Fibromyalgia is a frequent chronic pain syndrome with a complex physiopathology.
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Non-drug therapies are recommended as first-line treatment.
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Three-week spa therapy with standardized treatments is frequently prescribed in France.
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Spa therapy improved long-term fibromyalgia-specific quality of life.
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Spa therapy also improved pain and fatigue, and reduced drug consumption.
Abstract
Fibromyalgia is a common chronic pain pathology with an incidence of 4.3 per 1,000 person-years. An open, randomized clinical trial of patients with fibromyalgia comparing an immediate vs. delayed 18-day spa therapy in five spa therapy care facilities in France enrolled 220 patients. Randomization was in blocks of four, stratified by center, severity of fibromyalgia and previous spa therapy. Patients continued usual treatment. The main endpoint was the number of patients achieving minimal clinically important difference at 6 months, defined as 14% change in their baseline fibromyalgia impact questionnaire score. The intention-to-treat analysis included 100 and 106 patients in the intervention and control groups, respectively. At 6 months, 45/100 (45.0%) and 30/106 (28.3%) patients in the intervention and control groups, respectively, achieved a minimal clinically important difference (P= .013). There was also a significant improvement in pain, fatigue, and symptom severity (secondary outcomes) in the intervention group but not for generic quality of life (QOL), sleep or physical activity. None of the 33 serious adverse events reported by 25 patients were related to the spa therapy. Our results demonstrate the benefit of spa treatment in patients with fibromyalgia.
Perspective
A 12-month, open, randomized clinical trial of 220 patients with fibromyalgia compared an immediate versus delayed (ie, after 6 months) 18-day spa therapy. The results showed a clinically significant improvement at 6 months for those who received immediate therapy which was maintained up to 12 months.
Trial registration number
ClinicalTrials.gov: NCT02265029
Key Words
Fibromyalgia
spa treatment
pain measurement
patient satisfaction
treatment outcome
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Disclosures
Funding: This work was supported by the Association Française pour la Recherche Thermale (AFRETH), a nonprofit organization.
Conflict of interests: None of the authors have competing interests to declare, except Christian Roques who is President of the Association Française pour la Recherche Thermale (AFRETH) Scientific Committee.
