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Review Article | DOI: https://doi.org/10.31579/2639-4162/288
1 A.T. Still University School of Osteopathic Medicine Arizona, Mesa, AZ, 85206.
2 University of Nevada-Reno School of Medicine, Reno, NV, 89512.
3 California Health Sciences University College of Osteopathic Medicine, CA.
4 The Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel.
5Wayne State University School of Medicine, Detroit, MI.
*Corresponding Author: Leonard Goldstein, A.T. Still University School of Osteopathic Medicine Arizona, Mesa, AZ, 85206.
Citation: Damilola Oladinni, Alejandra S. Rodriguez, Kailey Bae, Sophie A. Serfaty, Daphne Pate, et al, (2025), Osteopathic Manipulative Medicine in Managing Hidradenitis Suppurativa-Associated Chronic Pain: A Comprehensive Review, J. General Medicine and Clinical Practice, 8(9); DOI:10.31579/2639-4162/288
Copyright: © 2025, Leonard Goldstein. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 27 June 2025 | Accepted: 01 August 2025 | Published: 08 September 2025
Keywords: hidradenitis suppurativa; osteopathic manipulative medicine
Hidradenitis suppurativa (HS) is a debilitating chronic inflammatory skin disorder characterized by recurrent, painful nodules and abscesses, significantly impairing patients’ quality of life due to chronic pain. Current pain management approaches in HS primarily target inflammation and lesions through pharmacological therapies, surgery, and supportive treatments; however, pain frequently remains inadequately controlled. Osteopathic manipulative medicine (OMM), a hands-on therapeutic approach that treats somatic dysfunction through biomechanical, neurologic, lymphatic, and psychosocial mechanisms, presents a promising, yet underexplored, adjunctive modality for managing chronic HS pain. This comprehensive literature review synthesizes peer-reviewed evidence on the pathophysiology of HS-associated pain, identifies limitations in existing pain management strategies, and critically evaluates current knowledge of OMM’s efficacy in analogous chronic pain conditions. The review highlights significant gaps in current dermatological practice concerning interdisciplinary pain management and proposes potential mechanisms by which OMM may alleviate HS pain, including modulation of inflammation, improvement of lymphatic drainage, normalization of autonomic nervous system function, and reduction of central pain sensitization. Despite strong theoretical and indirect empirical support, direct clinical evidence for OMM in HS remains absent, underscoring the necessity for rigorous interdisciplinary clinical trials to determine the efficacy, optimal techniques, and integration strategies for this promising therapeutic modality. By advocating for research into OMM’s application in HS, this review aims to fill a crucial knowledge gap, enhance patient-centered care, and stimulate innovative cross-specialty collaborations that may substantially improve chronic pain management outcomes in patients suffering from hidradenitis suppurativa.
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by recurrent painful nodules, abscesses, and draining sinus tracts in intertriginous regions like the axillae, groin, perineal, and inframammary areas [1]. Beyond its hallmark suppurating lesions, HS imposes a severe burden of chronic pain that profoundly diminishes patients’ quality of life [1,2]. Pain in HS correlates more strongly with quality-of-life impairment than objective disease severity. In an international survey of 1,299 HS patients, a majority rated their pain as moderate-to-severe, and 4.5?scribed it as “the worst possible” [2]. HS pain severity has been reported as comparable to or worse than pain in conditions like chronic post-traumatic headache, vulvar lichen sclerosus, and leg ulcers [3,4,5]. Both nociceptive and neuropathic mechanisms contribute to HS pain: ongoing inflammation drives nociceptive pain, while chronic recurrent disease may induce peripheral nerve alterations and central sensitization of pain pathways [5,6]. Central sensitization, a pathologic amplification of pain processing, appears prevalent in HS. A recent case-control study found 36% of HS patients met criteria for central sensitization (versus 12% of controls), meaning HS patients have more than fourfold higher odds of central sensitization, independent of disease stage [7]. This neurologic upregulation may help explain why many HS patients experience pain out of proportion to visible inflammation. Unrelenting pain contributes to depression, anxiety, work disability, and even substance use disorders in this population [2,8]. Addressing chronic pain in HS is therefore critical not only for symptom control but also to improve mental health and prevent analgesic misuse.
Despite the clear need, effective pain management in HS remains a challenge. Standard dermatologic treatments such as antibiotics, retinoids, biologics, and surgery primarily target disease activity and often provide incomplete analgesia. There are currently no dedicated analgesic therapies approved for HS pain, and evidence-based guidelines offer only general recommendations [9]. Many dermatologists have limited training in chronic pain management and may undertreat HS pain in practice [8]. Consequently, patients frequently resort to self-management. Surveys indicate that up to 80% of patients with severe HS regularly use over-the-counter analgesics, and 70% report using complementary and alternative medicine (CAM) therapies to cope with their pain [10]. These CAM approaches include herbal supplements, relaxation techniques, and physical modalities, suggesting patients are urgently seeking pain relief beyond what standard medical care provides. The reliance on CAM highlights an important gap in current practice and an opportunity to integrate novel pain management strategies into HS care.
