Search Results (100)

Background and Objectives: Fibromyalgia syndrome (FMS) is frequently accompanied by autonomic symptoms and autonomic dysregulation, which may influence ocular blood flow regulation. The choroid is a densely vascular, autonomically innervated tissue, and optical coherence tomography (OCT)-derived markers have been used to explore potential ocular microvascular changes in FMS, with inconsistent findings. The choroidal vascularity index (CVI), defined as the proportion of luminal area within the total choroidal area, has been proposed as a potentially more robust marker of choroidal vascular status than thickness alone. We aimed to compare CVI and choroidal thickness between patients with FMS and healthy controls and examine the association between autonomic symptom burden and CVI in FMS. Materials and Methods: This single-centre observational cross-sectional case–control study enrolled adults aged 18–65 years. Swept-source OCT was performed; low-quality scans were excluded, and only right eyes were analysed. CVI, subfoveal maximum and mean choroidal thickness were obtained using an artificial intelligence-assisted analysis platform. Autonomic symptom burden, fibromyalgia impact, and central sensitization-related symptoms were assessed using the Composite Autonomic Symptom Score-31 (COMPASS-31), the Revised Fibromyalgia Impact Questionnaire (FIQ-R), and the Central Sensitization Inventory (CSI), respectively. Group comparisons, Spearman correlations, and multivariable linear regression were performed. Results: COMPASS-31, FIQ-R, and CSI scores were higher in the FMS group (all p < 0.001). CVI and choroidal thickness did not differ significantly between groups (CVI p = 0.124; maximum thickness p = 0.136; mean thickness p = 0.097). CVI was not correlated with COMPASS-31, FIQ-R, or CSI within either group. In adjusted models, age was independently associated with CVI (p < 0.001), whereas FMS status and COMPASS-31 total score were not. Conclusions: CVI and choroidal thickness were similar in FMS and controls, and CVI was not associated with self-reported autonomic symptom burden in FMS. Studies incorporating objective autonomic testing and dynamic vascular imaging paradigms are warranted. Full article

Background/Objectives: Fibromyalgia is a painful syndrome with biopsychosocial components that predominantly affects middle-aged women. This study aimed to evaluate changes in sleep quality and quality of life following intravenous (IV) lidocaine treatment in patients with fibromyalgia (FM). Methods: This retrospective observational study included patients diagnosed with fibromyalgia who underwent intravenous lidocaine treatment at a tertiary pain clinic between June 2023 and June 2024 and had a Pittsburgh Sleep Quality Index (PSQI) score > 5. The patients’ demographic data, Fibromyalgia Impact Questionnaire (FIQ) scores at baseline and at 1 and 3 months post-treatment, Numerical Rating Scale (NRS-11) scores, Short Form-12 (SF-12) mental and physical component scores (MCS-12, PCS-12), and PSQI scores were recorded. Results: Overall, 51 patients were included. 92.2% of the patients were women, with a mean age of 41.6 ± 9.5 years. Statistically significant reductions in NRS-11, FIQ, and PSQI scores and increases in SF-12 component scores were observed at 1 and 3 months compared with baseline (p < 0.001). Negative correlations were found between NRS-11 and PCS-12 and MCS-12, and a positive correlation was found between FIQ and PSQI. Sleep quality showed a marked improvement at 1 month; however, attenuation of this benefit was observed at the 3-month follow-up. Conclusions: Sleep quality appeared to be associated with short-term functional outcomes, whereas pain intensity was associated with mid-term clinical status in patients with fibromyalgia. Prospective randomized controlled trials are required to confirm these findings and to determine optimal dosing and treatment schedules. Full article

