Skip to main content

Efficacy of manual lymph drainage and myofascial therapy in patients with fibromyalgia

A systematic review

Wirksamkeit manueller Lymphdrainage und myofaszialer Therapie bei Patienten mit Fibromyalgie

Ein systematischer Überblick



Fibromyalgia is a chronic disease of unknown origin characterized by widespread pain, fatigue, disordered sleep and joint stiffness among other symptoms.


To compare outcomes of manual lymph drainage and myofascial therapy in patients with fibromyalgia.


This was a systematic review. The databases PubMed/MEDLINE, CINAHL, SCOPUS, ScieLo, PEDro, Dialnet, Web of Science, and Elsevier were searched for articles in English or Spanish examining the efficacy of myofascial therapy and/or manual lymph drainage to treat fibromyalgia. Of 356 articles extracted, sixteen articles and one doctoral thesis fulfilled the criteria established for inclusion.


The methodological quality of the studies reported in the articles was good (PEDro score 7.49 ± 1.47). The studies included compared different treatments with lymph drainage and/or myofascial therapy. Outcomes indicated improved quality of life for both therapies in all the studies.


Myofascial therapy and lymph drainage may be effective in patients with fibromyalgia. Further work is needed as the scientific evidence available is still insufficient.



Fibromyalgie ist eine chronische Erkrankung, die u.a. durch Schmerzen in verschiedenen Körperregionen, Erschöpfung, Schlafstörungen und Gelenksteifigkeit gekennzeichnet ist. Die Ursachen für ihre Entstehung sind nicht bekannt.


Ein Vergleich der Ergebnisse, die durch manuelle Lymphdrainage und myofasziale Therapie bei Patienten mit Fibromyalgie erzielt werden.


Dies ist ein systematischer Überblick. In den Datenbanken PubMed/MEDLINE, CINAHL, SCOPUS, ScieLo, PEDro, Dialnet, Web of Science und Elsevier wurden Artikel in englischer bzw. spanischer Sprache recherchiert, in denen die Wirksamkeit myofaszialer Therapie und/oder manueller Lymphdrainage zur Behandlung von Fibromyalgie untersucht wird. Von den 356 herausgesuchten Artikeln erfüllten sechzehn Artikel und eine Doktorarbeit die für die Berücksichtigung aufgestellten Kriterien.


Die methodische Qualität der Studien, über die in den Artikeln berichtet wurde, war gut (PEDro Score 7,49 ± 1,47). In den berücksichtigten Studien wurden verschiedene Behandlungsmethoden mit Lymphdrainage und/oder myofaszialer Therapie verglichen. In allen Studien deuten die Ergebnisse darauf hin, dass durch beide Therapien eine Verbesserung der Lebensqualität erzielt werden kann.


Myofasziale Therapie und Lymphdrainage können bei Patienten mit Fibromyalgie wirksam sein. Es sind weitere Untersuchungen erforderlich, da die verfügbare wissenschaftliche Evidenz noch nicht hinreichend ist.

This is a preview of subscription content, access via your institution.

Fig. 1


  1. Martins M, Gritti C, Junior R, Araujo M, Dias L, Foss M et al (2014) Randomized controlled trial of a therapeutic intervention group in patients with fibromyalgia syndrome. Rev Bras Reumatol 54(3):179–184.

    Article  PubMed  Google Scholar 

  2. Ministerio de Sanidad, Política, Social e Igualdad (2011) Fibromialgia. Accessed 12 Dec 2018

  3. Úbeda Docasar E (2014) Eficacia de la terapia manual “EUD” comparada con la terapia miofascial convencional en el manejo del dolor en los pacientes con fibromialgia. Accesed 12 Dec 2018

  4. Rocha Ortiz M, Benito González E (2006) La fibromialgia: fundamentos y tratamiento. Revista de la Facultad de Ciencias de la Salud. Universidad Alfonso X el Sabio

    Google Scholar 

  5. Castro-Sánchez A, Matarán-Peñarrocha G, Granero-Molina J, Aguilera-Manrique G, Quesada-Rubio J, Moreno-Lorenzo C (2011) Benefits of massage-myofascial release therapy on pain, anxiety, quality of sleep, depression, and quality of life in patients with fibromyalgia. Evid Based Complement Alternat Med.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Cabo-Meseguer A, Cerdá-Olmedo G, Trillo-Mata J (2017) Fibromialgia: prevalencia, perfiles epidemiológicos y costes económicos. Med Clin (Barc) 149(10):441–448.

    Article  Google Scholar 

  7. Seoane-Mato D, Sánchez-Piedra C, Silva-Fernández L, Sivera F, Blanco F, Pérez Ruiz F et al (2018) Prevalencia de enfermedades reumáticas en población adulta en España (estudio EPISER 2016). Objetivos y metodología. Accesed 12 Dec 2018

  8. Liptan G (2010) Fascia: a missing link in our understanding of the pathology of fibromyalgia. J Bodyw Mov Ther 14(1):3–12.

    Article  PubMed  Google Scholar 

  9. Pinzón Rios Y (2014) Actualización en fibromialgia: implicaciones neurofisiológicas y biomecánicas útiles para el abordaje terapéutico. Rev Colomb Rehabil 13:14–25.

    Article  Google Scholar 

  10. Ekici G, Bakar Y, Akbayrak T, Yuksel I (2009) Comparison of manual lymph drainage therapy and connective tissue massage in women with fibromyalgia: a randomized controlled trial. J Manipulative Physiol Ther 32(2):127–133.