One such emerging strategy is osteopathic manipulative medicine (OMM), also known as osteopathic manipulative treatment (OMT). OMM is a hands-on, holistic form of therapy practiced by Doctors of Osteopathic Medicine (DOs) that aims to improve physiological function and alleviate pain by addressing somatic dysfunctions like impairments in the musculoskeletal, myofascial, lymphatic, or neural structures [11]. Osteopathic medicine is founded on the principles that the body is a unit of body-mind-spirit, it has self-healing capabilities, structure and function are interrelated, and treatment should be based on these tenets [12]. In practice, OMM encompasses a variety of manual techniques selected to target specific physiologic dysfunctions. The osteopathic approach can be conceptualized in five interacting models—biomechanical, respiratory-circulatory, neurologic, metabolic-energy, and behavioral—to address different aspects of a patient’s condition. Through these models, OMM seeks to restore normal structure and circulation, modulate neural reflexes, reduce stress, and support the body’s homeostatic and immune responses [13]. Given this multimodal, whole-person approach, OMM has been proposed as a beneficial adjunct in various difficult-to-treat disorders, including some dermatologic diseases with complex etiologies [11]. Notably, OMM has demonstrated efficacy in managing chronic musculoskeletal pain conditions, and evidence suggests it can modulate inflammation and autonomic function [14,15]. These properties raise the question: Could osteopathic manipulative medicine play a role in alleviating chronic pain in HS.
This review examines the intersection of OMM and HS-associated chronic pain. We provide a thematic synthesis of relevant literature from dermatology, pain management, and osteopathic medicine. We summarize the current understanding of chronic pain in HS and its management limitations, outline OMM principles and review evidence for its effectiveness in chronic pain and inflammatory conditions. Emerging research supports a multidisciplinary approach to chronic pain management, emphasizing the importance of collaborative care. By integrating dermatologic and osteopathic perspectives, osteopathic manipulative treatment (OMT) emerges as a promising interdisciplinary strategy for managing chronic pain in patients with HS. Incorporating OMT into HS management addresses an unmet clinical need and represents a meaningful step toward holistic, patient-centered care in dermatology.
2.1 Overview and Characteristics of HS Pain
Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disorder notable for recurrent, painful nodules, abscesses, and sinus tracts, predominantly in apocrine gland-bearing regions such as the axillae, groin, and inframammary areas. Pain is widely recognized as the most distressing and debilitating symptom experienced by patients with HS, often reported as severe, persistent, and difficult to control. Unlike other dermatologic diseases, pain in HS is present during both acute flares and between episodes, reflecting the ongoing inflammatory activity and tissue destruction. HS pain is frequently described as deep, throbbing, and stabbing, sometimes radiating beyond the lesions themselves [16,17]. The recurrent and unpredictable nature of HS flares further compounds pain experiences, with many patients reporting a constant baseline discomfort punctuated by episodes of acute, severe pain. This persistent pain contributes substantially to the overall disease burden and is a primary driver of physical disability, psychological distress, and impaired quality of life [18,19]. The social stigma associated with HS—arising from malodorous drainage and visible lesions—can intensify the subjective pain experience, further limiting patients’ social, occupational, and physical activities [20]. Ultimately, pain in HS is a multifaceted and dynamic symptom that significantly impacts the trajectory and management of the disease.
Types of Pain: Nociceptive, Inflammatory, Neuropathic
HS pain is complex and multifactorial, encompassing nociceptive, inflammatory, and neuropathic mechanisms. Nociceptive pain arises from tissue injury and direct mechanical damage due to nodules, abscesses, and sinus tracts. This type of pain is commonly acute and localized, correlating with periods of lesion rupture or infection. Inflammatory pain is perpetuated by chronic cytokine release (e.g., TNF-α, IL-1β) and infiltration of immune cells such as neutrophils and macrophages, leading to persistent activation and sensitization of peripheral nociceptors [18,21]. In advanced disease, repeated inflammation, scarring, and fibrosis can result in nerve injury, contributing to neuropathic pain. Patients may describe neuropathic symptoms as burning, tingling, or electric shock-like sensations, sometimes extending to areas without active lesions [22]. Moreover, the chronicity and intensity of HS pain can induce changes in pain pathways, resulting in pain that is disproportionate to clinical findings. Studies have also noted overlapping features between HS pain and other chronic pain syndromes, such as fibromyalgia, suggesting shared mechanisms of peripheral and central sensitization [16,23]. The interplay between these different types of pain underscores the need for a nuanced and individualized approach to pain assessment and management in HS patients.
Central Sensitization and Chronic Pain Syndromes
Central sensitization refers to an amplification of neural signaling within the central nervous system (CNS) that elicits pain hypersensitivity. In HS, repeated and prolonged nociceptive and inflammatory stimuli are thought to trigger maladaptive changes in the spinal cord and brain, lowering the threshold for pain perception [12,23]. This process manifests clinically as hyperalgesia (increased pain response to normally painful stimuli) and allodynia (pain from non-painful stimuli), and may help explain why many HS patients experience widespread, chronic pain even when lesions are quiescent. Central sensitization is associated with other chronic pain syndromes, such as complex regional pain syndrome and fibromyalgia, both of which have been reported with increased frequency in the HS population [18,24,25]. The resulting chronic pain not only increases physical morbidity but also amplifies psychological comorbidities, such as depression, anxiety, and sleep disturbances [22]. Importantly, central sensitization can diminish the effectiveness of traditional analgesics, necessitating multimodal and multidisciplinary approaches to pain management. The recognition of central sensitization as a major component of HS pain is shifting clinical paradigms, encouraging both clinicians and researchers to address underlying neuroplastic changes in addition to peripheral inflammation.
