Osteopathic Manipulation and Fibromyalgia

Fibromyalgia syndrome (FMS) is a a chronic musculoskeletal pain syndrome. Diagnosis is based on widespread pain and painful palpation of 11 of 18 specific tender points. There is little research on non-pharmacological treatments of fibromyalgia syndrome (FMS). This descriptive clinical study measured the effects of Osteopathic manipulative treatment on the intensity of tender points, and looked at the relationships among somatic dysfunction, the patient's activities of daily living, and pain perception.

18 subjects with fibromyalgia greater than 1 year of duration received ongoing medical care from their attending physicians. During the research trial, Osteopathic manipulative treatment was provided by the same Osteopathic physician blinded to the primary investigator's collected data. The trial had 6 treatment sessions 1 to 3 weeks apart and 3 follow-up sessions. data collected by the primary investigator, blinded to the Osteopathic manipulative findings, included tender point assessment, visual analogue scale and activities of daily living scale, and pre-Osteopathic manipulative treatment thermography.

Based on a 6 visit summary score of response to manipulative treatment, the group was divided into a sample of 12 Osteopathic manipulative treatment Responders and 6 Non-Responders. For the Responder group, tender point scored decreased an average of 14% from the 1st to 6th visit; the Non Responder group had a 34% increase in the tender point score. Change in pre-Osteopathic manipualtive treatmen tender points from visit 1 to 6 was significantly different between Responders and Non-Responders. Using the same parameter to determine who was a Responder, 4 of the 6 Non-Responders became Responders during the follow-up phase. Analysis of symmetry in thermographic patterns indicated that 66% of the Responders and 50% of the Non-Responders returned toward a symmetrical pattern by completion of the study.

Consistent correlations occurred between the following variables across visits: Activities of Daily Living score and the Visual Analogue Scale, and pre-Osteopathic treatment tender point score and Visual Analogue Scale.

Osteopathic Manipulative Treatment can be effective in reducing tender point scores, somatic dysfunction severity, and the subject's pain perception, while improving Activities of Daily Living. Return toward a symmetrical pattern of thermograms in the majority of subjects supports osteopathic theory that Osteopathic Manipulative Treatment restores an individual's capacity to restore health.
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The effects of OMT on the tender points associated with fibromyalgia. AD Stock, DO, et al. 37th Annual AOA Research Conference Abstracts, 1993.