Buscar en
Revista Colombiana de Reumatología
Toda la web
Inicio Revista Colombiana de Reumatología Acupuntura en el manejo complementario de la fibromialgia
Información de la revista
Vol. 19. Núm. 1.
Páginas 27-39 (Marzo 2012)
Descargar PDF
Más opciones de artículo
Vol. 19. Núm. 1.
Páginas 27-39 (Marzo 2012)
DOI: 10.1016/S0121-8123(12)70037-3
Acceso a texto completo
Acupuntura en el manejo complementario de la fibromialgia
Acupuncture as complementary treatment of fibromyalgya
Nelly Rodríguez Martínez1,
Autor para correspondencia

, Mauricio Ángel Macías1
1 Maestría en Medicina Alternativa. Facultad de Medicina. Universidad Nacional de Colombia. Bogotá, Colombia
Información del artículo

La fibromialgia es una entidad clínica que se presenta con frecuencia en la población y cuyo tratamiento, a pesar de los avances de la medicina moderna, no ha controlado la enfermedad; por este motivo se hace necesaria la búsqueda de nuevas herramientas terapéuticas. La acupuntura es una medicina alternativa que viene siendo aplicada con utilidad en el manejo integral de los pacientes con fibromialgia. Esta práctica ha mostrado ejercer acciones en el nivel molecular y del funcionamiento del sistema nervioso central que permiten pensar en la plausibilidad y utilidad del tratamiento como complemento al tratamiento convencional. Desde el modelo de la medicina basada en la evidencia ya han comenzado a realizarse estudios; aun los resultados son contradictorios, y es por ello que se deben desarrollar más ensayos clínicos de buena calidad metodológica y con métodos apropiados, que permitan en su desarrollo la adecuada aplicación de la acupuntura desde el entendimiento clínico de la medicina tradicional china.

Palabras clave:
medicina alternativa/complementaria

Fibromyalgia is a clinical condition that occurs frequently in the population and whose treatment despite the advances of modern medicine has not controlled the disease, which is why it is necessary to search for new therapeutic tools. Acupuncture is an alternative medicine that has been applied usefully in the comprehensive management of patients with fibromyalgia. This practice has been shown to exert actions at the molecular level and the central nervous system function which suggest the plausibility and utility of treatment as an adjunct treatment to conventional therapy. From evidence-based medicine model have begun to perform studies, although the results are contradictory, and therefore to be developed further clinical trials of good methodological quality and appropriate methods that allow in its development proper application of acupuncture from the clinical understanding of traditional chinese medicine.

Key words:
alternative/complementary medicine
El Texto completo está disponible en PDF
B.M. Solitar.
Fibromyalgia: knowns, unknowns, and current treatment.
Bull NYU Hosp Jt Dis, 68 (2010), pp. 157-161
W.R. Gowers.
A lecture on lumbago: its lessons and analogues: delivered at the national hospital for the paralysed and epileptic.
Br Med J, 1 (1904), pp. 117-121
H. Moldofsky.
Rheumatic manifestations of sleep disorders.
Curr Opin Rheumatol, 22 (2010), pp. 59-63
M.B. Yunus.
Central sensitivity syndromes: a new paradigm and group nosology for fibromyalgia and overlapping conditions, and the related issue of disease versus illness.
Semin Arthritis Rheum, 37 (2008), pp. 339-352
K. Kato, P.F. Sullivan, B. Evengard, N.L. Pedersen.
Chronic widespread pain and its comorbidities: A populationbased study.
Arch Intern Med, 166 (2006), pp. 1649-1654
J.L. Shaver.
Fibromyalgia syndrome in women.
Nurs Clin North Am, 39 (2004), pp. 195-204
D. Buskila.
Developments in the scientific and clinical understanding of fibromyalgia.
Arthritis Res Ther, 11 (2009), pp. 242
K.P. White, M. Harth.
Classification, epidemiology, and natural history of fibromyalgia.
Curr Pain Headache Rep, 5 (2001), pp. 320-329
L.M. Arnold, D.J. Clauw, B.H. McCarberg.
For the Fibro- Collaborative Improving the Recognition and Diagnosis of Fibromyalgia.