Patient-Reported Impact on Quality of Life
Pain is the most significant predictor of poor health-related quality of life (HRQoL) in HS and often surpasses that reported by patients with other chronic dermatologic or systemic diseases. Studies using the Dermatology Life Quality Index (DLQI) and pain-specific assessment tools have shown that HS patients consistently score among the lowest for HRQoL, particularly in domains related to physical discomfort, social functioning, and emotional well-being [17,22]. Pain leads to sleep disturbances, chronic fatigue, difficulty with mobility, and impairment in daily activities, including work and self-care. The unpredictable nature of HS pain and flares fosters chronic anxiety, social isolation, and increased risk of depressive disorders [18]. Many patients report withdrawing from relationships, employment, and public activities due to fear of pain, embarrassment, and stigmatization related to visible lesions and malodor. These psychosocial effects can be as disabling as the physical pain itself and may lead to a vicious cycle of distress, disease flares, and worsening overall function.
2.2 Current Pain Management Approaches
Pharmacological Interventions
Pharmacologic management of HS pain is challenging and often unsatisfactory. Nonsteroidal anti-inflammatory drugs (NSAIDs) are typically first-line agents, providing moderate relief for acute inflammatory pain but rarely adequate for severe or chronic cases [17]. Opioids may be used for intractable pain; however, they carry significant risks of dependence, tolerance, and adverse events, and their long-term efficacy is limited. Antibiotics with anti-inflammatory properties (e.g., tetracyclines, clindamycin-rifampin) can be helpful during acute flares but do not address chronic pain [21]. Biologics, particularly TNF-α inhibitors like adalimumab, have shown promise in reducing both lesion count and associated pain, though not all patients respond, and the cost can be prohibitive [26]. Other agents, such as corticosteroids, anti-androgens, and intralesional injections, may provide temporary relief but are rarely sufficient as monotherapy. Neuropathic pain agents, including gabapentinoids and tricyclic antidepressants, may benefit some patients with documented neuropathic symptoms [22]. Given the heterogeneity of HS pain, pharmacological therapy is most effective when tailored to the individual patient’s pain profile and used as part of a broader multimodal plan.
Surgical and Procedural Interventions
Surgical intervention remains a mainstay for patients with advanced or refractory HS, particularly when sinus tracts and scarring predominate. Procedures range from minor interventions (e.g., incision and drainage, deroofing) to wide excision of affected areas [17,21]. While surgery can reduce the burden of lesions and provide periods of pain relief, it is not curative, and recurrence rates remain high, especially without ongoing medical management. Postoperative pain, wound complications, and scarring are important considerations, and some patients may experience worsened or neuropathic pain following surgery [27]. Laser therapies, such as Nd-YAG and CO2 lasers, offer noninvasive options for select cases and can help control mild to moderate disease, sometimes resulting in decreased pain and improved quality of life. Successful surgical management typically requires a multidisciplinary approach, including pain specialists and wound care, and should be tailored to disease severity, patient preference, and overall health status.
Complementary and Alternative Medicine (CAM) Use
A growing proportion of HS patients seek complementary and alternative medicine (CAM) for pain relief, motivated by dissatisfaction with conventional therapies and the desire for holistic care. CAM approaches reported include dietary modifications (e.g., dairy- or gluten-free diets), supplements (e.g., turmeric, zinc), acupuncture, herbal remedies, and mind-body therapies such as yoga, meditation, and cognitive-behavioral therapy [27]. While some patients anecdotally report pain improvement with CAM, robust clinical evidence is lacking, and randomized controlled trials are scarce. Nonetheless, these modalities may serve as useful adjuncts to medical and surgical care, especially in managing stress, sleep disturbances, and the psychological burden of chronic pain. It is important for clinicians to discuss CAM openly with patients to ensure safety and avoid interactions with prescribed medications. Integrating evidence-based CAM therapies into multidisciplinary care models may offer additional avenues for addressing the multifaceted pain of HS.
Limitations and Inadequacies of Existing Treatments
Despite an expanding armamentarium of therapies, pain control in HS remains suboptimal for many patients. The multifactorial and chronic nature of HS pain—encompassing nociceptive, inflammatory, neuropathic, and centrally mediated mechanisms—renders monotherapy largely ineffective. Many current interventions, including pharmacologic, surgical, and CAM modalities, offer only partial or temporary relief and are often associated with adverse effects or high rates of recurrence [16,23]. There is a notable lack of high-quality clinical trials specifically targeting pain endpoints in HS, and most treatment guidelines focus on lesion clearance rather than pain reduction as a primary goal. Fragmented care, delayed diagnosis, and limited access to multidisciplinary pain management further compound treatment inadequacies [17,20]. There remains a critical need for research into novel analgesic targets, more rigorous evaluation of multimodal strategies, and development of comprehensive care pathways that prioritize both physical and psychosocial aspects of pain. Improving patient-centered outcomes will require a paradigm shift toward integrating pain as a central focus in HS management and research.