Background: The Mediterranean diet (MedDiet) has been associated with anti-inflammatory effects and potential benefits in several chronic conditions. However, adherence to the MedDiet and its relationship with lifestyle factors and disease severity across different rheumatological diseases remain poorly characterized. Objectives: This study aimed to evaluate differences in MedDiet adherence among patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and fibromyalgia (FM), and to explore its association with cardiovascular comorbidities, bowel habits, and disease-related outcomes. Methods: In this monocentric cross-sectional study, adherence to the MedDiet was assessed using the 14-item PREDIMED questionnaire. Self-reported data on sociodemographic characteristics, cardiovascular comorbidities, bowel habits, and dietary behaviors were collected through questionnaires. Disease activity and severity were assessed using validated disease-specific measures. Differences in MedDiet adherence across diagnostic groups were evaluated using non-parametric tests. Multivariable models were performed to examine associations between MedDiet adherence and cardiovascular comorbidities or disease outcomes, adjusting for potential confounders including age, sex, BMI, smoking status, and educational level. Results: A total of 422 participants were included (RA n = 165, PsA n = 85, FM n = 172). Significant differences in MedDiet adherence were observed across diagnostic groups (p < 0.001), with the highest adherence in RA, intermediate values in PsA, and the lowest in FM. Compared with the other groups, a higher proportion of FM participants reported food intolerances (46.5%) and restrictive diets, including lactose-free (34.9%) and gluten-free (15.1%) diets. In the FM group, high adherence to the MedDiet was significantly associated with lower FIQR scores (β = −16.9; 95% CI −32.1 to −1.7; p = 0.01) and lower PDS scores (β = −4.34; 95% CI −7.81 to −0.86; p = 0.01). Sensitivity analyses using the continuous PREDIMED score confirmed these associations. Conclusions: Adherence to the MedDiet differs across rheumatological diseases, with the lowest adherence observed in FM. Higher adherence was associated with lower disease severity and impact in FM. These findings highlight the potential relevance of nutritional counselling in rheumatological diseases and support the need for longitudinal and interventional studies evaluating the role of the MedDiet within multidisciplinary disease management. Full article

Background: The biopsychosocial model positions fibromyalgia (FM) as the result of altered pain modulation shaped by trauma, psychological vulnerability, and structural stressors. The Sense of Coherence (SOC) may be a key resilience factor explaining differences in symptom severity after similar hardships. Objectives: To evaluate whether SOC mediates and/or moderates associations between trauma-related adversity and symptom burden in FM and whether comorbidities, medication use, healthcare factors, or treatment engagement modify these relationships. Methods: In this cross-sectional study, 2099 women with FM completed an online survey assessing adversity, psychosocial factors, core symptoms, healthcare support, treatment engagement, and medication use. A theory-driven SOC composite followed Antonovsky’s model (comprehensibility, manageability, meaningfulness) using the proxy SOC composite derived from a theory-driven framework that underwent internal construct validation, including discriminant validity analyses and latent structure evaluation, but it was not benchmarked against a gold-standard SOC questionnaire. Linear regression evaluated adversity–symptom associations, SOC mediation, and moderation by SOC and medication classes. Results: Higher adversity predicted lower SOC (e.g., cumulative abuse: B = −0.25), and lower SOC predicted higher symptom burden (e.g., Fibromyalgia Impact Questionnaire (FIQ): B = −6.77), producing significant indirect effects (cognitive symptoms: 0.22; FIQ: 1.69). SOC also moderated the effects of adversity on fatigue and global impact, weakening associations at higher SOC. Comorbidities showed modest influence: hypertension had minor indirect effects (ab = 0.27), scheduled consultation produced small interactions (cognition β = −0.38 to −0.46; fatigue β = ~0.05–0.06), and stroke showed the only clinically meaningful moderation (β ≈ 4.9–5.2), all far smaller than SOC effects. Conclusions: SOC functions as a central psychosocial pathway and resilience-related factor in the association between trauma and FM symptoms. Targeting SOC-related processes may help reduce symptom burden and improve outcomes. Full article