Mayo Clin Proc, 86 (2011),
F. Wolfe, D.J. Clauw, M.A. Fitzcharles, D.L. Goldenberg, R.S. Katz, P. Mease, et al.
The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity.
Arthr Care Res, 62 (2010), pp. 600-610
K. Lawson.
Pharmacological treatments of fibromyalgia: do complex conditions need complex therapies?.
Drug Discov Today, 13 (2008), pp. 333-340
D.J. Clauw.
Kelley's Reumatologia, pp. 417-427
M.A. Morales Osoria, J.M. Mejía Mejía, E. Reyes Sanmiguel.
Síndrome fibromiálogico: tratamiento multidiscliplinario según evidencia.
Revista Colombiana de Reumatologia, 17 (2010), pp. 231-244
A. Winkelmann, S. Perrot, C. Schaefer, K. Ryan, A. Chandran, A. Sadosky, et al.
Impact of fibromyalgia severity on health economic costs: results from a European cross-sectional study Impact of fibromyalgia severity on health economic costs: results from a European cross-sectional study.
Appl Health Econ Health Policy, 9 (2011), pp. 125-136
L. Eshkevari.
Acupuncture and pain: a review of the literature.
AANA J, 71 (2003), pp. 361-370
N. Wiseman, Ye. Fang.
A Practical Dictionary of Chinese Medicine Paradigm Pbns.
Massachusets, (1998),
S. Pei-Lin, L. Vangermeersch.
Classification of Bi syndrome.
J Trad Chin Med, 47 (1995), pp. 8-14
D.J. Clauw.
Fibromyalgia: more than just a musculoskeletal disease.
Am Fam Physician, 52 (1995), pp. 843
J.I. Hudson, M.S. Hudson, L.F. Pliner, D.L. Goldenberg, H.G. Pope Jr..
Fibromyalgia and major affective disorder: a controlled phenomenology and family history study.
Am J Psychiatry, 142 (1985), pp. 441-446
M. Offenbaecher, B. Bondy, S. de Jonge, et al.
Possible association of fibromyalgia with a polymorphism in the serotonin transporter gene regulatory region.
A.G. Nackley, K.S. Tan, K. Fecho, et al.
Catechol-Omethyltransferase inhibition increases pain sensitivity through activation of both beta2- and beta3-adrenergic receptors.
P.B. Wood, J.C. Patterson 2nd, J.J. Sunderland, et al.
Reduced presynaptic dopamine activity in fibromyalgia syndrome demonstrated with positron emission tomography: a pilot study.
L.J. Crofford.
Neuroendocrine abnormalities in fibromyalgia and related disorders.
Am J Med Sci, 315 (1998), pp. 359
B.S. McEwen.
Allostasis and allostatic load: implications for neuropsychopharmacology.
Neuropsychopharmacology, 22 (2000), pp. 108-124
M. Di Franco, C. Lannuccelli, G. Valesini.
Neuroendocrine immunology of fibromyalgia.
Ann New York Acad Sci, 1193 (2010), pp. 84-90
B.S. McEwen, M. Kalia.
The role of corticosteroids and stress in chronic pain conditions.
Metabolism, 59 (2010), pp. S9-S15
R.M. Salpolski, M. Romero, A.V. Munck.
How do glucocorticoids influence stress responses? Integrating, permissive, suppressive, stimulatory and preparative actions.
Endocrine Reviews, 21 (2000), pp. 55-89
W.C. Clark, J.C. Yang, M.N. Janal.
Altered pain and visual sensitivity in human: the effects of acute and chronic stress.
Ann NY Acad Sci, 467 (1986), pp. 116-129
R. Geenen, J.W.J. Bijlsma.
Deviations in the endocrine system and brain of patients with fibromyalgia: cause or consequence of pain and associated features?.
Ann New York Acad Sci, 1193 (2010), pp. 98-110
E.N. Griep, J.W. Boersma, E.R. Dekloet.
Altered reactivity of the hypothalamic-pituiatry-adrenal axis in the primary fibromyalgia syndrome.
J Rheumatol, 20 (1993), pp. 469-474
R. Geenen, J.W.G. Jacobs, J.W.J. Bijlsma.
A psychoneuroendocrine perspective on the management of fibromyalgia syndrome.
