Effectiveness of myofascial release on pain, sleep, and quality of life in patients with fibromyalgia syndrome: A systematic review

Background and purpose: There is limited evidence on the effects of myofascial release on fibromyalgia symptoms. This review aims to update the evidence on the effectiveness of myofascial release on pain, sleep, and quality of life in patients with fibromyalgia syndrome. Methods: The review was prepared following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Scopus, Cochrane Library, Physiotherapy Evidence Database, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature Complete, and ProQuest Medical library were searched from their inception to April 1, 2021 for randomized or nonrandomized clinical trials published in English. Studies consisting of myofascial release alone or in combination with exercise as the intervention were included. The quality of the studies was evaluated using Cochrane Risk of Bias 2.0. Results: Six studies, including a total of 279 participants, were included in the review. The meta-analysis showed a large significant effect of myofascial release on pain posttreatment (−0.81[95% CI = −1.15 to −0.47], p < 0.00001) and a moderate effect at 6 months post-treatment (−0.61, 95% CI = −0.95 to −0.28, p = 0.0003). Conclusion: The review demonstrated moderate evidence for the effect of therapist administered and self-myofascial release in improving pain, sleep subscales, and quality of life against sham and no treatment, respectively, in fibromyalgia syndrome patients. However, more high-quality randomized controlled trials with manual control group are required to be conducted at different geographical locations to generalize the findings.