Efficacy of Acupuncture in Patients with Fibromyalgia Syndrome: A Meta-Analysis

Purpose: Fibromyalgia syndrome (FMS) is a chronic disorder characterized by widespread pain, fatigue, and reduced quality of life. Although acupuncture is commonly used for symptom management, evidence regarding its efficacy remains inconsistent. This systematic review and meta-analysis aimed to evaluate the short- and long-term effects of acupuncture on core symptoms of FMS. Methods: Following PRISMA guidelines, we systematically searched PubMed, Embase, CENTRAL, and ClinicalTrials.gov for randomized controlled trials (RCTs) through February 24, 2025. Eligible trials compared acupuncture versus conventional treatment, with or without sham acupuncture, in adults with FMS. Study quality was assessed using Cochrane RoB 2.0. Data were synthesized with random-effects models in Stata 18.0, and subgroup analyses explored effects of gender, treatment frequency, and acupuncture type. Results: Seventeen RCTs comprising 773 participants were included. Meta-analysis demonstrated that acupuncture significantly improved pain (SMD = – 0.72, 95% CI: – 1.02 to – 0.41, P < 0.01, I 2 = 70.86%) and stiffness (SMD = – 0.72, 95% CI: – 1.10 to – 0.34, P < 0.01, I 2 = 48.71%) in the short term, with these benefits remaining statistically significant during long-term follow-up. However, benefits in quality of life, mental health, work ability, anxiety, depression, and energy were observed only in the short term. No significant overall improvements were found in physical function or fatigue. Subgroup analysis indicated that high-session-frequency acupuncture was associated with better physical function, while acupuncture with electrical stimulation provided additional benefits in reducing fatigue and number of tender points (NTP). Conclusion: Acupuncture is an effective treatment for key FMS symptoms, particularly pain and stiffness. Therapeutic effects are influenced by treatment frequency and acupuncture type. Further high-quality trials are needed to optimize treatment protocols and sustain long-term benefits. Keywords: fibromyalgia syndrome, acupuncture, pain, meta-analysis A Letter to the Editor has been published for this article .