3. Osteopathic Manipulative Medicine (OMM): Principles and Mechanisms
3.1 Foundational Principles of OMM
Founded by Andrew Taylor Still, DO in 1874, osteopathic medicine is based on a holistic philosophy defined by four key tenets: 1. the body is a unit, and the person is a unified being of body, mind, and spirit; 2. the body has inherent capacities for self-regulation, self-healing, and health maintenance; 3. structure and function are closely interconnected; and 4. rational treatment is based on these core principles [28]. These tenets form the basis of five osteopathic treatment models commonly used in clinical care: biomechanical, respiratory circulatory, neurologic, metabolic energy, and behavioral. First, the biomechanical model identifies structural dysfunctions and uses osteopathic manipulative treatment (OMT) to improve range of motion, posture, somatic strain, and tissue texture, particularly important in addressing chronic musculoskeletal pain. In the respiratory circulatory model, enhancing respiratory mechanics and circulation helps facilitate tissue oxygenation and waste removal and contributes to decreased pain intensity and improved systemic function [29]. By promoting slower and deeper breathing, this model supports autonomic regulation and contributes to physical relaxation. The neurologic model targets imbalances in the autonomic nervous system through segmental facilitation and reflex activity [30]. Structural issues such as radiculopathy also highlight the importance of the neurologic model, as they can trigger broader neurological effects. Additionally, the metabolic energy model emphasizes maintaining homeostasis and supporting immune and endocrine function to optimize the body's energy utilization during healing processes [31]. Lastly, the behavioral model integrates the psychological, emotional, and social aspects of health, recognizing the dynamic interplay between somatosensory input, cognitive processing, and behavioral responses. This model reinforces the first tenet of osteopathic medicine to treat the body as a whole unit. Together, understanding the four tenets and five models of osteopathic medicine reinforces its emphasis on patient-centered, integrative care and highlights OMM's broad applicability to diverse health conditions.
3.2 Common OMM Techniques Relevant to Chronic Pain
Chronic pain is a biopsychosocial condition that requires multimodal and interdisciplinary treatment; therefore the use of osteopathic manipulative medicine (OMM) techniques is valuable especially in relation to the biomechanical model [28]. Five commonly used OMM techniques for chronic pain include myofascial release, muscle energy techniques, high-velocity low-amplitude (HVLA), lymphatic pump techniques and counterstrain and osteopathy in the cranial field. Myofascial release which can be applied directly or indirectly helps release restricted tissues within the musculoskeletal system and improves blood flow [32]. This technique enhances circulation and tissue mobility potentially reducing chronic muscular tension. Muscle energy techniques (MET) reduce chronic pain by activating patients’ muscles and engaging the stretch reflex to relax and lengthen shortened muscle groups [28,32]. They allow the patient to engage in the treatment actively and reinforce functional improvement. Another technique is HVLA which relieves joint restrictions in chronic conditions by engaging a restrictive barrier thereby decreasing joint pain and improving range of motion [32]. It provides a rapid mechanical release which can relieve chronic joint stiffness and localized pain. Lymphatic pump techniques promote smoother lymphatic flow and enhance immune function through rhythmic pumping motions [32]. This method supports fluid homeostasis and enhances immune surveillance by facilitating lymphatic drainage. Counterstrain involves specific positioning to relieve tender points and induce spontaneous muscle relaxation while osteopathy in the cranial field addresses primary respiratory mechanisms to treat chronic dysfunctions such as headaches [28,33]. These five OMM techniques are widely used in osteopathic medicine and represent valuable approaches in the management of chronic pain.
3.3. Evidence for OMM Effectiveness in Chronic Pain Conditions
Comprehensive Benefits of OMM: Musculoskeletal, Psychosocial, and Quality-of-Life Outcomes Osteopathic manipulative medicine (OMM) has emerged as an effective treatment approach for chronic pain, which affects multiple aspects of health, including psychological well-being, functional capacity, and physical mobility. Rotter et al. reported that OMM significantly reduced pain intensity and improved condition-specific outcomes in patients with four common chronic musculoskeletal pain conditions: chronic neck pain, chronic low back pain, chronic shoulder pain, and chronic knee pain [34]. These findings underscore the broad clinical relevance of OMM beyond these specific conditions. Similarly, OMM led to substantial improvements in quality of life for patients with chronic low back pain, with long-lasting therapeutic effects [35]. These results suggest that OMM not only improves physical function but also directly enhances psychosocial outcomes. Additional research supports the therapeutic value of OMM beyond musculoskeletal disorders; Hope-Bell et al. show that patients treated with OMM reported feeling more relaxed after treatment, a meaningful indicator of reduced psychological distress, including symptoms of depression and anxiety [36]. This suggests that OMM may play a role in improving chronic mental health through relaxation-based mechanisms. Furthermore, OMM reduced levels of cortisol, a key physiological marker of stress, supporting its potential application in managing anxiety, depression, and symptoms of attention-deficit/hyperactivity disorder (ADHD) [37]. Although further studies with larger participant groups are necessary to confirm these findings, current evidence indicates that OMM may significantly benefit both psychosocial health and overall quality of life. Continued research into its broader therapeutic applications is needed.