Rheumatoid arthritis (RA) is a chronic autoimmune rheumatic disease of unknown etiolgy, characterized by erosive polyarthritis that leads to joint destruction and systemic inflammatory lesions in internal organs. Pain is a primary symptom of RA and a major contributor to psychological disturbances, which influence patients’ subjective evaluation of their condition. These psychological issues may stem from disruptions in central pain regulation mechanisms, such as central sensitization (CS), which can also affect central metabolic processes. The objective was to investigate how the severity of central sensitization, measured by the Central Sensitization Inventory (CSI) questionnaire (Part 1), impacts clinical and neuropsychiatric parameters, as well as the expression of genes related to inflammation, tissue destruction, carbohydrate metabolism, and fatty acid metabolism in peripheral blood mononuclear cells (PBMCs) in patients with RA. Methods involved collecting blood samples from 59 RA patients (mean age 52.0 years). Clinical status was assessed using the DAS28 index and serum levels of CRP, ASPA, and RF. Neuropsychiatric parameters were evaluated through questionnaires measuring CS severity score (CSI), pain intensity (VAS, BPI), neuropathic pain (PainDETECT), anxiety and depression (HADS), fatigue (FSS, FACIT-F), fibromyalgia symptoms (FIRST), and pain catastrophizing. Protein expression in PBMCs was measured by ELISA, while gene expression was analyzed using quantitative real-time RT-PCR. All patients exhibited moderate to high disease activity. Participants were divided into four subgroups according to their CSI scores: subclinical (0–29 points), mild (30–39 points), moderate (40–49 points), and severe/extreme (50–100 points). Higher CSI scores correlated with significant increases in neuropsychiatric symptoms and a notable decrease in vitality. However, clinical parameters showed no significant differences among the subgroups. Gene expression analysis revealed upregulation of genes involved in the pentose phosphate pathway (G6PD), antioxidant defense (SOD1), fatty acid metabolism (FASN, CPT1B), apoptosis (CASP3), and tissue destruction and hypernociception (MMP-9) compared to healthy controls. The pro-inflammatory cytokine IL-1β expression was comparable to controls, while TNFα expression was elevated only in patients with severe/extreme CS scores. These findings suggest that CS-related disturbances may contribute to increased disease severity in RA, even in patients receiving active antirheumatic treatment. At the cellular level, disease severity appears linked to dysregulated expression of genes governing central metabolic processes, despite low expression of pro-inflammatory cytokine genes. Full article

Background/Objectives: The prevalence of mental disorders has increased in fibromyalgia (FM). Therefore, individuals’ pain perception, emotional schemas, and coping strategies are important. Our study aims to examine emotional schemas and metacognitive levels in FM. Methods: The study included 88 FM and 88 healthy controls who consecutively presented to the clinic. All participants completed the Leahy Emotional Schema Scale-II (LESS-II) and the Metacognition Questionnaire-30 (MCQ-30). Patients were also administered the Polysymptomatic Distress scale (PSD) and the Fibromyalgia Impact Questionnaire (FIQ). Results: The study included 88 FM patients and 88 controls. In the study, the LESS-II total score and MCQ-30 score were significantly higher in the patient group compared to the control group (p < 0.05). When examining the factors affecting FIQ severity, LESS-II scores and gender variables were found to be variables predicting FIQ values (p = 0.002, p = 0.002, respectively). When looking at the factors affecting the PSD score, the LESS-II score is a significant variable predicting the PSD score (p = 0.029). Conclusions: This study demonstrated that FM patients have higher levels of negative emotional schemas compared to healthy controls, and that emotional schemas are associated with both FM symptom severity and the impact of the disease on daily life. In particular, that LESS-II scores predict PSD scores and that LESS-II and gender variables predict FIQ scores suggests that symptom burden and functional effects in FM may be closely related to cognitive-emotional processes. The findings support the importance of considering emotional schemas in FM assessment and treatment approaches. Full article

Background: Fibromyalgia syndrome (FMS) and post-traumatic stress disorder (PTSD) may co-occur and are associated with increased symptom burden, functional impairment, and reduced quality of life. Accumulating evidence suggests shared neurobiological mechanisms. Trauma-focused interventions targeting maladaptive memory processes may therefore represent a relevant therapeutic approach in this population. Objective: To evaluate the feasibility, tolerability, and preliminary clinical associations of a brief reconsolidation-based therapy in women with comorbid FMS and PTSD. Methods: This multicenter pilot study included adult women diagnosed with FMS and PTSD who underwent six sessions of reconsolidation therapy combining traumatic memory reactivation with propranolol administration. Clinical outcomes were assessed at baseline and at 3-month follow-up using the Fibromyalgia Impact Questionnaire (FIQ), the Impact of Event Scale–Revised (IES-R), the Montgomery–Åsberg Depression Rating Scale (MADRS), the Beck Depression Inventory (BDI), the Rosenberg Self-Esteem Scale (RSES), and the SF-36. Changes over time were analyzed using paired statistical tests and linear mixed-effects models. Results: Fourteen participants completed the intervention and follow-up assessments. The intervention was feasible and well tolerated. Changes over time were observed in fibromyalgia-related quality of life (FIQ scores), PTSD symptom severity (IES-R), and depressive symptoms (MADRS, BDI), as well as in selected SF-36 domains, including vitality, social functioning, and mental health. A progressive decrease in IES-R scores was observed across treatment sessions. Conclusions: This pilot study suggests that reconsolidation-based therapy is feasible in women with comorbid FMS and PTSD and was associated with changes in PTSD symptoms and fibromyalgia-related functional impact. Given the exploratory design and absence of a control group, these findings should be interpreted cautiously and warrant confirmation in larger, controlled trials. Full article

