Falaguera-Vera, Francisco Javier, Garcia-Escudero, María, Bonastre-Férez, Javier et al. · International journal of environmental research and public health · 2020 · DOI
This study tested whether hands-on physiotherapy (manual therapy) could help people with fibromyalgia (FM) by reducing pain sensitivity and improving quality of life. Researchers measured pain sensitivity before and after treatment using a special device called an algometer. The main finding was that people with fibromyalgia alone responded better to the therapy than those who had both fibromyalgia and ME/CFS.
This research is important for ME/CFS patients because it identifies that the presence of ME/CFS alongside fibromyalgia may predict poorer responses to manual physiotherapy—information that could help clinicians set realistic expectations and tailor treatment plans. Understanding why ME/CFS comorbidity affects treatment response could also reveal shared biological mechanisms between these overlapping conditions.
This study does not prove that manual physiotherapy is ineffective for ME/CFS patients, only that this particular protocol showed reduced efficacy in the comorbid subgroup compared to FM-only patients. The observational design without a randomized control group cannot establish causation or rule out confounding variables (such as disease severity differences). Negative findings in one small patient cohort do not preclude benefits from other physiotherapy approaches or in other populations.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Falaguera-Vera, Francisco Javier, Garcia-Escudero, María, Bonastre-Férez, Javier, Zacarés, Mario, & Oltra, Elisa (2020). Pressure Point Thresholds and ME/CFS Comorbidity as Indicators of Patient's Response to Manual Physiotherapy in Fibromyalgia.. International journal of environmental research and public health. https://doi.org/10.3390/ijerph17218044
BibTeX
@article{mecfsatlas-falaguera-vera-2020-pressure-point,
author = {Falaguera-Vera, Francisco Javier and Garcia-Escudero, María and Bonastre-Férez, Javier and Zacarés, Mario and Oltra, Elisa},
title = {Pressure Point Thresholds and ME/CFS Comorbidity as Indicators of Patient's Response to Manual Physiotherapy in Fibromyalgia.},
journal = {International journal of environmental research and public health},
year = {2020},
doi = {10.3390/ijerph17218044},
note = {PubMed: 33142896},
url = {https://www.mecfsatlas.com/evidence/falaguera-vera-2020-pressure-point},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/falaguera-vera-2020-pressure-point
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