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The Somatic Connection  |   July 2014
Short-Term Effects of a Manual Therapy Protocol on Pain and Functioning in Patients With Fibromyalgia
Author Affiliations
  • Janice Blumer, DO
    Western University of Health Sciences College of Osteopathic Medicine of the Pacific-Northwest, Lebanon, Oregon
Article Information
The Somatic Connection   |   July 2014
Short-Term Effects of a Manual Therapy Protocol on Pain and Functioning in Patients With Fibromyalgia
The Journal of the American Osteopathic Association, July 2014, Vol. 114, 590. doi:10.7556/jaoa.2014.117
The Journal of the American Osteopathic Association, July 2014, Vol. 114, 590. doi:10.7556/jaoa.2014.117
Castro-Sánchez AM, Aguilar-Ferrándiz ME, Matarán-Peñarrocha GA, Sánchez-Joya MD, Arroyo-Morales M, Fernández-de-Las-Peñas C. Short-term effects of a manual therapy protocol on pain, physical function, quality of sleep, depressive symptoms and pressure sensitivity in women and men with fibromyalgia syndrome: a randomized controlled trial [published online November 25, 2013]. Clin J Pain. doi:10.1097/AJP.0000000000000008.  
Fibromyalgia syndrome (FMS) is a chronic musculoskeletal pain condition affecting up to 2% of the US population.1 Patients with FMS experience a constellation of symptoms including fatigue, sleep disturbance, musculoskeletal pain, and depression.2 In a randomized controlled trial, researchers from Spain set out to compare the effect of manual therapy with that of no intervention in 89 adult patients with FMS. Outcome measures included patients' pressure pain threshold and patients' self-reported scores on the McGill Pain Questionnaire, the Fibromyalgia Impact Questionnaire, the Pittsburgh Quality of Sleep Questionnaire Index, and the Center for Epidemiologic Studies Depression Scale. 
Participants in the experimental group (24 women and 21 men; mean age, 54 years) received 5 weekly 45-minute sessions of manual therapy, whereas those in the control group (24 women and 20 men; mean age, 53 years) did not receive any intervention. The manual therapy protocol included the following techniques: suboccipital release, release of the pectoral region, diaphragm release, lumbosacral decompression, release of the psoas fascia, and thoracic spine extension manipulation (high-velocity, low-amplitude). 
A 2 × 2 analysis of covariance revealed statistically significant improvements after 5 weeks in widespread pressure sensitivity, pain, impact of FMS symptoms, tender point count, sleep quality, and depressive symptoms for participants in the experimental group compared with those in the control group. Differences in men's and women's response to treatment were also found: men had a greater reduction in depressive symptoms and pressure hypersensitivity, and women had a greater reduction in pain and impact of FMS symptoms. 
The results of this study show promising improvement in patients with FMS receiving manual therapies and demonstrate the need for further research in this area. 
References
Wolfe F, Ross K, Anderson J, Russell IJ, Hebert L. The prevalence and characteristics of fibromyalgia in the genral population. Arthritis Rheum. 1995;38(1):19-28. [CrossRef] [PubMed]
Goldberg DL, Burckhardt C, Crofford L. Management of fibromyalgia syndrome. JAMA. 2004;292(19):2388-2395. [CrossRef] [PubMed]