Abstract

Background: Fibromyalgia is a chronic pain disorder marked by widespread pain, fatigue, and sleep disturbances. Osteopathic Manipulative Treatment (OMT) is a hands-on therapy that aims at improving musculoskeletal (MSK) function and various health conditions. While OMT has shown promise in managing MSK conditions, the potential benefits and limitations of OMT in alleviating symptoms, enhancing physical function, and improving quality of life in fibromyalgia patients have yet to be fully documented.

Methods: A comprehensive search of the PubMed database yielded relevant papers published between 2002 and 2020. "[osteopathic manipulative medicine OR OMM OR osteopathic manipulative therapy OR OMT] AND [fibromyalgia]" were among the search terms utilized.

Results: A study with 37 women diagnosed with fibromyalgia was given muscle energy treatment for scalene, upper trapezius, and sternocleidomastoid cervical accessory respiratory muscles. The treatment improved their expiratory muscle strength and respiratory muscle endurance, along with the severity of pain, fatigue, and disability; cervical flexibility increased greatly (p<0.05) as well. The effect size was r>0.4 for all the variables.

Another study assessed OMT’s effect in reducing pain in 29 fibromyalgia patients, dividing them into three groups: 8 patients in gabapentin only (900 mg/day), 11 patients in OMT (only), and ten patients combined treatment of gabapentin plus OMT. OMT-only treatment and combined treatment groups significantly improved the Wong-Baker FACES Pain Rating Scale (p < 0.01 and p = 0.03, respectively). In addition, the OMT-only treatment group had a “significant decline in the Clinical Global Impression of Health scale (p<0.01)”.

A study conducted on 24 female fibromyalgia patients assessed the effect of OMT usage along with other treatments. The participants were divided into four groups: the OMT group, the OMT and teaching group, the moist heat group, and the control group, which received current medication treatment only [5]. The study assessed the participant’s pain perceptions at the ten bilateral tender points (TP). The findings showed that patients in the OMT groups had a “significantly higher pain threshold at the left and right second costochondral junction, and the left medial epicondyle TPs.” Participants’ activities of daily living were also measured, and participants in the OMT groups were “better able to stand alone [...], walk, open doors, [...], go shopping, and get in and out of a car compared to control subjects”. In addition, the participants showed “fewer symptoms related to failure, frustration, inhibition, struggling, helplessness, guilt, incapacity, wakefulness, and tiredness associated with pain.”

Conclusion: The studies on osteopathic manipulative treatment (OMT) for fibromyalgia offer promising insights into its potential benefits. They show improvements across various symptoms such as pain severity, fatigue, and disability, as well as in areas like respiratory muscle function and daily activities. One study focused on muscle energy treatment, revealing significant enhancements in respiratory muscle strength and pain severity. Another study explored OMT alone or with gabapentin, improving pain ratings and overall health status. Additionally, combining OMT with standard medical care increased pain thresholds and improved functional abilities. However, limitations include small sample sizes and variable intervention durations, suggesting a need for more extensive, longer-term studies with standardized protocols. Future research should focus on randomized controlled trials to solidify OMT's efficacy, investigate its mechanisms in fibromyalgia treatment, and identify patient subgroups that could benefit the most.