Current pharmacological treatments of Fibromyalgia (FM) are merely symptom palliative, as clinical trials have so far failed to provide overall benefits without associated harms. Polypharmacy often leads to patient’s health deterioration and chronic drug use to an eventual lack of patient’s response. Emerging evidence supports that physiotherapy treatments based on mechanical triggers improve FM symptoms and therefore could be used for therapeutic purposes by themselves or in combination with current pharmacological treatments, as part of integrative medicine programs. However, a paucity of studies rigorously and systematically evaluating this possibility exists. This study uses scores from validated standardized questionnaires, algometer pressure point threshold (PPT) readings and responses from a custom self-developed questionnaire to determine the impact of a pressure-controlled custom manual protocol on FM hyperalgesia/allodynia, fatigue and patient’s quality of life. The results show that patient’s baseline sensitivity to pain inversely correlates with treatment response in FM. Moreover, post-stratification analysis unexpectedly reveals that patients presenting comorbid ME/CFS do not seem to respond to the applied therapy as those presenting FM only. Therefore, pre-treatment PPTs and ME/CFS comorbidity may serve as indicators to predict patient’s response to physiotherapy programs based on mechanical triggers. Further exploration of these findings is granted. In addition, the study of gene expression profiles in the blood collection generated by this study should help unveil the molecular mechanisms behind patient’s differential response to manual therapy.

Background and Objectives: The International Society for Modulation defines persistent spinal pain syndrome type 2 (PSPS-type 2), formerly known as failed back surgery syndrome, as a condition where patients continue to experience pain or develop new pain following spinal surgery intended to alleviate back or lower-limb discomfort. PSPS-type 2 is characterized by pain and significant disability, affecting quality of life. Spinal cord stimulation has proven effective in treating this syndrome, although the role of psychological factors, such as pain catastrophizing and central sensitization, remain unclear. This study seeks to examine the potential connection between psychosocial responses and both functionality and pain perception in patients with persistent spinal pain syndrome type 2 who have undergone spinal cord stimulation treatment. Materials and Methods: A single-site, cross-sectional study was conducted on individuals diagnosed with persistent spinal pain syndrome type 2 who were receiving spinal cord stimulation. Study participants were required to meet specific eligibility criteria and were assessed for disability, pain perception, fear of movement, pain catastrophizing, and central sensitization. The spinal cord stimulation procedure involved the placement of electrodes at vertebral levels T8–T11 for precise pain control, with a particular focus on targeting the dorsal root ganglion to alleviate chronic pain. Results: Thirty-seven patients with persistent spinal pain syndrome type 2 have undergone spinal cord stimulation treatment for 4.68 ± 5.25 years. Clinical assessments indicated a pain perception score of 5.6 ± 1.96, Central Sensitization Inventory score of 42.08 ± 18.39, disability score of 37.62 ± 16.13, fear of movement score of 33.11 ± 8.76, and pain catastrophizing score of 28.43 ± 13.14. Finally, pain catastrophizing was significantly associated with pain perception (β = 0.075 and p = 0.008) and disability (β = 0.90 and p < 0.01). Conclusions: Catastrophizing plays a crucial role in pain perception and disability among patients with persistent spinal pain syndrome type 2 receiving spinal cord stimulation. Integrating psychological interventions may improve clinical outcomes for these patients.

Fibromyalgia (FM), classified by ICD-11 with code MG30.0, is a chronic debilitating disease characterized by widespread pain, fatigue, cognitive impairment, sleep, and intestinal alterations, among others. FM affects a large proportion of the worldwide population, with increased prevalence among women. The lack of understanding of its etiology and pathophysiology hampers the development of effective treatments. Our group had developed a manual therapy (MT) pressure-controlled custom manual protocol on FM showing hyperalgesia/allodynia, fatigue, and patient’s quality of life benefits in a cohort of 38 FM cases (NCT04174300). With the aim of understanding the therapeutic molecular mechanisms triggered by MT, this study interrogated Peripheral Blood Mononuclear Cell (PBMC) transcriptomes from FM participants in this clinical trial using whole RNA sequencing (RNAseq) and reverse transcription followed by quantitative Polymerase Chain Reaction (RT-qPCR) technologies. The results show that the salt-induced kinase SIK1 gene was consistently downregulated by MT in FM, correlating with improvement of patient symptoms. In addition, this study compared the findings in a non-FM control cohort subjected to the same MT protocol, evidencing that those changes in SIK1 expression with MT only occurred in individuals with FM. This positions SIK1 as a potential biomarker to monitor response to MT and as a therapeutic target of FM, which will be further explored by continuation studies.

Background: Seaweeds are typically considered a part of traditional diets in several Asian countries and have recently acquired significant attention owing to the therapeutic potential of their bioactive compounds. sulfated polysaccharides, polyphenols, and proteins are the most common seaweed-derived substances with pronounced antioxidant and anti-inflammatory properties. However, the analgesic effects of these compounds have not yet been well established. Methods: An extensive systematic search of four databases, including PubMed, Scopus, Web of Science, and the Cochrane Library, was conducted until May 2025. Preclinical and clinical studies evaluating the analgesic effects of seaweed-derived compounds were included in this review. Results: Preclinical studies have shown significant antinociceptive effects of various seaweed-derived substances. Sulfated polysaccharides demonstrated a dose-dependent peripheral analgesic effect, whereas central analgesic effects appeared at the highest doses. Phlorotannin-rich polyphenols also showed substantial peripheral analgesic effects, reaching 90.16% inhibition in the writhing test, and prominent central analgesic responses lasting 120 min. Furthermore, lecithin extracts exhibited significant peripheral antinociceptive effects with favorable safety profiles. Evidence from human studies is limited to four small trials (total n = 91). In one study (n = 30) on mild knee osteoarthritis, a multi-mineral seaweed formulation (Aquamin ⁺ ) produced greater pain reduction than glucosamine. Risk of bias assessment showed an overall low-to-moderate quality across the included studies. Conclusion: Seaweed extracts exhibit promising peripheral and central antinociceptive effects. However clinical data remain preliminary and heterogenous. Further research is warranted to standardize the extracts, explore chronic pain applications, and validate the findings in large-scale human trials. Clinical trial registration: https://www.crd.york.ac.uk/prospero/ , identifier systematic review is registered with PROSPERO CRD420251078862.

Background: Fibromyalgia (FM) is a chronic disorder causing widespread musculoskeletal pain, often leading to physical deconditioning that affects posture and gait. This study evaluates the effects of a manual therapy protocol targeting dorsal muscles in the lower back on plantar pressure modifications, considering body mass index (BMI) influence. Methods: A single-arm, non-randomized clinical trial included 24 women diagnosed with FM for at least three years. They underwent an eight-session manual therapy protocol over four weeks, applying moderate pressure to dorsal muscles in the lower back. Baropodometric analyses were conducted pre- and post-intervention under dynamic conditions. Statistical analyses used paired t-tests and effect size calculations to assess intervention effects and BMI impact. Results: Significant improvements in plantar pressure distribution were observed in both the left foot (p = 0.01, d = −0.54) and the right foot (p = 0.008, d = −0.59). However, strength and peak pressure metrics showed no significant changes. Patients with normal BMI exhibited greater improvements than those in the overweight category. Conclusions: Preliminary findings suggest that manual therapy positively influenced plantar pressure distribution in FM patients, particularly in those with normal BMI. Further research is needed to explore long-term effects and broader clinical applications.