Osteopathic manual therapy in fibromyalgia: a pilot study.

OBJECTIVE

The aim of this pilot study was to evaluate the preliminary efficacy and feasibility of integrating Osteopathic Manual Therapy Techniques combined with Clinical Pilates on pain, symptom severity, and sleep quality in patients with fibromyalgia.

METHODS

Twenty women with fibromyalgia were randomized into Osteopathic Manual Therapy Techniques+Clinical Pilates (n=11) and Clinical Pilates (n=9) groups. The protocol lasted 6 weeks (3 sessions/week). Osteopathic Manual Therapy Techniques included rib raising, suboccipital myofascial release, Sternocleidomastoid (SCM) mobilization, diaphragm/mediastinum techniques, and visceral mobilizations. Primary outcomes were the Widespread Pain Index, Symptom Severity Scale, and Pressure Pain Threshold. Sleep was assessed via the Pittsburgh Sleep Quality Index.

RESULTS

Both groups showed significant intra-group improvements (p<0.05). Within-group analyses revealed that the Osteopathic Manual Therapy Techniques+Clinical Pilates group achieved significant improvements in Widespread Pain Index (p=0.003), Symptom Severity Scale (p=0.005), and Pittsburgh Sleep Quality Index (p=0.007). However, in the between-group analysis of change scores, the Osteopathic Manual Therapy Techniques+Clinical Pilates group demonstrated significantly superior improvements exclusively in sleep quality (Pittsburgh Sleep Quality Index, p=0.034) and maximal Pressure Pain Threshold at the trapezius (p=0.035) compared to the Clinical Pilates-only group, while between-group differences for Widespread Pain Index and Symptom Severity Scale did not reach statistical significance (p>0.05).

CONCLUSION

Integrating Osteopathic Manual Therapy Techniques into exercise-based rehabilitation presents promising preliminary evidence for enhancing central sensitization symptoms and sleep quality in fibromyalgia patients, though larger trials are needed.