increased, which means that things that usually do not hurt for healthy people is perceived as painful for someone with the condition. Fibromyalgia affects approximately 2–6% of the population, of which 80 percent are women.
What is the effect of dietary interventions in fibromyalgia?
|* One study is included in both systematic reviews.
RCT = Randomized Controlled Trial, CCT = Controlled Clinical Trial (non-randomized); UCT = Uncontrolled Clinical Trial
FODMAPs = Low Fermentable Oligo-. Di- and Monossacharides, Alcohols and Polyols
|Silva et al 2019 |
|7 included studies
(3 RCT, 1 CCT, 3 UCT)
|Patients with fibromyalgia diagnosed according to American College of Rheumatology (ACR) criteria revised in 2010
Dietary intervention (dietary supplementation was not included)
|Primary patient-reported outcome (PRO):
Pain and functional repercussion
Fatigue, quality of sleep, quality of life, anxiety and depression, gastrointestinal symptoms, and inflammation biomarkers
“Pain and functional repercussion in fibromyalgia patients seem to improve with a hypocaloric diet, a raw vegetarian diet or a low FODMAPs diet. Other PROs, such as quality of life, quality of sleep, anxiety and depression and inflammatory biomarkers also showed a significant improvement with these interventions. However, due to the low quality of the included studies, these promising results should be interpreted with caution, and no quantitative and objective conclusions should be drawn.”
|Joustra et al 2017* |
|32 observational studies
1 RCT + observational data
2 RCT + observational data
(45 studies in total for FMS and chronic fatigue syndrome)
|Patients with fibromyalgia (FMS) according to official diagnostic criteria
Vitamin and mineral supplements
|Vitamin or mineral status, clinical parameters including symptom severity and quality of life|
“We found little evidence to support our hypothesis that vitamin and mineral deficiencies play a role in the pathophysiology of […] FMS, or that the use of nutritional supplements is effective in these patients. Poor study quality and considerable heterogeneity in most studies was found, which makes it difficult to reach a final conclusion.”
|Straube et al 2015* |
|1 study on fibromyalgia
(10 studies in total on different chronic pain conditions)
|Studies of adults with all types of chronic pain conditions (including fibromyalgia)
Vitamin D supplementation
Patient-reported clinically significant pain relief
Other patient-rated pain outcomes, adverse events, withdrawals, quality of life
“There is no evidence that vitamin D supplementation reduces pain in people with chronic pain. Treating chronic pain with vitamin D is unlikely to have any benefit, or be cost effective.”
SBU Enquiry Service consists of systematic literature searches to highlight studies that can address questions received by the SBU Enquiry Service from Swedish healthcare or social service providers. Relevant references are compiled by an SBU staff member, in consultation with an external expert when needed. The quality of the studies identified is not systematically reviewed.
|Registration no:||SBU 2018/519|
Laura Lintamo and Sara Fundell at SBU.