Visceral manual therapy as an intervention for musculoskeletal disorders: A scoping review

Background: Chronic musculoskeletal pain, affecting ∼35 % of adults in industrialized countries, impairs physical function, mental health, and quality of life. Visceral manual therapy (VMT), targeting visceral dysfunction to alleviate musculoskeletal pain, is underutilized in clinical practice. Aims: To evaluate VMT's effectiveness for chronic low back, shoulder, and cervical pain. Methods: A scoping review, following PRISMA guidelines, searched PubMed, PEDro, and Google Scholar for English-language randomized controlled trials (RCTs), quasi-controlled trials, or pilot studies (2015–2025) involving adults with chronic musculoskeletal pain treated with VMT. Study quality was assessed using the PEDro scale by two independent reviewers. Results: Nine studies (326 participants, PEDro scores 4–9, mean 6.1) demonstrated that VMT, alone or in combination with conventional physical therapy (e.g., exercises, manual therapy), significantly reduced pain in eight studies, often exceeding the minimal clinically important difference. Improvements in function, lumbar mobility, depression relief, and visceral mobility were noted in some studies; however, the outcomes for range of motion and muscle activation remained inconsistent due to the use of heterogeneous measures. No serious adverse events were reported, though safety data were inconsistently reported, and small sample sizes limit generalizability. Conclusion: VMT is a promising adjunctive therapy for chronic musculoskeletal pain, particularly when combined with conventional treatments. Clinicians should screen for visceral dysfunction, while future high-quality RCTs with standardized protocols and validated outcomes are needed to strengthen evidence.