OBJECTIVE: to verify the impact of the use of connective tissue massage (CTM) technique versus myofascial release (MFR) performed manually by the therapist and foam roller self-myofascial release (FRSMR) performed by the patient on fibromyalgia pain-related outcomes. METHOD: this is a systematic review and meta-analysis, performed in the PubMed, Web of Science, Scopus, SciELO, LILACS, and Embase databases. The PRISMA 2020 guidelines were followed, and the risk of bias was assessed using the National Institutes of Health tool, with agreement measured by Cohen's Kappa. RESULTS: 10 studies were included in the qualitative synthesis and meta-analysis. Dysfunctions of the muscle fascia contribute to the pathogenesis of fibromyalgia and can directly influence pain and central sensitization. In the meta-analysis, under the random-effects model, MFR significantly reduced pain (SMD -1.16, p = 0.0003), whereas CTM did not reach significance (p = 0.29). By contrast, the fixed-effect model underestimated the results due to heterogeneity. CONCLUSION: MFR has is more effective prognosis in pain reduction compared to CTM. However, the efficacy of MFR depends on the demographic and adaptive factors of the individuals and, especially, on the methodological definition of the intensity and time for which the MFR technique should be applied. In populations of different age groups, FRSMR techniques are recommended to be adapted. The personalized and specific approach of MFR suggests that it could be a promising strategy in the management of fibromyalgia, with the possibility of more robust and sustainable outcomes.

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