Abstract
BACKGROUND: Fibromyalgia syndrome (FMS) is a common condition in rheumatology that affects patients' physical and mental health. Some studies have demonstrated the efficacy of acupuncture in alleviating pain in patients with FMS, but there is still insufficient evidence to support the improvement of pain and associated symptoms in FMS patients through acupuncture. Therefore, this study investigates whether acupuncture has therapeutic effects on patients with FMS. METHODS: We searched 8 databases to identify randomized controlled trials (RCTs) evaluating acupuncture interventions for FMS. We used ROB 2.0 tool to assess the risk of bias in selected studies. Heterogeneity among the studies was detected using the I (2) test. Identifying sources of heterogeneity using subgroup analysis. Sensitivity analysis was performed to assess the stability of the results. Meta-analysis was performed using Stata 15.1. RESULTS: 17 RCTs involving 1,066 patients were included. Meta-analysis results showed that the intervention group had significantly lower VAS scores (SMD: -0.77; 95% CI: -1.00, -0.55), FIQ scores (SMD: -0.98; 95% CI: -1.43, -0.53), and the number of pain points (SMD: -1.36; 95% CI: -1.65, -1.08). It also improved depression and fatigue (SMD: -0.78; 95% CI: -1.10, -0.47) and fatigue (SMD: -0.51; 95% CI: -0.72, -0.30), P < 0.05, but did not significantly improve sleep quality (P > 0.05). CONCLUSIONS: Acupuncture can reduce pain, improve depression and fatigue, and overall lower FIQ scores in the treatment of FMS. These findings require further confirmation through larger-scale, high-quality studies. SYSTEMATIC REVIEW REGISTRATION: Identifier CRD20251120515.