Fibromyalgia with Gabapentin and osteopathic manipulative medicine: A pilot study

Fibromyalgia is a chronic pain disorder with an estimated prevalence of 2-8% in the United States. Gabapentin and Osteopathic Manipulation Medicine (OMM) both were reported to be recommended for the treatment of fibromyalgia. But none of the studies compare the efficacy of both the procedures. Therefore, in the present study, the author demonstrated that OMM treatment and gabapentin are the safe and clinically efficacious treatment option for the fibromyalgia.

To compare the efficacy and safety of three approaches used to reduce pain and improve fibromyalgia symptoms.

A total of 40 individuals who met the American College of Rheumatology (ACR) 1990 criteria for fibromyalgia from Contra Costa, Solano, and Sonoma counties of California from 2006 to 2009. These patients divided into three groups and received osteopathic manipulative medicine (OMM) only, 900 mg/day gabapentin alone, and combined treatment of gabapentin plus OMM. Advanced medical students administered OMM therapy for 30 min, once a week. The analysis was completed in 8 weeks, six weeks of treatment with initial and final visits. The outcome measures involved a Clinical Global Impression of Health (CGI), Wong-Baker FACES Pain Rating Scale (WBF), number of tender points, and Fibromyalgia Impact Questionnaire (FIQ).

The analysis was completed by 29 individuals out of 11 received OMM only, 8 taken gabapentin only and 10 obtained gabapentin plus OMM. A significant clinical improvement based on WBF was seen among the groups OMM alone and combined treatment of gabapentin plus OMM than gabapentin-only. Further, the decline in the CGI scale was showed only among the patients of OMM group. No statistically meaningful differences were noticed with the number of tender points or FIQ. The changes across the groups also were not statistically significant. This is to be presumed in a feasibility analysis with small sample size.

All these findings validate that the gabapentin and  OMM treatment is clinically efficient and safe to treat constitutional and somatic symptoms and pain related to fibromyalgia. However, further investigation using the new ACR 2010 Fibromyalgia criteria is required to validate these outcomes.