Objective: This study aimed to evaluate blood count-derived inflammatory indices—the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and the systemic immune-inflammation index (SII)—in patients with fibromyalgia and to explore their association with disease activity and pain severity. Methods: A cross-sectional study was conducted with 85 fibromyalgia patients and 84 age- and sex-matched healthy controls. Demographic, clinical, and laboratory data were recorded. Inflammatory indices were calculated from blood counts. Disease activity and functional status were assessed with the Fibromyalgia Impact Questionnaire (FIQ), Health Assessment Questionnaire (HAQ), and pain severity with the Visual Analog Scale (VAS). Results: Compared to controls, the fibromyalgia group had significantly higher BMI, PLR, MLR, and NLR (all p < 0.05), and lower lymphocyte levels. PLR and MLR moderately discriminated fibromyalgia (AUC = 0.623 and 0.661, respectively), suggesting limited diagnostic utility when used alone. MLR and BMI were independently associated with fibromyalgia in multivariate analysis. Disease duration showed significant positive correlations with PLR (r = 0.167), MLR (r = 0.228), FIQ (r = 0.773), HAQ (r = 0.589), and VAS at rest and movement (r = 0.584 and r = 0.601; all p < 0.05). PLR, MLR, and NLR were also positively correlated with VAS scores, while SII showed no significant associations. FIQ was strongly correlated with pain severity and HAQ with VAS during movement. Conclusions: Blood count-derived indices, particularly PLR and MLR, are elevated in fibromyalgia and are associated with disease duration, severity, and pain. Although PLR and MLR were higher in fibromyalgia patients, their discriminatory ability was limited and should be interpreted cautiously, indicating that their diagnostic specificity is low, as these ratios primarily reflect nonspecific inflammatory processes. Full article

Background: Fibromyalgia (FM) is a condition characterised by chronic pain, which may or may not be associated with muscular stiffness. Sarcopenia is the progressive loss of muscle mass and strength. The loss of muscle mass is a key factor in the progression of both fibromyalgia and sarcopenia and therefore warrants thorough evaluation. It has been demonstrated that obesity directly influences factors that increase pain perception and disease severity and reduce quality of life. The primary objective of this study was to examine the association between fibromyalgia and the increased risk of developing sarcopenia. Methods: The sample consisted of 84 patients diagnosed with FM. We assessed sociodemographic characteristics, anthropometric variables (circumferential and ultrasound) pain with a Visual Analogue Scale (VAS) and algometry, risk of developing sarcopenia with SARC-F, quality of sleep, anxiety, and depression using validated questionnaires. Results: A total of 96.3% of the participants were women. Overall, 56.3% of the sample presented a high risk of sarcopenia according to SARC-F, VAS scores showed significant negative correlations with anxiety (p < 0.01) and with almost all algometric measures (p < 0.05). The Fibromyalgia Impact Questionnaire (FIQ) demonstrated a positive and significant correlation with sleep quality (p < 0.01) and depression (p < 0.01). Furthermore, presence of a high risk of sarcopenia according to SARC-F was significantly associated with FIQ scores (p = 0.002) and depression (p < 0.001). Conclusions: There is a significant association between the impact of FM and a high risk of developing sarcopenia according to SARC-F. This population exhibits a high degree of pain, which are significantly associated with elevated levels of anxiety and depression. Full article

