The goal of this study was to investigate the therapeutic effects of a manual therapy protocol for improving pain, function, pressure pain thresholds, quality of sleep, and depressive symptoms in women and men with fibromyalgia syndrome (FMS). Eighty-nine patients were placed at random into an experimental or control group. The experimental group (24 female, 21 male) received 5 sessions of manual therapy and the control group (24 female, 21 male) did not receive any intervention. Pressure pain thresholds (PPT), pain, impact of FMS symptoms, quality of sleep and depressive symptoms were assessed in both groups at baseline and after 48-hours of the last intervention in the experimental group. The ANCOVA found significant Group* Time* Sex interactions for McGill PPI and CES-D (P<0.01) was also found: men exhibited a larger effect size for depressive symptoms than women whereas women exhibited a greater effect size than men in the McGill PPI. A significant Group* Time* Sex interaction for PPT over suboccipital, upper trapezius, supraspinatus, second rib, gluteal region and tibialis anterior muscle was also found: men included in the experimental group experienced significantly larger improvements in PPT as compared to women with FMS in the experimental group.
The study found that manual therapy protocol was effective for improving pain intensity, widespread pressure pain sensitivity, impact of FMS symptoms, sleep quality and depressive symptoms. In addition, sex differences were observed in response to treatment: women and men get similar improvements in quality of sleep and tender point count, whereas women showed a greater reduction in pain and impact of FMS symptoms than men, while men reported higher reductions in depressive symptoms and pressure hypersensitivity than women.