The Somatic Connection  |   October 2012
Myofascial Release Relieves Pain and Improves Function in Patients With Fibromyalgia
Article Information
The Somatic Connection   |   October 2012
Myofascial Release Relieves Pain and Improves Function in Patients With Fibromyalgia
The Journal of the American Osteopathic Association, October 2012, Vol. 112, 658-659. doi:10.7556/jaoa.2012.112.10.658
The Journal of the American Osteopathic Association, October 2012, Vol. 112, 658-659. doi:10.7556/jaoa.2012.112.10.658
Castro-Sánchez AM, Matarán-Peñarrocha GA, Arroyo-Morales M, et al. Effects of myofascial release techniques on pain, physical function, and postural stability in patients with fibromyalgia: a randomized controlled trial. Clin Rehabil. 2011;25(9):800-813.  
Osteopathic physicians caring for patients with fibromyalgia syndrome (FMS) often use osteopathic manipulative medicine in conjunction with pharmaceutical therapy. Osteopathic manipulative treatments, including myofascial release (MFR) techniques, are used in the management of FMS to modify autonomic input, treat somatic dysfunction, reduce pain, and restore normal motion.1 Physical therapists also use MFR techniques. Researchers in Spain performed a randomized, placebo-controlled trial to determine the efficacy of MFR techniques as performed by a physical therapist in patients with FMS. This research group previously reported that weekly sessions of MFR therapy improve sleep duration and reduce pain and anxiety in FMS patients.2 In this study, the researchers investigated whether a more frequent protocol (2 sessions per week) would improve physical function and postural stability in FMS patients. 
Of the 94 FMS patients that enrolled in the study, 86 completed it: 45 of 47 in the experimental group and 41 of 47 in the placebo group. All patients were taking at least 1 of the following prescription medications during the study: anxiolytics, antidepressants, anti-inflammatories, corticosteroids, antibiotics, sleep inducers, or muscle relaxants. Patients included in the study were aged 40 to 65 years, agreed to attend evening therapy sessions, and reported pain-related limitation of usual activities in the past 30 days or an average pain level less than or equal to 4 on a 10-point scale. Exclusion criteria were receipt of other nonpharmaceutical therapies; presence of infection, fever, hypotension, or treatment-limiting respiratory disorders; and alterations in cutaneous integrity. 
The MFR group received 1-hour sessions consisting of 10 MFR techniques that addressed the following regions: temporal, suboccipital, posterior cervical, pectoral, diaphragm, and lumbosacral. The placebo group received sham (unplugged) short-wave therapy and ultrasonography on cervical, dorsal, and lumbar regions for 10 minutes per region. Both groups received 2 sessions per week for 20 weeks. The outcome variables included the number of tender points, report of pain, posture stability, overall physical functioning, severity of clinical symptoms and signs, and global improvement determined by clinical assessment. 
Outcome measures were assessed before and immediately after interventions and at 6 months and 1 year after the last session of intervention. After 20 weeks of MFR therapy, the experimental group showed a significant improvement in painful tender points (P<.05), McGill Pain Score (P<.032), physical function (P<.029), and clinical severity (P<.039). Six months after intervention, the experimental group had a significantly lower mean number of painful points (P<.05), pain score (P<.048), physical function (P<.049), and clinical severity (P<.043). There were no adverse events reported. The sex of the participants in each group was not reported. 
The researchers concluded that MFR therapy can be an adjunct therapy for pain symptoms, physical function, and clinical severity, but this therapy does not improve postural stability in patients with FMS. —M.A.S., K.M.,* and D.J.Z.* 
   *Kate McCaffrey, DO, and David Joyce Zuniga, OMS III, are guest authors from the Western University of Health Sciences College of Osteopathic Medicine of the Pacific-Northwest in Lebanon, Oregon.
Gamber RG, Shores JH, Russo DP, Jimenez C, Rubin BR. J Am Osteopath Assoc. 2002;102(6):321-325. [PubMed]
Castro-Sańchez AM, Matarán-Peñarrocha GA, Granero-Molina Jet al. Benefits of massage-myofascial release therapy on pain, anxiety, quality of sleep, depression, and quality of life in patients with fibromyalgia. Evid Based Complement Alternat Med. 2011. doi:10.1155/2011/561753.