Effects on inflammatory markers and autonomic nervous system
Inflammation is a critical factor in chronic myofascial pain (MFP), a common inflammatory condition characterized by elevated levels of inflammatory mediators such as interleukin-1β (IL-1β), IL-6, and tumor necrosis factor-α (TNF-α) [38]. The quantitative analysis of these inflammatory markers should be evaluated to investigate the efficacy of osteopathic manipulative medicine (OMM) in treating chronic inflammatory conditions. Shah et al. reported that neuropeptides, cytokines, and catecholamines are significantly elevated near active myofascial trigger points [39]. Therefore, if OMM treatment demonstrates reduced levels of these mediators near trigger points, it would support its effectiveness in managing chronic myofascial pain. Some indirect OMT techniques such as counterstrain have already demonstrated their effectiveness by reducing IL-6 levels, while broader non-pharmacologic interventions including OMM and spinal manipulative therapy have shown decreased pro-inflammatory markers such as TNF-α and IL-6 and increased levels of anti-inflammatory cytokines like IL-4 [38,40]. Although more specific studies that directly measure inflammatory marker levels before and after OMM treatment are necessary, its potential as a non-toxic, drug-free therapeutic option for chronic inflammation is promising. In addition to its anti-inflammatory effects, OMT may influence the autonomic nervous system (ANS), which plays an important role in physiological stress regulation. Rechberger et al. demonstrated that high-velocity low-amplitude (HVLA) and cranial OMT techniques applied to the cervical spine increased parasympathetic activity, while thoracic techniques elevated sympathetic output [41]. These findings suggest that OMT may help restore autonomic balance and reduce sympathetic overactivity, providing clinical benefits for both stress-related and inflammatory conditions.
Safety profile and patient acceptability
Osteopathic manipulative medicine (OMM) is generally considered a safe intervention when performed by well-trained physicians. In a study of 925 patients with chronic conditions, the incidence of adverse events was only 2.5%, with the most common symptoms being mild pain or discomfort [28]. When applied with careful attention to vulnerable areas such as the cervical spine, OMM can be safely performed and is effective for managing chronic pain. Lam et al. present a study of 16 patients with chronic coccydynia treated with OMT and report significant clinical improvement, along with a high satisfaction rate, as 50% of patients completed follow-up, and none of them reported negative feedback [42]. These findings indicate a high level of patient acceptability and trust in OMM as a reliable form of care for chronic conditions although the small sample size limits the findings. Unlike drug-induced therapies, OMM avoids systemic side effects, making it preferable for patients sensitive to medications or with contraindications to drug-based treatments. Consorti et al. explored patient experiences through qualitative interviews and found that participants described OMM as “a path of awareness,” emphasizing not only physical benefits but also a deeper understanding of their body and overall well-being [43]. These insights emphasize the value of continued research on OMM in patient care, which could enhance future OMM strategies for chronic pain management by valuing patient expectations and satisfaction.
4. Application of OMM to Hidradenitis Suppurativa Pain
4.1 Potential Mechanisms for OMM Benefit in HS
Osteopathic Manipulative Medicine (OMM) is a multifactorial treatment for pain modulation and this may be important in regards to hidradenitis suppurativa (HS), where traditional therapies often fall short in chronic pain management. OMM targets numerous physiological pathways contributing to the chronic pain in HS through its effect on lymphatic drainage, neural signaling and the autonomic system. Lymphatic drainage is a manipulative therapy intended to increase lymphatic flow [13]. Lymphatic drainage has been proven to reduce edema and infections by removing excess fluid, inflammatory mediators, and cellular waste from the interstitial space [44,45]. Therefore, chronic inflammation associated with HS can be helped with lymphatic drainage techniques targeting lymphatic system flow to decrease edema, and to limit the development of painful nodules and abscesses. In addition, individuals who suffer from HS acknowledge that they have high-stress levels that are likely contributing to inflammation and pain perception as a result of autonomic dysregulation [46]. This is substantial since HS has both nociceptive and neuropathic pain contributions [47,48]. osteopathy in the cranial field (OCF), a second type of osteopathic manipulative therapy, is based upon noninvasive techniques of fascial palpation from cranium to sacrum [49]. OCF is designed to down-regulate elevated sympathetic nervous system responses typically seen in patients with chronic pain by modifying craniosacral body rhythms. In increasing parasympathetic activity, a patient may experience relaxation of tissue and enhanced physiological regulation. This shift may also reduce central sensitization and persistent pain [49]. These mechanisms suggest that OMM may be able to alter some mechanisms that drive HS pain such as inflammation or autonomic dysregulation, although it will be necessary to conduct further clinical investigations to substantiate its therapeutic role in HS.
4.2 Existing Evidence and Preliminary Observations
Although clinical trials on OMM in the treatment of HS have not been carried out to date, indirect evidence from other related disorders supports its potential relevance. Randomized controlled trials have validated that OMM can reduce pain and improve function in most illnesses such as headaches and chronic low back pain [50,51]. These findings show OMM’s influence on both inflammatory and neuromuscular pathways involved in chronic pain. A study done by Walkowski et al. indicated that lymph drainage methods caused significant changes in levels of cytokines, including IL-8, MCP-1, MIP-1α and G-CSF [13]. These findings indicate that OMM can modulate immune response and systemic inflammation. In dermatology, the use of OMM, particularly lymphatic drainage, has been shown to be successful in the treatment of such conditions as stasis dermatitis, Elephantiasis nostras verrucosa and trigeminal neuralgia where there is also autonomic and lymphatic dysfunction [44]. Although these findings are not HS-specific, they are relevant information that makes it worthwhile to further investigate the use of OMM in treating chronic pain in HS. There is a critical literature deficiency of clinical trials that evaluate specifically the efficacy, safety and long-term effects of OMM in HS. Lack of previous studies in this area present a clear window of opportunity for interdisciplinary studies to assess OMM’s contribution to HS chronic pain treatment. Lastly, recent case reports offer evidence, and literature suggests that OMGG may benefit patients with chronic inflammatory conditions — an applicable consideration, considering HS is likewise a chronic inflammatory condition. The overlap of pathophysiology and mechanisms presents it as reasonable and imperative, therefore, to explore the possible role of OMM in HS.
