Water-Based Exercise As a Multidimensional Non-Pharmacological Intervention In Fibromyalgia Treatment: A Narrative Review

Background. Fibromyalgia, as a multidimensional syndrome, requires interventions that target multiple aspects of the disease simultaneously. This complexity underscores the importance of non-pharmacological strategies aimed at improving patients’ overall well-being. Among such interventions, aquatic therapy represents a structured form of physical activity, which offers additional therapeutic benefits related to the physical properties of water. Aim. The purpose of this study is to evaluate the therapeutic efficacy of aquatic therapy as a part of non-pharmacological management of fibromyalgia. Material and methods. This narrative review was conducted using PubMed and Google Scholar as the main sources of examined studies, including meta-analyses, systematic reviews and clinical trials. Results. Studies consistently show that hydrotherapy is associated with clinically meaningful improvements in core fibromyalgia symptoms, including pain, functional capacity and psychological well-being. Conclusions. Aquatic exercise positively influences physical function and psychological well-being in patients with fibromyalgia syndrome. As a non-pharmacological treatment, it may be effectively incorporated into multimodal care strategies. Future research should focus on the long-term effects of hydrotherapy and the development of standardized aquatic exercise protocols for patients with FMS.