title: Effectiveness of different styles of massage therapy in fibromyalgia: a systematic review and meta-analysis.
abstract: The systematic review aimed to evaluate the effectiveness of massage in fibromyalgia. An electronic search was conducted at MEDLINE, SCiELO, EMBASE, ISI, PEDro, SPORTDiscus, CINAHL, Cochrane CENTRAL and LILACS (Jan 1990-May 2013). Ten randomized and non-randomized controlled trials investigating the effects of massage alone on symptoms and health-related quality of life of adult patients with fibromyalgia were included. Two reviewers independently screened records, examined full-text reports for compliance with the eligibility criteria, and extracted data. Meta-analysis (pooled from 145 participants) shows that myofascial release had large, positive effects on pain and medium effects on anxiety and depression at the end of treatment, in contrast with placebo; effects on pain and depression were maintained in the medium and short term, respectively. Narrative analysis suggests that: myofascial release also improves fatigue, stiffness and quality of life; connective tissue massage improves depression and quality of life; manual lymphatic drainage is superior to connective tissue massage regarding stiffness, depression and quality of life; Shiatsu improves pain, pressure pain threshold, fatigue, sleep and quality of life; and Swedish massage does not improve outcomes. There is moderate evidence that myofascial release is beneficial for fibromyalgia symptoms. Limited evidence supports the application of connective tissue massage and Shiatsu. Manual lymphatic drainage may be superior to connective tissue massage, and Swedish massage may have no effects. Overall, most styles of massage therapy consistently improved the quality of life of fibromyalgia patients.
authors.affiliation: University of Sao Paulo, School of Medicine, Department of Physical Therapy, Occupational Therapy and Speech Therapy, Rua Cipotanea, 51 - Cidade Universitaria, CEP: 05360-160 Sao Paulo, SP, Brazil. Electronic address: susanlkyuan@yahoo.com.br.
authors.forename: Susan Lee King
authors.initials: SL
authors.lastname: Yuan
authors.affiliation: University of Sao Paulo, School of Medicine, Department of Physical Therapy, Occupational Therapy and Speech Therapy, Rua Cipotanea, 51 - Cidade Universitaria, CEP: 05360-160 Sao Paulo, SP, Brazil.
authors.forename: Luciana Akemi
authors.initials: LA
authors.lastname: Matsutani
authors.affiliation: University of Sao Paulo, School of Medicine, Department of Physical Therapy, Occupational Therapy and Speech Therapy, Rua Cipotanea, 51 - Cidade Universitaria, CEP: 05360-160 Sao Paulo, SP, Brazil.
authors.forename: Amélia Pasqual
authors.initials: AP
authors.lastname: Marques
mesh_terms: D000368:Aged; D005260:Female; D005356:Fibromyalgia / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D006801:Humans; D008297:Male; D008405:Massage / Q000379:methods*; D008875:Middle Aged; D010147:Pain Measurement; D017288:Pain Threshold / Q000502:physiology*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: Fibromyalgia; Massage; Physical therapy modalities; Review; Systematic