4.3 Practical Considerations and Treatment Adaptations
Safety Precautions in Active HS Lesions
Application of Osteopathic Manipulative Medicine (OMM) in hidradenitis suppurativa (HS) requires careful clinical judgment, particularly during active flare-ups. Many OMM techniques involve direct manipulation. If these techniques are done over draining, ulcerated, or inflamed lesions, especially to areas such as the axillae or groin, they may exacerbate pain or risk secondary infection. In these cases, practitioners can use indirect maneuvers that support systemic function without aggravating active lesions.
Contraindications of Lymphatic Techniques
Lymphatic drainage has been proved to reduce edema and enhance immune clearance in chronic inflammatory diseases. However, in the context of HS, its use must be cautious and condition-dependent. Lymphatic techniques are contraindicated over acute infection sites, open abscesses, active drainage, or systemic bacteremia due to the risk of pathogen dissemination [52]. These complications are particularly relevant in the setting of HS flares, in which lesions may possibly be under risk of rupture or secondary infection. Other contraindications include deep vein thrombosis, acute heart failure, recent fractures, organomegaly, and hematologic disease. Indirect maneuvers, such as the pedal and thoracic pump, may offer a safer alternative to support lymphatic flow without direct contact with active lesions. The pedal pump technique involves gentle rhythmic dorsiflexion applied at the feet, creating a fluid wave that enhances whole-body circulation. The thoracic pump also follows the same philosophy of regulating thoracic pressure to allow lymphatic return and respiratory effectiveness [53]. With proper application, such indirect techniques are able to provide systemic lymphatic drainage without aggravating the lesions seen in HS.
Contraindications for Osteopathy in the Cranial Field
Osteopathy in the cranial field (OCF), an OMM modality employed to reduce central sensitization and sympathetic tone, is generally well tolerated in stable patients. However, it has important contraindications. Cranial manipulation is contraindicated in patients with acute trauma, absence of biomechanical dysfunction, or treatment-resistant patients [44]. Before initiating OCF in HS patients, especially with a history of neurological disease, a thorough neurologic history and screening are warranted. Lastly, the safe and effective application of OMM in HS relies upon individualized patient assessment, clear knowledge of contraindications, and close collaboration with dermatology and other specialist services. If used judiciously, OMM can be of great value in pain mitigation and regulation of physiology without compromise to patient safety.
Proposed Strategies for Integration with Standard Dermatologic Care
Integration of Osteopathic Manipulative Medicine (OMM) and manual therapies into fundamental dermatologic treatment of hidradenitis suppurativa (HS) must be a coordinated and multidisciplinary process. Successful integration is initiated with clear communication among dermatologists, osteopathic physicians, and other medical professionals to make certain that manual intervention is optimally suited to the dermatologic disease and overall state of general health of individual patients. OMM techniques are safest when performed on stable or quiescent phases of HS in order to minimize the risk of eliciting inflammation or secondary infection [52]. When paired with pharmacologic therapies—such as antibiotics and biologics—OMM may have synergistic effects through the augmentation of lymphatic drainage and systemic inflammation regulation. While dermatology clinics are often fast-paced and don't always permit regular OMM, many dermatologic conditions, such as HS, would be enhanced by its use [44]. Standardized treatment protocols and investment in educational training of clinicians can enhance care's safety, accessibility, and dependability further. Even though training in OMM has not been provided to all clinicians, information about its value as an adjunct therapy and early referral to trained professionals can open up more treatment options to more complex dermatologic illnesses [44]. Further research is needed to confirm the efficacy of OMM and to more clearly establish its role in the treatment of HS.
Patient Selection and Individualized Treatment Approaches
Safe and effective use of OMM in HS patients demands careful patient selection and personalized treatment planning. Manual therapy may not be suitable for all patients with HS at all stages of their condition. Treatment methods are to be taken into consideration by keeping in mind the frequency and severity of active lesions, patient preference, pain tolerance, and co-morbidities. During severe flares, particularly on draining, open, or with systemic symptoms, manual therapy as a whole should be avoided, especially those with direct contact near the affected areas [52]. Pedal or thoracic pumping may be utilized to aid systemic lymphatic function without exacerbating local tissue integrity further [53]. A personalized approach requires careful consideration of relative and absolute contraindications to certain OMM maneuvers. A medical history and physical exam should always precede any use of OMM, with particular consideration of cardiovascular, neurologic, and lymphatic systems. For instance, osteopathy in the cranial field may be indicated in certain patients with HS who have characteristics of chronic pain or central sensitization but not for those with recent head injury or other neurologic contraindications [44]. Equally important is aligning manual therapy with the goals of care and tolerance of the patient. Most take most benefit from integrative care during phases of quiescence in HS, in which manual therapies can relieve pain, assist lymphatics, and modulate the stress response. Shared decision-making, informed consent, and patient education regarding OMM objectives and limitations are key to delivering safe, individualized care. Combination of osteopathic and dermatologic teams enhances clinical outcomes by optimizing benefit and reducing risk by having therapeutic decisions dependent on both dermatologic and systemic factors.