Introduction/Objectives: Restless legs syndrome (RLS), a chronic neurological disorder related to brain iron metabolism, has been linked to immune-mediated inflammatory conditions such as psoriatic arthritis (PsA). However, the role that inflammation plays in this association and the impact of RLS on PsA outcomes remain unclear. This study aims to investigate the association between RLS and inflammatory/clinical parameters in PsA patients. Materials and Methods: In this cross-sectional study, 230 PsA patients completed the International Restless Legs Syndrome Study Group (IRLSSG) screening questionnaire, with diagnoses confirmed by a neurologist. Data collected included clinical features, disease activity, and comorbidities (obesity, anxiety, depression, insomnia, and fibromyalgia). Results: In total, forty-six patients met the IRLSSG criteria (20%). Those with RLS more frequently had polyarthritis (27% vs. 6%; p < 0.001), more swollen joints (2.0 vs. 1.4; p = 0.04), greater psoriatic involvement (5.7 vs. 3.6; p < 0.001), greater fatigue (39.0 vs. 30.5; p < 0.001), and greater disease activity (14.5 vs. 10.5; p < 0.001). They also exhibited increased disease impact (4.7 vs. 2.9; p < 0.001), poorer functioning (0.7 vs. 0.5; p = 0.01), and higher levels of anxiety (8.0 vs. 5.5; p < 0.001), depression (6.5 vs. 3.9; p < 0.001), and sleep disturbance (13.9 vs. 8.7; p < 0.001). Skin lesions and polyarthritis explained nearly 40% of RLS cases (Odds Ratio (OR) 1.4; 95% Confidence Interval (CI) 1.03–2.0; p = 0.03 and OR 1.03; 95% CI 1.00–1.9; p = 0.04). Conclusions: Psoriatic activity and inflammation may contribute to RLS in PsA. The coexistence of RLS was associated with greater disease activity, greater disease impact, and more emotional and sleep-related comorbidities. Full article

Background and Purpose: The Swallowing Quality of Life Questionnaire (SWAL-QoL) is recognized as the gold-standard instrument for assessing the impact of dysphagia on health-related quality of life (HRQoL). However, a validated Spanish version is currently unavailable. Therefore, the aim of this study was to evaluate the psychometric properties of the Spanish adaptation of the SWAL-QoL (SSWAL-QoL) in fibromyalgia patients. Materials and Methods: A cross-sectional study was completed. Participants completed the SSWAL-QoL, the Spanish version of Hospital Anxiety and Depression Scale (HADS), the Spanish version of Short Form12 (SF12), the Spanish version of EQ-5D-3L, and the Spanish version of the Impact Fibromyalgia Questionnaire (FIQ). Construct validity, evaluated through Exploratory Factor Analysis and correlations with related measures, and reliability, estimated via internal consistency, were found to be adequate for the SSWAL-QoL. Results: The results indicated that the psychometric properties of the SSWAL-QoL are adequate and comparable to those of the original instrument. The result of Bartlett’s test of sphericity was 970.573 (df = 55, p < 0.001), and the value of the Kaiser–Meyer–Olkin (KMO) measure of sampling adequacy was 0.857. A total of two factors could be extracted. The reliability was high for the total subscales of the SSWAL-QoL. Differences were found between groups in all included outcomes. Conclusions: The SSWAL-QoL demonstrates satisfactory psychometric properties for its use in a Spanish-speaking population with fibromyalgia. As the first validation of this instrument in this specific population, it provides clinicians and researchers with a reliable and valid tool to assess the impact of dysphagia on HRQoL. Full article

Background: Equine-assisted interventions have shown positive effects on psychoemotional well-being. However, little is known about their effects in populations with chronic pain such as fibromyalgia. Objective: This pilot study evaluated the impact of an equine coaching program with and without a diagnosis of fibromyalgia. Methods: The sample consisted of 20 adult women (mean age = 32 years), 12 with fibromyalgia and 8 without a clinical diagnosis. Instruments used included the Beck Depression Inventory-II (BDI-II), the State-Trait Anxiety Inventory (STAI), and the General Health Questionnaire-28 (GHQ-28). Results: The findings indicated significant improvements in depression, anxiety, and general health in both groups, suggesting benefits for women with and without fibromyalgia. Conclusions: These findings suggest potential benefits of equine coaching as a complementary approach to psychoemotional wellbeing, although causal conclusions cannot be drawn. Full article

