Pain can make it difficult to enjoy everyday activities, but for people with fibromyalgia, pain can be constant- interfering with sleep, work and daily tasks. Fibromyalgia is a disorder characterized by widespread muscle pain and tenderness. Other common symptoms associated with FM include fatigue, intolerance to cold, tension headaches, cognitive difficulties, sleep difficulties and irritable bowel syndrome (there are many more symptoms). According to the American Chronic Pain Association, FM affects more than 6 million Americans. Though there is no cure currently, massage therapy may be one way to make life easier for people with FM. Treatment is varied as there is no one pill that cures fibromyalgia or even relieves all of the symptoms, so many people with FM deal with this condition using multiple approaches, and of all the alternative therapies available, more and more research is showing that massage therapy provides real benefits to people dealing with FM.
Interestingly, more of the research on FM is showing that the condition is actually a central nervous system disorder, even though muscle pain is one of its primary symptoms. More specifically, evidence points to the idea that FM is a disorder of the central nervous system pain processing pathways instead of a primary auto-immune disorder of the peripheral tissue, as once believed. “There were studies that showed the association between stressors and FM,” explains Stephen Perle, Professor of Clinical Sciences at Bridgeport University. “… fMRI has shown that people with FM, when exposed to non-painful stimuli, have activation of the brain in areas that are normally activated only by painful stimuli.”
A study in 2011 showed that massage therapy caused reductions in sensitivity to pain at tender points in patients with FM, as well as lowering anxiety levels and increasing quality of sleep. Another study from 2014, which systematically reviewed nine other studies about massage therapy and FM, found that massage therapy had immediate beneficial effects on improving pain, anxiety and depression in patients with FM. According to this same study, massage therapy is particularly effective when it is administered to soft and connective tissues because this improves muscle flexibility, as well as modulating local blood and lymph circulation. The modalities I use in my massage sessions for people with FM are commonly:
Myofascial Release:
This type of FM massage treats muscle pain, fascial pain and stiffness by relaxing contracted muscles, releasing sticky fascia, improving blood flow, and stimulating the “stretch reflex” in muscles. This approach was supported by the inventor of osteopathic medicine, Dr. Andrew Taylor Still. This FM massage technique can be active (patient provides resistance) or passive (patient stays relaxed).
Connective Tissue Massage or “Deep Fascia” massage:
This type of FM massage uses slower strokes with more pressure to release deeper layers of muscle and fascia (connective tissue).
Lymphatic Facilitation:
This gentle massage aids in the natural flow of lymphatic fluid, which is responsible for circulating through the body’s lymph system, carrying waste products away from the tissues and back toward the heart. This system works by movement of skeletal muscles and contraction of the “smooth muscle” in the walls of lymph vessels. This FM massage uses rhythmic motions to get the lymph fluid moving.
If you have FM, keep these things in mind when going to a massage:
-Make sure your massage therapist understands your condition and your symptoms
-Only you know what feels good and relieves your pain; don’t be afraid to ask your massage therapist to use less (or more) pressure as many times as you need to
-Make sure you tell your massage therapist about any sensitivity to lotions, oils, scents or have any allergies to any ingredients
-Treatment for fibromyalgia often involves multiple techniques and approaches for symptom relief and it may take some trial and error to find the combination that works for you
-Expect a need for more than one session to keep symptoms at bay
What to expect in a massage for FM:
-Full body relaxation
-Level of pressure may need to be adjusted as you go from one area of the body to another
-Interspersed Swedish massage with passive movement of joints and stretching (if it feels good to the client)
-Going over tender points (but not treating them like trigger points)
-Diaphragmatic breathing
-Extra attention spent on the key relaxation areas for FM: head, neck, shoulders, abdomen, hands and feet
My hope is that more FM sufferers reach out to massage as a part of their medical maintenance and reap all the benefits listed above. We know more about FM than ever before, and I’m looking forward to new discoveries in the near future.
Resources:
Michael J. Schneider, DC, PhD, David M. Brady, ND, DC, and Stephen M. Perle, DC, MS (2006) Differential diagnosis of fibromyalgia syndrome: Proposal of a model and algorithm for patients presenting with the primary symptom of chronic widespread pain. J Manipulative Physiol Ther. 2006 Jul–Aug;29(6):493-501.
Walen HR, Oliver K, Groessl E, Cronan TA, Rodriguez VM. Traumatic events, health outcomes, and health care use in patients with fibromyalgia. J Musculoskelet Pain 2001;9: 19–38
Castro-Sánchez, A.M., Matarán-Peñarrocha, G.A., Granero-Molina, J., Aguilera-Manrique, G., Quesada-Rubio, J.M., Moreno-Lorenzo, C. (2011). Benefits of massage-myofascial release therapy on pain, anxiety, quality of sleep, depression, and quality of life in patients with fibromyalgia. Evid Based Complement Alternat Med. 2011:561753.
“Massage Therapy for Fibromyalgia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials”
Yan-hui, Feng-yun, et. al, Feb. 2014
“Effectiveness of Different Styles of Massage Therapy in Fibromyalgia: A Systematic Review and Meta-Analysis”
Manual Therapy, Susan Yuan et. al, Jan. 2014