5. Critical Analysis: Identified Research Gaps and Future Directions
5.1 Current Limitations and Knowledge Gaps
Despite the increased interest and need for pain management strategies in those with hidradenitis suppurativa (HS), there is a lack of research regarding the clinical application of osteopathic manipulative medicine (OMM). There is a notable absence of dedicated clinical trials assessing the efficacy, safety, and long-term sequelae of OMM in populations with HS. Theoretical rationale and indirect evidence from other chronic pain conditions support OMM's potential for pain management in HS. However, the lack of empirical data limits the validation of these implications. The therapeutic value must be confirmed by randomized control trials before OMM can be incorporated [44]. For those physicians who do practice OMM, there is a lack of evidence-based treatment protocols for the use of OMM in HS patients. Since patients with HS often have inflammatory nodules, sinus tracts, and/or chronic neuropathic pain, a standardized technique for OMM that would be applicable to HS is needed [54]. Dermatologic care typically focuses on immunologic and surgical management of the active lesion, with pain management often falling short [55]. There is a lack of knowledge about which patients with HS would be most likely to benefit from OMM since predictors of treatment response are not yet established. With heterogeneity of HS, and central sensitization occurring in over one-third of patients, clinical or neurophysiological indicators that are pertinent to treatment stratification must be established [56]. Otherwise, clinicians are unable to tailor OMM to those who would be most likely to benefit.
5.2 Recommendations for Future Research
Initially, pilot clinical trials should be initiated to determine the feasibility, safety, and therapeutic impact of OMM on HS-associated pain. These studies must utilize validated pain assessment tools, stratify based on central sensitization status, and assess the functional and quality-of-life outcomes. Because the pain of HS is frequently refractory to conventional treatments and neuropathic in nature, early-phase trials can provide insight into patient selection, treatment durations, and appropriate OMM modalities. Mechanistic studies are also needed, specifically to elucidate how OMM would be capable of exerting anti-inflammatory, immunomodulatory, or neuromodulatory effects in HS [57]. Understanding the effects is important for the application of OMM in HS patients. Earlier studies have suggested that OMM techniques may influence lymphatic drainage, autonomic tone, and neural reflex arcs, but underlying molecular and neurophysiological processes are poorly characterized [57]. Laboratory-based and translational research must focus on quantifying changes in cytokine profiles, autonomic balance, and neural sensitization following OMM interventions. Finally, research must be directed toward developing and implementing models of interdisciplinary care that integrate dermatology, osteopathic medicine, and pain management. These models would enable coordination between the lesion-directed treatments used now and new holistic therapies such as OMM. This creates a more patient-centered strategy for addressing the pain caused by HS.
Chronic pain associated with hidradenitis suppurativa (HS) significantly diminishes patient quality of life and remains inadequately addressed by conventional management strategies. This comprehensive review underscores osteopathic manipulative medicine (OMM) as an innovative yet underexplored therapeutic modality uniquely capable of addressing multiple dimensions of HS pain, including inflammation, lymphatic congestion, musculoskeletal dysfunction, autonomic imbalance, and central sensitization. Although current evidence specifically applying OMM to HS is limited, strong theoretical rationale and demonstrated efficacy of OMM in similar chronic inflammatory and pain conditions justify rigorous clinical investigation. Future interdisciplinary studies, incorporating dermatologists, osteopathic physicians, pain specialists, and immunologists, are essential to establish OMM’s clinical utility, optimal techniques, and integration strategies within HS management. Ultimately, validating and adopting OMM could substantially enhance patient-centered, holistic care for those suffering from this challenging dermatologic condition, marking a significant advancement toward comprehensive interdisciplinary treatment in dermatology.
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.
Dear Ms. Mayra Duenas, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. “The International Journal of Clinical Case Reports and Reviews represented the “ideal house” to share with the research community a first experience with the use of the Simeox device for speech rehabilitation. High scientific reputation and attractive website communication were first determinants for the selection of this Journal, and the following submission process exceeded expectations: fast but highly professional peer review, great support by the editorial office, elegant graphic layout. Exactly what a dynamic research team - also composed by allied professionals - needs!" From, Chiara Beccaluva, PT - Italy.
Dear Maria Emerson, Editorial Coordinator, we have deeply appreciated the professionalism demonstrated by the International Journal of Clinical Case Reports and Reviews. The reviewers have extensive knowledge of our field and have been very efficient and fast in supporting the process. I am really looking forward to further collaboration. Thanks. Best regards, Dr. Claudio Ligresti
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation. “The peer review process was efficient and constructive, and the editorial office provided excellent communication and support throughout. The journal ensures scientific rigor and high editorial standards, while also offering a smooth and timely publication process. We sincerely appreciate the work of the editorial team in facilitating the dissemination of innovative approaches such as the Bonori Method.” Best regards, Dr. Matteo Bonori.
I recommend without hesitation submitting relevant papers on medical decision making to the International Journal of Clinical Case Reports and Reviews. I am very grateful to the editorial staff. Maria Emerson was a pleasure to communicate with. The time from submission to publication was an extremely short 3 weeks. The editorial staff submitted the paper to three reviewers. Two of the reviewers commented positively on the value of publishing the paper. The editorial staff quickly recognized the third reviewer’s comments as an unjust attempt to reject the paper. I revised the paper as recommended by the first two reviewers.
