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Impact of water therapy on pain management in patients with fibromyalgia: current perspectives

Authors Zamunér AR, Andrade CP, Arca EA, Avila MA

Received 15 August 2018

Accepted for publication 20 May 2019

Published 3 July 2019 Volume 2019:12 Pages 1971—2007

DOI https://doi.org/10.2147/JPR.S161494

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 5

Editor who approved publication: Dr Erica Wegrzyn


Antonio Roberto Zamunér,1 Carolina Pieroni Andrade,2 Eduardo Aguilar Arca,3 Mariana Arias Avila4

1Departamento de Kinesiología, Universidad Católica del Maule, Talca, Maule, Chile; 2Secretaria de Saúde do Município de Guareí, Guareí, São Paulo, Brasil; 3Departamento de Fisioterapia, Universidade do Sagrado Coração, Bauru, São Paulo, Brasil; 4Departamento de Fisioterapia e Programa de Pós-Graduação em Fisioterapia, Universidade Federal de São Carlos, São Carlos, São Paulo, Brasil

Abstract: Exercise-related interventions have been recommended as one of the main components in the management of fibromyalgia syndrome (FMS). Water therapy, which combines water’s physical properties and exercise benefits, has proven effective in improving the clinical symptoms of FMS, especially pain, considered the hallmark of this syndrome. However, to our knowledge, the mechanisms underlying water therapy effects on pain are still scarcely explored in the literature. Therefore, this narrative review aimed to present the current perspectives on water therapy and the physiological basis for the mechanisms supporting its use for pain management in patients with FMS. Furthermore, the effects of water therapy on the musculoskeletal, neuromuscular, cardiovascular, respiratory, and neuroendocrine systems and inflammation are also addressed. Taking into account the aspects reviewed herein, water therapy is recommended as a nonpharmacologic therapeutic approach in the management of FMS patients, improving pain, fatigue, and quality of life. Future studies should focus on clarifying whether mechanisms and long-lasting effects are superior to other types of nonpharmacological interventions, as well as the economic and societal impacts that this intervention may present.

Keywords: hydrotherapy, exercise, pain management, chronic pain, physical therapy, aquatic therapy

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