Efficacy of Manual Therapy for Fibromyalgia Syndrome: A Systematic Review and Meta-analysis

Objectives : This review was conducted to investigate the evidence of efficacy of manual therapy for fibromyalgia syndrome (FMS). Methods : We searched 10 electronic databases (CAJ [CNKI], CINAHL, Cochrane Library, Embase, PubMed, Web of Science, DBpia, KISS, RISS, and OASIS) to find randomized-controlled clinical trials (RCTs) investigating manual therapy for FMS. Visual Analogue Scale (VAS) and score in the Fibromyalgia Impact Questionnaire (FIQ) were analyzed as the main evaluation criteria. Results : Among 273 articles, 254 were screened and 19 RCTs were selected. Only 17 RCTs could be statistically analyzed. Manual therapy was more effective than placebo or sham or no treatment in terms of VAS (p=0.0003). When combined with medication or exercises, manual therapy showed therapeutic effect in terms of reducing pain (VAS) and ameliorating symptoms of FMS (FIQ). However, manual therapy did not show its effect in terms of VAS compared to medication. Lastly, there were no significant difference between manual therapy and exercise in terms of improvements in VAS and FIQ. Conclusions : Effectiveness of manual therapy including CMT for treating FMS was identified. However, this study has its limitations due to the small size and number of RCTs that were included in this study. Nevertheless this study could be a groundwork for well-designed research for CMT for FMS.