Background/Objectives: Fibromyalgia (FM) is a nociplastic pain disorder marked by altered central nervous system processing and abnormal sensory modulation. Diagnosis remains largely symptom-based and lacks objective biomarkers. Sensory modulation disorder (SMD)—impaired regulation of responses to non-noxious input—may represent a clinically relevant diagnostic dimension. This study aimed to estimate the prevalence/diagnostic value of SMD in FM, examine links with symptom severity and stress, and assess its potential for patient stratification. Methods: In this cross-sectional study, 182 adults were enrolled (104 FM; 78 controls). Standardized instruments included the Adolescent/Adult Sensory Profile (AASP), Fibromyalgia Impact Questionnaire (FIQ), and Perceived Stress Scale (PSS). Group comparisons, regression, and discriminant analyses evaluated SMD profiles. Results: Compared with controls, FM adults showed higher sensory sensitivity and avoidance (both p < 0.001), lower sensation seeking (p = 0.002), and modestly higher low registration (p = 0.027). Elevated SMD correlated with greater symptom severity and perceived stress. Stress significantly predicted FM’s impact (β = 0.57, p < 0.001). A discriminant model achieved 84% apparent in-sample accuracy for classifying FM severity from sensory/stress profiles. Conclusions: Sensory modulation abnormalities are highly prevalent in FM and show meaningful associations with symptom severity and stress, suggesting that SMD could represent a potential diagnostic dimension and stratification aid. These findings should be interpreted within an exploratory, cross-sectional design. Incorporating sensory modulation assessment into FM evaluation may improve diagnostic precision, reduce delays, and guide individualized management. Confirmation in larger longitudinal studies is warranted. Full article

Background: Fibromyalgia (FM) is a chronic musculoskeletal disorder characterized by widespread body pain and various symptoms. Its etiology remains unclear to date. It has been associated with various pathogenic mechanisms, primarily inflammation. Immature granulocytes (IGs) have been proposed as a potential biomarker, playing a role in both inflammatory responses and prognosis in numerous diseases. No other study has investigated the count of immature granulocytes (IG#) and percentage of immature granulocytes (IG%) in FM patients. The aim of this study is to investigate the IG# and IG% in FM patients and to evaluate the relationship between these parameters and disease parameters. Methods: This retrospective observational study included 95 patients diagnosed with FM and 63 healthy control subjects matched for body mass index and gender. Biochemical, hematological parameters, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and other inflammatory markers were recorded for both groups. Fibromyalgia Survey Diagnostic Criteria and Severity Scale (FSDC) and Fibromyalgia Impact Questionnaire (FIQ) scores were recorded for FM patients. Results: In FM patients, the IG% and IG# were significantly higher than in the healthy control group (p < 0.001, p: 0.006, respectively). There was no significant difference between the CRP and ESR values of the two groups. The platelet large cell count (PLCC) was significantly lower in the FM group (p < 0.032). Conclusions: IG levels can be used as a systemic early, sensitive, and low-cost marker in patients with FM. Based on our current knowledge, and considering the heterogeneous nature of FM, IG levels may serve as a meaningful tool in identifying subgroup elements reflecting an inflammatory phenotype. However, these findings require further validation through larger sample size, prospective studies, and advanced analyses including cytokine levels. Full article

Fibromyalgia (FM) affects millions of people around the world, causing widespread physical pain, exhaustion, and psychological disorders. Through this study, we aim to observe the effectiveness of two different rehabilitation programs in reducing the impact of FM on daily functioning and psychological factors. Specifically, we compare a complex conservative program that combines physical therapy and hydrokinetotherapy in a hospital setting with a therapy focused on intrinsic relaxation. Methods: This comparative study involved 63 patients aged between 19 and 69 years diagnosed with FM, divided into two groups: the study group (SG, 32 participants) and the control group (CG, 31 participants). Over 90% of participants are female, 30 in the study group and 28 in the control group. SG followed a conservative physiotherapy combined with thermal water therapy, and CG followed a recovery program through intrinsic relaxation. Participants were evaluated on the first and last day of the rehabilitation program using the Revised Fibromyalgia Impact Questionnaire (FIQR) and the Hamilton Anxiety Rating Scale (Ham—A). The rehabilitation program consisted of 10 sessions conducted over a period of two weeks. Results: After the two-week recovery period, the results showed a significant improvement in both FIQR and Ham—A scores in the study group (p < 0.001). In the control group, there were no significant changes in FIQR variables (p > 0.05), while a significant improvement was observed on the anxiety scale (p < 0.001). Conclusions: The combination of hydrokineto-therapy and physical therapy is more effective in improving the overall condition of patients with FM compared to relaxation. Full article