Every year, more than 3 million Americans suffer with fibromyalgia (FM). Among other symptoms, this chronic disorder produces widespread muscle soreness and heightened sensitivity to stimuli, which frequently result in pain and make it difficult to fall asleep. There are many different forms of treatment, but some recent study suggests that massage therapy may be able to ease some of the discomfort.
Yet, because FM is a complicated disorder, working with FM clients is similar to dealing with clients who have other chronic or pre-existing health issues in that you need to have a deeper understanding of how the condition affects the client and when massage therapy can be beneficial. In the sections that follow, you’ll learn more about FM, what the most recent research has to say about it, and how massage therapy can help patients cope with some of its symptoms.
What is Fibromyalgia?
A illness called fibromyalgia is characterised by widespread and painful muscles. Fatigue, tension headaches, issues with cognition, and irritable bowel syndrome are a few more symptoms that are frequently linked to FM.
Curiously, despite the fact that one of the disorder’s main symptoms is muscle pain, more research on FM is beginning to point towards the fact that it is essentially a central nervous system disorder. More specifically, contrary to what was previously assumed, evidence now supports the notion that FM is a disease of the pathways in the central nervous system that process pain. 1 Stephen Perle, professor of clinical sciences at Bridgeport University, said research have demonstrated a link between stressors and FM. For instance, fMRI research has revealed that individuals with FM have brain activity in regions that are typically exclusively affected by painful stimuli.
As a result, central nervous system involvement may account for why FM patients are frequently hypersensitive to stimuli other than only mechanical pressure or touch. Further details are offered by Dr. Michael Schneider, an Associate Professor at the University of Pittsburgh and the creator of numerous studies on FM: The typical fibromyalgia sufferer, according to him, “simply isn’t sensitive to touch and can’t succumb to mechanical pressure.” “They don’t take heat and cold very well, are sensitive to light and sound, [may have] various chemical sensitivities, and multiple food allergies.”
Who Develops Fibromyalgia?
It is more convoluted than that, but the short answer is that women are significantly more likely than males to acquire fibromyalgia. The risk that someone may get FM is unknown, however genetics and personal trauma appear to be associated factors. The study of genetics is rather simple. Typically, FM runs in families.
But trauma is a little more complicated. Although one does not necessarily lead to the other, there appears to be a connection between FM and post-traumatic stress disorder. An exceptionally high prevalence of prior mental, physical, and/or sexual trauma was linked to the beginning of FM symptoms, according to a 2001 study including 600 FM patients. 2 The connection between personal trauma and FM may be that trauma frequently leads a person’s limbic system to go into overdrive, leading to the central nervous system hypersensitivity, according to Schneider’s evaluation of the FM study literature. 1 While working with individuals who have FM, keep in mind that not everyone has suffered trauma, but you should be prepared for it. “There’s a high association with trauma, and people need to be aware of that when they’re treating these patients,” says Schneider.
Treatment for Fibromyalgia
As there is no single medication or therapy that may completely cure fibromyalgia or even alleviate all of its symptoms, many FM sufferers choose a variety of strategies to manage their condition. You should conduct a comprehensive intake and understand how any medications they are taking may effect the massage therapy session because the majority of people will probably be taking medication that has been given by their primary care physician. Keep in mind that these clients’ ability to better manage the main FM symptoms depends on them practising self-care. Focus instead on how massage therapy can benefit them, such how it can help them sleep better or reduce stress.
Some patients might also practise acupuncture, yoga, or other complementary therapies in addition to massage treatment. Schneider observes significant advantages from combining conventional and unconventional therapies. “A collaborative approach is better for treating these folks,” he claims.