J Musculoskelet Pain, 17 (2009), pp. 178-188
D.J. Wallace, K. Margolin, P. Waller.
Fibromyalgia and interleukin-2 therapy for malignancy.
Ann Intern Med, 108 (1988), pp. 909
G.D. Middleton, J.E. McFarlin, P.E. Lpisky.
The prevalence and clinical impact of fibromyalgia in systemic lupus erythematosus.
Artrh Rheum, 37 (1994), pp. 1181-1188
F.K.M. Wolfe.
Severe rheumatoid arthritis, worse outcomes, comorbid illness, and sociodemographic disadvantage characterize RA patients with pibromyalgia.
J Rheumatol, 1 (2004), pp. 695-700
A. Gur, P. Oktayoglu.
Status of immune mediators in fibromyalgia.
Curr Pain Headache Rep, 12 (2008), pp. 175-181
D. van West, M. Maes.
Neuroendocrine and immune aspects of fibromyalgia.
BioDrugs, 15 (2001), pp. 521-531
D. Buskila, P. Sarzi-Puttini.
Fibromyalgia and autoimmune diseases: the pain behing autoimmunity.
IMAJ, 10 (2008), pp. 77-78
H. Moldofsky.
Sleep, neuroimmune and neuroendocrine functions in fibromyalgia and chronic fatigue syndrome.
Adv Neuroimmunol, 5 (1995), pp. 39-56
A.T. Slotkoff, D.A. Radulovic, D.J. Clauw.
The relationship between fibromialgia and the multiple chemical snsitivity síndrome.
Scand J Rheumatol, 26 (1997), pp. 364
P. Montoya, C. Sitges, M. García-Herrera, A. Rodríguez- Cotes, R. Izquierdo, M. Truyols, et al.
Reduced brain habituation to somatosensory stimulation in patients with fibromyalgia.
Arth Rheum, 56 (2006), pp. 1995-2003
M.E. Geisser, J.M. Glass, L.D. Rajcevska, D.J. Clauw, D.A. Williams, P.R. Kileny, et al.
A psychophysical study of auditory and pressure sensitivity in patients with fibromyalgia and helthy controls.
J.A. Desmeules, C. Cedraschi, E. Rapiti, E. Baumgartner, A. Finckh, P. Cohen, et al.
Neurophysiologic evidence for a central sensitization in patients with fibromyalgia.
Arth Rheum, 48 (2003), pp. 1420-1429
J.L. Wilbarger, D.B. Cook.
Multisensory hypersensitivity in women with fibromyalgia: implications for well being and intervention.
Arch Phys Med Rehabil, 92 (2011), pp. 653-656
R.E. Harris.
Elevated excitatory neurotransmitter levels in the fibromyalgia brain.
Arthr Res Ther, 12 (2010), pp. 141
P.B. Wood, M.F. Glabus, R. Simpson, J.C. Patterson.
Changes in gray matter density in fibromyalgia: correlation with dopamine metabolism.
J. Pujol, M. López-Solá, H. Ortiz, J.C. Vilanova, B.J. Harrison, M. Yücel, et al.
Mapping brain response to pain in fibromyalgia patients using temporal analysis of fMRI.
N. Julien, P. Goffaux, P. Arsenault, S. Marchand.
Widespread pain in fibromyalgia is related to a deficit of endogenous pain inhibition.
J.M. Mountz, L.A. Bradley, G.S. Alarcon.
Abonormal functional activity of the central nervous system in fibromyalgia syndrome.
Am J Med Sci, 315 (1998), pp. 385-396
L.F. Da Silva, R.Y. Walder, B.L. Davidson, S.P. Wilson, K.A. Sluka.
Changes in expression of NMDA-NR1 receptor subunits in the rostral ventromedial medulla modulate pain behaviors.
R. Radhakrishnan, K.A. Sluka.
Increased glutamate and decreased glycine release in the rostral ventromedial medulla during induction of a pre-clinical model of chronic widespread muscle pain.
Neurosci Lett, 457 (2009), pp. 141-145
M.K. Bement, K.A. Sluka.
Co-localization of p-CREB and p-NR1 in spinothalamic neurons in a chronic muscle pain model.
Neurosci Lett, 418 (2007), pp. 22-27
M.K. Hoeger-Bement, K.A. Sluka.
