Objective: Compare degree of improvement can reach patients diagnosed with fibromyalgia syndrome, by treatment with Manipulative and Massage Techniques versus an exercise program for lower thoracic and cervical spine.

Study Design: A single-blind randomized controlled trial was conducted on patients with fibromyalgia syndrome (FMS).

Setting: Clinical setting. Methods: Sixty-four subjects with FMS were randomly assigned to an experimental group receiving manipulative and massage therapy, or to a control group for exercise program.

Inclusion Criteria:

• Diagnosed Fibromyalgia Syndrome.
• Limitation of usual activities due to pain on at least 1 day in the previous 30 days.
• Agreement to attend evening therapy sessions.
• Non-practice of regular physical activity.

Exclusion Criteria:

• A history of surgery.
• The presence of comorbid conditions (e.g., morbid obesity, inflammatory diseases, irritable bowel syndrome and interstitial cystitis).
• A history of whiplash injury.
• Severe physical disability.
• Uncontrolled endocrine disorders (e.g., hyperthyroidism, diabetes).
• Illness (e.g., schizophrenia or substance abuse).
• The use of medication other than as-needed analgesics (excluding long-term narcotics).
• Malignancy.
• Psychiatric disorders.
• A score of ≥ 9 points in the Beck depression inventory.