Dear Maria Emerson, Editorial Coordinator, Journal of Clinical Research and Reports. Thank you for publishing our case report: "Clinical Case of Effective Fetal Stem Cells Treatment in a Patient with Autism Spectrum Disorder" within the "Journal of Clinical Research and Reports" being submitted by the team of EmCell doctors from Kyiv, Ukraine. We much appreciate a professional and transparent peer-review process from Auctores. All research Doctors are so grateful to your Editorial Office and Auctores Publishing support! I amiably wish our article publication maintained a top quality of your International Scientific Journal. My best wishes for a prosperity of the Journal of Clinical Research and Reports. Hope our scientific relationship and cooperation will remain long lasting. Thank you very much indeed. Kind regards, Dr. Andriy Sinelnyk Cell Therapy Center EmCell
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. It was truly a rewarding experience to work with the journal “Clinical Cardiology and Cardiovascular Interventions”. The peer review process was insightful and encouraging, helping us refine our work to a higher standard. The editorial office offered exceptional support with prompt and thoughtful communication. I highly value the journal’s role in promoting scientific advancement and am honored to be part of it. Best regards, Meng-Jou Lee, MD, Department of Anesthesiology, National Taiwan University Hospital.
Dear Editorial Team, Journal-Clinical Cardiology and Cardiovascular Interventions, “Publishing my article with Clinical Cardiology and Cardiovascular Interventions has been a highly positive experience. The peer-review process was rigorous yet supportive, offering valuable feedback that strengthened my work. The editorial team demonstrated exceptional professionalism, prompt communication, and a genuine commitment to maintaining the highest scientific standards. I am very pleased with the publication quality and proud to be associated with such a reputable journal.” Warm regards, Dr. Mahmoud Kamal Moustafa Ahmed
Dear Maria Emerson, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews’, I appreciate the opportunity to publish my article with your journal. The editorial office provided clear communication during the submission and review process, and I found the overall experience professional and constructive. Best regards, Elena Salvatore.
Dear Mayra Duenas, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews Herewith I confirm an optimal peer review process and a great support of the editorial office of the present journal
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. I am really grateful for the peers review; their feedback gave me the opportunity to reflect on the message and impact of my work and to ameliorate the article. The editors did a great job in addition by encouraging me to continue with the process of publishing.
Dear Cecilia Lilly, Editorial Coordinator, Endocrinology and Disorders, Thank you so much for your quick response regarding reviewing and all process till publishing our manuscript entitled: Prevalence of Pre-Diabetes and its Associated Risk Factors Among Nile College Students, Sudan. Best regards, Dr Mamoun Magzoub.
International Journal of Clinical Case Reports and Reviews is a high quality journal that has a clear and concise submission process. The peer review process was comprehensive and constructive. Support from the editorial office was excellent, since the administrative staff were responsive. The journal provides a fast and timely publication timeline.
Dear Maria Emerson, Editorial Coordinator of International Journal of Clinical Case Reports and Reviews, What distinguishes International Journal of Clinical Case Report and Review is not only the scientific rigor of its publications, but the intellectual climate in which research is evaluated. The submission process is refreshingly free of unnecessary formal barriers and bureaucratic rituals that often complicate academic publishing without adding real value. The peer-review system is demanding yet constructive, guided by genuine scientific dialogue rather than hierarchical or authoritarian attitudes. Reviewers act as collaborators in improving the manuscript, not as gatekeepers imposing arbitrary standards. This journal offers a rare balance: high methodological standards combined with a respectful, transparent, and supportive editorial approach. In an era where publishing can feel more burdensome than research itself, this platform restores the original purpose of peer review — to refine ideas, not to obstruct them Prof. Perlat Kapisyzi, FCCP PULMONOLOGIST AND THORACIC IMAGING.
Dear Grace Pierce, International Journal of Clinical Case Reports and Reviews I appreciate the opportunity to review for Auctore Journal, as the overall editorial process was smooth, transparent and professionally managed. This journal maintains high scientific standards and ensures timely communications with authors, which is truly commendable. I would like to express my special thanks to editor Grace Pierce for his constant guidance, promt responses, and supportive coordination throughout the review process. I am also greatful to Eleanor Bailey from the finance department for her clear communication and efficient handling of all administrative matters. Overall, my experience with Auctore Journal has been highly positive and rewarding. Best regards, Sabita sinha
Dear Mayra Duenas, Editorial Coordinator of the journal IJCCR, I write here a little on my experience as an author submitting to the International Journal of Clinical Case Reports and Reviews (IJCCR). This was my first submission to IJCCR and my manuscript was inherently an outsider’s effort. It attempted to broadly identify and then make some sense of life’s under-appreciated mysteries. I initially had responded to a request for possible submissions. I then contacted IJCCR with a tentative topic for a manuscript. They quickly got back with an approval for the submission, but with a particular requirement that it be medically relevant. I then put together a manuscript and submitted it. After the usual back-and-forth over forms and formality, the manuscript was sent off for reviews. Within 2 weeks I got back 4 reviews which were both helpful and also surprising. Surprising in that the topic was somewhat foreign to medical literature. My subsequent updates in response to the reviewer comments went smoothly and in short order I had a series of proofs to evaluate. All in all, the whole publication process seemed outstanding. It was both helpful in terms of the paper’s content and also in terms of its efficient and friendly communications. Thank you all very much. Sincerely, Ted Christopher, Rochester, NY.