Phosphorylation of CREB and mechanical hyperalgesia is reversed by blockade of the cAMP pathway in a time-dependent manner after repeated intramuscular acid injections.
J Neurosci, 23 (2003), pp. 5437-5445
R.E. Harris, P.C. Sundgren, A.D. Craig, E. Kirshenbaum, A. Sen, V. Napadow, et al.
Elevated insulir glutamate (Glu) in fibromyalgia is associated with experimental pain.
Arthritis Reum, 60 (2009), pp. 3146-3152
E. Legangneux, J.J. Mora, O. Spreux-Varoquaux, I. Thorin, M. Herrou, G. Alvado, et al.
Cerebrospinal fluid biogenic amine metabolites, plasma-rich platelet serotonin and [3H]imipramine reuptake in the primary fibromyalgia syndrome.
Rheumatology, 40 (2001), pp. 290-296
I.J. Russell, H. Vaeroy, M. Javors, F. Myberg.
Cerebrospinal fluid biogenic amine metabolites in fibromyalgia/fibrosistis syndrome and rheumatoid arthritis.
Arthritis Rheum, 37 (1992), pp. 1593-1601
I.J. Russell.
Characteristics of spinal fluid substance P and CGRP in fibromialgia síndrome.
Arthritis Rheum, 39 (1996), pp. 1485
P. Sarchielli, M.L. Mancini, A. Floridi, F. Coppola, C. Rossi, K. Nardi, et al.
Increased levels of neurotrophins are not specific for chronic migraine: evidence from primary fibromyalgia syndrome.
Maciocia G. En la práctica de la medicina china. Madrid, Editorial Elsevier. 1091-1124.
H.M. Langevin, D.L. Churchill, M.J. Cipolla.
Mechanical signaling through connective tissue: a mechanism for the therapeutic effect of acupuncture.
FASEB J, 15 (2001), pp. 2275-2282
K. Kawakita, H. Shinbara, K. Imai, F. Fukuda, T. Yano, K. Kuriyama.
How do acupuncture and moxibustion act? Focusing on the progress in japanese acupuncture research.
J Pharmacol Sci, 100 (2006), pp. 443-459
Z.Q. Zhao.
Neural mechanism underlying acupuncture analgesia.
Prog Neurobiol, 85 (2008), pp. 335-375
V. Clement-Jones, L. McLoughlin, R. Corder, P.J. Lowry, G.M. Besser, L.H. Rees, H.L. Wen.
Increased betaendorphin but not met-enkephalin levels in human cerebrospinal fluid after acupuncture for recurrent pain.
Lancet, 2 (1980), pp. 946-949
M.T. Cabyglu, N. Ergene, U. Tan.
The mechanism of acupuncture and clinical applications.
Inter J Neurosci, 116 (2006), pp. 115-125
J.S. Han, J. Tang, B.S. Huang, X.N. Liang, N.H. Zhang.
Acupuncture tolerance in rats: antiopiate substrates implicated.
Chin Med J, 92 (1979), pp. 625-627
H.M. Langevin, D.L. Churchill, J.R. Fox, G.J. Badger, B.S. Garra, M.H. Krag.
Biomechanical response to acupuncture needling in humans.
J Appl Physiol, 91 (2001), pp. 2471-2478
K. Wang, S. Yao, Y. Xian, Z. Hou.
A study on the receptive field on acupoints and the relationship between characteristics of needle sesation and groups of afferent fibres.
Sci Sin, 28 (1985), pp. 963-971
V. Napadow, R.P. Dhond, J. Kim, L. LaCount, M. Vangel, R.E. Harris, et al.
Brain encoding of acupuncture sensation-coupling on-line rating with fMRI.
Neuroimage, 47 (2009), pp. 1055-1065
D. Pyne, N.G. Shenker.
Demystifying acupuncture.
Rheumatology, 47 (2008), pp. 1132-1136
K.K.S. Hui, O. Marina, J. Liu, B.R. Rosen, K.K. Kwong.
Acupuncture, the limbic system, and the anticorrelated networks of the brain.
Autonom Neurosci Bas Clin, 157 (2010), pp. 81-90
H.J. Lee, J.H. Lee, H.J. Lee, K.H. Kim, K.S. Lee, C.H. Lee, et al.
