The objective of this study was to systematically review the efficacy of hydrotherapy in FM syndrome (FMS). Ten out of 13 RCTs with 446 subjects, with a median sample size of 41 (range 24-80) and a median treatment time of 240 (range 200-300) min, were included into the meta-analysis. Only three studies had a moderate quality score. There was moderate evidence for reduction of pain and improved health-related quality of life at the end of therapy. There was moderate evidence that the reduction of pain and improvement of HRQOL could be maintained at follow-up (median 14 weeks).
There is moderate evidence that hydrotherapy has short-term beneficial effects on pain and HRQOL in FMS patients. There is a risk to over-estimate the effects of hydrotherapy due to methodological weaknesses of the studies and to small trials included in meta-analysis.