Massage Therapy and Fibromyalgia
More and more studies are demonstrating that massage therapy—out of all the alternative therapies available—really helps people with a variety of medical issues, including fibromyalgia. A 2011 study found that massage therapy decreased FM patients’ sensitivity to pain at tender spots while also reducing anxiety and improving sleep quality. 3 Another 2014 study that systematically examined nine prior studies on massage treatment and FM revealed that it immediately helped patients with the symptoms of pain, anxiety, and despair. 4
The same study found that massage therapy works best when applied to soft and connective tissues because doing so increases muscular flexibility and modifies local blood and lymph circulation. 4
Myofascial release has been demonstrated to be moderately useful, but there isn’t an one approach that is more effective with FM than others. 5 According to Rhode Island-based massage therapist Joseph Swinski, who frequently works with clients who have chronic disorders like FM, “to new massage therapists who would like to work with FM clients, I would urge them to load their proverbial tool box with as many modalities as they can. “There is no one solution that works for all when working with the FM population.”
It will be crucial for many customers to apply the proper amount of pressure, thus it’s crucial to communicate with the client effectively before and during the session and make adjustments as needed. Keep in mind that these clients probably won’t be able to handle deep pressure. “If they’re hypersensitive, the idea is that you’re going to have to go really light with them and kind of coddle that client,” says Schneider. This concept applies to every element of the massage treatment. He continues, “Talk to them in a quieter voice; that person’s going to adore the dark room with some great calming music.”
Flexibility is also a key ingredient to success when working with people with FM. “The most important thing I could hope to impress on a new massage therapist working with a client with FM is to be patient, not in a hurry and as observant as possible during the actual session,” says Erika Crisafulli, a massage therapist with the Texas Health Harris Methodist Hospital in Fort Worth. “Be compassionate. We all know what it is like to deal with physical ailments that we cannot get a hold of on our own.” Crisafulli knows this better than most, as she herself has had to deal with symptoms of FM. “Trying to control the symptoms so you can still live a full life is challenging, but not impossible if you are willing to help yourself,” she says. “It is so important to practice what you preach. If I don’t take care of myself, how in the world can I take care of my clients, something I love to do so much?”
After a massage treatment appointment, it’s a good idea to follow up with a client; this may require waiting a few days. After your first massage, you might need to adjust your strategy, advises Swinski. “I get in touch with my clients as a result following the massage. I reassure them that we can try different strategies if the outcomes are not what we had hoped for on their next appointment. You should remember that clients with FM will have various needs. Listen carefully and be prepared to modify the massage therapy session as necessary because what works for one person may not work for another.
Despite the complexity of FM, research indicates there are numerous ways massage therapy might make patients feel better. Massage treatment is demonstrating genuine potential in assisting people in better managing FM symptoms, from improved sleep to decreased stress.
Related: An Evidence-Based Guide to Fibromyalgia for Massage Therapists | 2 Credit Hours
Does Your Client Really Have Fibromyalgia?
The process of receiving a fibromyalgia diagnosis can be drawn out and challenging for many people. Yet, overdiagnosis is a growing issue because FM is a complicated, poorly understood disorder.
Dr. Michael Schneider, an associate professor at the University of Pittsburgh and the author of numerous studies on FM, observed that the condition was frequently used as a blanket diagnosis in a paper titled Differential Diagnosis of Fibromyalgia Syndrome published in 2006. The study finds that there is an issue with the existing conceptual paradigm of FM, which views all individuals with unexplained broad pain as belonging to one grandiose illness.
You can run against customers who were possibly misdiagnosed due to the complexity of FM diagnosis. What does that entail for massage therapists who treat FM patients? The fact is that massage therapy can be successful even when a client has received a wrong diagnosis, but massage therapists must allow the client take the initiative.
The question then becomes: Is the massage beneficial or not? If that client comments, “Oh, I feel terrific after that first massage,” when they return the following week for another treatment. Wonderful, let’s do that again,” Schneider adds. What’s the difference if the patient expects to receive temporary relief, and they do? They continue to receive aid.
1. 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.
2. 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
3. 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.
4. Li Y.H., Wang F.Y., Feng C.Q., Yang X.F., Sun Y.H. (2014) Massage therapy for fibromyalgia: a systematic review and meta-analysis of randomized controlled trials. 2014 Feb 20;9(2):e89304. doi: 10.1371/journal.pone.0089304. eCollection 2014.
5. 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.