Substance P and beta endorphin mediate electroacupuncture induced analgesic activity in mouse cancer pain model.
Acupunct Electrother Res, 34 (2009), pp. 27-40
S.M. Wang, Z.N. Kain, P. White.
Acupuncture analgesia: I The scientific basis.
Anesth Analg, 106 (2008), pp. 602-610
W. Qin, L. Bai, J. Dai, P. Liu, M. Dong, J. Liu, et al.
The temporal-spatial encoding of acupuncture effects in the brain.
Mol Pain, 11 (2011), pp. 19
A.Y. Leung, S.J. Kim, G. Schulteis, T. Yaksh.
The effect of acupuncture duration on analgesia and peripheral sensory thresholds.
BMC Complement Altern Med, 8 (2008), pp. 18
R.B. Kelly.
Acupuncture for pain.
Am Fam Physician, 80 (2009), pp. 481-484
E. Manheimer, K. Cheng, K. Linde, L. Lao, J. Yoo, S. Wieland, D.A.W.M. van der Windt, B.M. Berman, L.M. Bouter.
Acupuncture for peripheral joint osteoarthritis.
Cochrane Database of Systematic Reviews, (2010),
K. Linde, G. Allais, B. Brinkhaus, E. Manheimer, A. Vickers, A.R. White.
Acupuncture for migraine prophylaxis.
Cochrane Database of Systematic Reviews, (2009),
K. Linde, G. Allais, B. Brinkhaus, E. Manheimer, A. Vickers, A.R. White.
Acupuncture for tension-type headache.
Cochrane Database of Systematic Reviews, (2009),
K. Trinh, N. Graham, A. Gross, C.H. Goldsmith, E. Wang, I.D. Cameron, T.M. Kay.
Cervical Overview Group Acupuncture for neck disorders.
Cochrane Database of Systematic Reviews, (2006),
A.D. Furlan, M.W. van Tulder, D. Cherkin, H. Tsukayama, L. Lao, B.W. Koes, B.M. Berman.
Acupuncture and dryneedling for low back pain.
Cochrane Database of Systematic Reviews, (2005),
B.K. Lind, W.E. Lafferty, P.T. Tyree, P.K. Diehr, D.E. Grembowski.
Usse of complementary and alternative medicine providers by fibromyalgia patients under insurance coverage.
Arthr Rheum, 57 (2007), pp. 71-76
D.P. Martin, C.D. Sletten, B.A. Williams, I.H. Berger.
Improvement in fibromyalgia symptoms with acupuncture: results of a randomized controlled trials.
Mayo Clin Proc, 81 (2006), pp. 749-757
N.P. Assefi, K.J. Sherman, C. Jacbosen, J. Goldberg, W.R. Smith, D. Buchwald.
A randomized clinical trial of acupuncture compared with sham acupuncture in fibromyalgia.
Ann Intern Med, 143 (2005), pp. 10-19
K. Itoh, H. Kitakoji.
Effects of acupuncture to treat fibromyalgia: A preliminary randomised controlled trial.
R.A. Targino, M. Imamura, H.H.S. Kaziyama, L.P.M. Souza, W.T. Hsing, A.D. Furlan, et al.
A randomized controlled trial of acupuncture added to usual treatment for fibromyalgia.
J Rehabil Med, 40 (2008), pp. 582-588
H. Cao, J. Liu, G.T. Lewith.
Traditional chinese medicine for treatment of fibromyalgia: a systematic review of randomized controlled trials.
J Altern Complement Med, 16 (2010), pp. 397-409
E. Martin-Sánchez, E. Torralba, E. Díaz-Domínguez, A. Barriga, J.L. Martin.
Efficacy of acupuncture for the treatment of fibromyalgia: systematic review and metaanalysis of randomized trials.
Open Rheumatol J, 3 (2009), pp. 25-29
A.R. Jadad, R.A. Moore, D. Carrol, C. Jenkinson, D.J. Reynolds, D.J. Gavaghan, et al.
Assessing the quality of reports of randomized clinical trials: is blinding necessary?.
Controlled Clin Trials, 17 (1996), pp. 1-12
Copyright © 2012. Asociación Colombiana de Reumatología
Opciones de artículo