Abstract
Background & Introduction
Fibromyalgia is a musculoskeletal condition which results in generalized dull or throbbing pain of unknown origin. The pain can be localized to one muscle group or be widespread and primarily affects females in the general population. Fibromyalgia is a chronic condition that, overtime, becomes debilitating in everyday life. The pain is usually treated with prescribed and over the counter medications, but usually only provides temporary relief. Numerous studies have indicated that a combination of treatments provide long–term health benefits for this patient population. Osteopathic manipulative medicine can be introduced in individuals struggling with this tiring disease. There are four tenets of osteopathic medicine, each of which emphasizes how the human body is a unit and is capable of self-healing. Techniques such as muscle energy have been shown to provide relief in patients with Fibromyalgia. Muscle energy is a technique in which a patient actively contracts a muscle group while gradually moving into the restrictive barrier of motion. Myofascial release is another technique which involves applying deep pressure to help aid release of the muscles being treated by an Osteopathic physician. OMM use in Fibromyalgia can provide patients with many options and methods to aid their day-to-day activities.
Methods
The study adhered to PRISMA guidelines and utilized Covidence software to conduct a systematic review. A comprehensive PubMed search was conducted using the following terms: "Osteopathic Manipulation AND Chronic pain," "Fibromyalgia AND osteopathic manipulative medicine," and "Fibromyalgia AND osteopathic treatment." Following the initial search, duplicates, non-English studies, and articles published more than ten years ago were excluded. Two independent reviewers then screened the titles and abstracts of the remaining studies. Eligible articles underwent a full-text review, also conducted by two independent reviewers. Lastly, data extraction was performed independently by two reviewers to ensure accuracy and minimize bias.
Results
Out of 311 studies identified through PubMed, six met the inclusion criteria after screening and full-text review. These studies found that muscle energy, myofascial release, dry needling, and gentle touch therapy improved pain and quality of life in fibromyalgia patients. Osteopathic treatment showed mixed results, with one study suggesting it was more effective than gabapentin alone. Common limitations included small sample sizes, lack of control groups, and methodological constraints.
Conclusion
Data gathered from studies demonstrated strong correlation between use of osteopathic manual treatment (OMT) in patients with fibromyalgia and reduced pain levels, as well as reduced disease impact and increased quality of life. Data from the comparative study using gabapentin, it was also found that using OMM alone without gabapentin showed significant pain reduction in the patient population while also drastically improving quality of life. Positive quality of life changes were also observed in the retrospective study through use of myofascial release technique. Patients found pain relief and reported better psychological health with OMT treatment for their fibromyalgia. Research into OMT has shown positive impact on fibromyalgia patients, particularly in those patients who have been under psychiatric distress and experience poor quality of life as a result of their condition.
