Effectiveness of acupuncture vs. core stability training in balance and functional capacity of women with fibromyalgia: a randomized controlled trial

Fibromyalgia is a chronic condition that primarily affects women and causes widespread body pain, but its symptoms go far beyond pain. Balance problems are among the ten most disabling complaints reported by people with fibromyalgia, affecting between 45% and 68% of patients. Studies show that women with fibromyalgia perform significantly worse on balance tests and experience six times more falls compared to healthy individuals. This instability profoundly impacts quality of life, limiting basic daily activities and creating insecurity when walking and moving.

Impaired balance is also related to other functional problems, such as decreased muscle strength, reduced physical endurance, and difficulty walking. Therefore, finding effective treatments to improve balance in patients with fibromyalgia is essential to reduce suffering and improve these individuals' independence.

This study aimed to compare the efficacy of two different therapeutic approaches in treating balance problems in women with fibromyalgia: core stabilization exercises (trunk muscles) and acupuncture. The researchers conducted a randomized controlled clinical trial—considered the gold standard of medical research—performed between September 2012 and October 2015 in Spain. The study included 135 women diagnosed with fibromyalgia who reported balance problems. They were randomly divided into three groups: one received physical therapy based on core strengthening exercises, another received acupuncture, and the third served as a control group without receiving any specific treatment.

Each treatment group performed ten sessions over five weeks, with two sessions per week. The researchers evaluated the participants at three time points: before treatment, immediately after the end of the sessions, and five weeks later to track whether the benefits were maintained.

The results showed that both core-exercise physical therapy and acupuncture produced significant improvements in dynamic balance compared to the control group. Women who received these treatments showed better scores on the Berg Balance Scale, a test widely used to assess fall risk, and also performed better on the "Timed Up and Go" test, which measures the time required for a person to rise from a chair, walk three meters, turn around, and sit back down. Both treatment groups also walked faster at a comfortable pace after the sessions. The physical therapy group showed additional improvements in maximum walking speed.

It is important to note that there were no significant differences between the two treatments, meaning both proved equally effective. Regarding static balance, measured using a pressure platform, there were no significant improvements in any of the groups. As for functional capacity for daily activities, although there was a trend toward improvement in the treated groups, the changes were not statistically significant.

For patients with fibromyalgia, these results bring hope and concrete treatment options. The study demonstrates that both specific exercises to strengthen the trunk muscles and acupuncture sessions can significantly improve balance and reduce the risk of falls. This is especially important because balance problems generate considerable fear and drastically limit the daily activities of these patients. The core exercises used in the study were simple and safe, performed on the floor with controlled movements to strengthen the deep abdominal and back muscles, always respecting pain limits.

Acupuncture was applied using specific points of traditional Chinese medicine chosen for their properties of tonifying body energy and improving lower-limb strength. For health professionals, the study offers robust scientific evidence that these two therapeutic modalities are effective and can be incorporated into the multidisciplinary treatment of fibromyalgia. Both approaches are relatively inexpensive, safe when applied by qualified professionals, and can be implemented in different care contexts.

The study presents some important limitations that should be considered. The five-week treatment period may have been insufficient to demonstrate all possible benefits, especially for the physical therapy exercises, since patients generally need three to four sessions to fully familiarize themselves with the principles of stabilization exercises. The wide variability of symptoms characteristic of fibromyalgia—including fluctuations in pain intensity related to sleep, stress, and physical exertion—may have influenced the results unpredictably. Furthermore, neither participants nor therapists could be "blinded" as to the treatment received, due to the nature of the interventions, which may introduce some bias into the results.

Despite these limitations, this study represents a valuable contribution to understanding how to treat balance problems in fibromyalgia. The researchers suggest that future studies should investigate the combination of both therapeutic modalities and use longer treatment periods to maximize benefits. For fibromyalgia patients suffering from balance problems, this study offers encouraging evidence that effective treatments are available that can significantly improve their stability, confidence in moving, and consequently their quality of life.