    Article  PubMed  Google Scholar 

  11. Torres Lacomba M (2006) Drenaje linfático manual. In: Torres Lacomba M (ed) Guía de masoterapia para fisioterapeutas. Editorial Médica Panamericana, Madrid, pp 239–266

    Google Scholar 

  12. Llobet C (2003) El drenaje linfático manual en el tratamiento de la fibromialgia. Masaje Téc Man Ter Man 33:16

    Google Scholar 

  13. Colegio Profesional de Fisioterapeutas de Castilla-La Mancha (2018) El drenaje linfático manual: relaja, clama y drena nuestro organismo. Accessed 15 Jan 2018

  14. Vairo GL, Miller SJ, Rier NMCbI, Uckley WBI (2013) Systematic Review of Efficacy for Manual Lymphatic Drainage Techniques in Sports Medicine and Rehabilitation: An Evidence-Based Practice Approach. J Manual Manip Ther 17(3):80E–89E

  15. De Morton N (2009) The PEDro scale is a valid measure of the methodological quality of clinical trials: a demographic study. Aust J Physiother 55(2):129–133.

    Article  PubMed  Google Scholar 

  16. Asplund R (2003) Manual lymph drainage therapy using light massage for fibromyalgia sufferers: a pilot study. J Orthop Nurs 7(4):192–196.

    Article  Google Scholar 

  17. Brattberg G (1999) Connective tissue massage in the treatment of fibromyalgia. Eur J Pain 3(3):235–244.

    CAS  Article  PubMed  Google Scholar 

  18. Castro-Sánchez A, Matarán-Peñarrocha G, Arroyo-Morales M, Saavedra-Hernández M, Fernández-Sola C, Moreno-Lorenzo C (2011) Effects of myofascial release techniques on pain, physical function, and postural stability in patients with fibromyalgia: a randomized controlled trial. Clin Rehabil 25(9):800–813.

    Article  PubMed  Google Scholar 

  19. Çıtak-Karakaya İ, Akbayrak T, Demirtürk F, Ekici G, Bakar Y (2006) Short and long-term results of connective tissue manipulation and combined ultrasound therapy in patients with fibromyalgia. J Manipulative Physiol Ther 29(7):524–528.

    Article  PubMed  Google Scholar 

  20. Field T, Diego M, Cullen C, Hernandez-Reif M, Sunshine W, Douglas S (2002) Fibromyalgia pain and substance P decrease and sleep improves after massage therapy. J Clin Rheumatol 8(2):72–76.

    Article  PubMed  Google Scholar 

  21. Field T, Delage J, Hernandez-Reif M (2003) Movement and massage therapy reduce fibromyalgia pain. J Bodyw Mov Ther 7(1):49–52.

    Article  Google Scholar 

  22. Liptan G, Mist S, Wright C, Arzt A, Jones K (2013) A pilot study of myofascial release therapy compared to Swedish massage in fibromyalgia. J Bodyw Mov Ther 17(3):365–370.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Alnigenis M, Bradley J, Wallick J, Emsley C (2001) Massage therapy in the management of fibromyalgia: a pilot study. J Musculoskelet Pain 9(2):55–67.

    Article  Google Scholar 

  24. Stall P, Teixeira M (2014) Fibromyalgia syndrome treated with the structural integration Rolfing® method. Revista Dor.

    Article  Google Scholar 

  25. Sunshine W, Field T, Quintino O, Fierro K, Kuhn C, Burman I et al (1996) Fibromyalgia benefits from massage therapy and transcutaneous electrical stimulation. J Clin Rheumatol 2(1):18–22.

    CAS  Article  PubMed  Google Scholar 

  26. Valencia M, Alonso B, Álvarez M, Barrientos M, Ayán C, Sánchez V (2009) Effects of 2 physiotherapy programs on pain perception, muscular flexibility, and illness impact in women with fibromyalgia: a pilot study. J Manipulative Physiol Ther 32(1):84–92.

    CAS  Article  PubMed  Google Scholar 

  27. Ceca D, Elvira L, Guzmán JF, Pablos A (2017) Benefits of a self-myofascial release program on health-related quality of life in people with fibromyalgia: a randomized controlled trial. J Sports Med Phys Fitness 57:993–1002.

    Article  PubMed  Google Scholar 

  28. Úbeda Docasar E (2014) Mejora en la calidad de vida y disminución del dolor en pacientes con fibromialgia tratadas mediante terapia manual EUD. Cuest Fisioter 43(3):183–195

    Google Scholar 

  29. Ekici G, Unal E, Akbayrak T, Vardar-Yagli N, Yakut Y, Karabulut E (2016) Effects of active/passive interventions on pain, anxiety, and quality of life in women with fibromyalgia: randomized controlled pilot trial. Women Health 57(1):88–107.

    Article  PubMed  Google Scholar 

  30. Nergis M, Bradley JD, Wallick J, Emsley CL (2001) Massage therapy in the management of fibromyalgia: a pilot study. J Musculoskelet Pain 9(2):55–67.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to J. P. Hervás-Pérez PhD PT.

Ethics declarations

Conflict of interest

M. Algar-Ramírez, E. Úbeda-D’Ocasar and J.P. Hervás-Pérez declare that they have no competing interests.

For this article no studies with human participants or animals were performed by any of the authors. All studies cited were in accordance with the ethical standards indicated in each case.

Supplementary Information

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Algar-Ramírez, M., Úbeda-D’Ocasar, E. & Hervás-Pérez, J.P. Efficacy of manual lymph drainage and myofascial therapy in patients with fibromyalgia. Schmerz 35, 349–359 (2021).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


  • Tender point
  • Manual lymphatic drainage
  • Quality of life
  • Treatment outcome
  • Pain reduction


  • Druckpunkt
  • Manuelle Lymphdrainage
  • Lebensqualität
  • Behandlungsergebnis
  • Schmerzreduktion