Physical Modalities for the Treatment of Pain in Patients with Fibromyalgia.

Generalised pain is the major symptom in patients with fibromyalgia. The management of pain includes both pharmacological and non-pharmacological options. Exercise, meditative movement therapies and mindfulness-based stress reduction are examples of non-pharmacological treatments. Over the last decades, there is growing evidence regarding the role of physical modalities in the management of fibromyalgia-related pain. Physical modalities demonstrate their effects by using several energy types such as electrical, thermal, acoustic, or radiant energy. They may act through the alteration of blood flow, cellular activity, and nerve excitability. By reviewing the recent literature, the current article aimed to provide a comprehensive insight to the potential effects of physical modalities in the treatment of fibromyalgia-related pain. Evidence regarding the potential therapeutic role of transcutaneous electrical nerve stimulation, interferential current, therapeutic ultrasound, non-invasive brain stimulation techniques (e.g. transcranial direct current stimulation, transcranial magnetic stimulation), photobiomodulation therapy [e.g. Light Amplification by Stimulated Emission of Radiation (LASER)], the use of therapeutic cold (e.g. whole-body cryotherapy) was discussed.