Massage and Fibromyalgia
Fibromyalgia (FM, or Fibromyalgia Syndrome, FMS) is characterized by chronic
widespread pain and a heightened and painful response to
gentle touch. The typical fibromyalgia patient is
female, 40ish, insomniac, and under daily stress.
The FMS
symptoms that seem to respond well to massage therapy
are:
- Pain,
- Stiffness,
- Fatigue,
- Depression, and
- Sleep disturbances.
Tender Points vs. Trigger Points
A
doctor would consider a diagnosis of fibromyalgia if you
had a history of widespread body pain as well as at
least 11 of the 18 mapped "tender points" (at right).
These points cause pain when gently pressed. Although
there is much controversy about the root cause of this
pain, I think of it as a short circuit of the nervous
system's pain receptors. It just hurts for no
apparent reason.
On the other hand,
trigger points are irritated knots of muscle fibers
that may feel tender. Trigger point therapy involves
pressing firmly on those knots, forcing blood out of the
tissue, and forcing the muscle tissues to realign by
stretching.
I don't recommend treating a tender point this
way. It will just hurt. (A lot!)
However, the pain associated with tender points
often causes trigger points to form in the same
area, which make the pain even worse. If your massage
therapist doesn't know you have fibromyalgia and tries
to treat your trigger points... well, it can be
unpleasant.
My Approach
There is a wide range in the amount of pressure that
clients with FM can tolerate, so if you have FM, it is
important to communicate with me during the massage.
Most fibromyalgia clients know what works best for them
and are not shy about filling me in.
If you are having a flare-up, I usually suggest a
slow, gentle, relaxing
Esalen massage, with lots of stretching and range of
motion (ROM) exercises, rather than a vigorous deep
massage. We'll probably avoid trigger point
massage altogether and keep the touch light and calming.
We should not plan more than an hour session. You may
wish to be positioned on your side, since many FM
sufferers are uncomfortable face-down.
Later, when your pain has abated, we might try a
longer session and some deeper work, but no more than
you can easily tolerate.
Diagnosis
I'm just a massage therapist, so I can't make a
diagnosis. There are other conditions that can
mimic FM, and your doctor will know how to tell the
difference. If I suspect that you have fibromyalgia and
you are not aware of it (and it will probably take us a
half hour of unexpected ouches to figure it out), then I
will recommend that you see your doctor.
Since massage therapy is good for pain management, I
see a lot of clients with fibromyalgia. If you have FM
or think you may have FM, please discuss it with me when
you make your appointment. You are welcome to call me at
214-395-8000 with
questions at any time.
For more information about fibromyalgia, see the
Tranquility Times
article from January, 2008.
