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Fibromyalgia is a chronic, widespread pain condition affecting the musculoskeletal system, often accompanied by tiredness, decreased mood, and somatic dysfunction. This report aims to: (1) evaluate perineural therapy as a treatment for fibromyalgia, and (2) observe patient outcomes using an osteopathic approach including acupuncture and Osteopathic Manipulative Treatment (OMT). This case highlights a 63-year-old female with fibromyalgia treated with acupuncture, OMT, and perineural therapy (PNT). This report demonstrates the benefits of combining perineural therapy with other osteopathic techniques and treatment modalities. Further studies could evaluate the standalone effectiveness of perineural therapy.