Massage

Fibromyalgia and Massage Therapy

by: Debra Sewell, NCTMB, LMT

Quick Links:
  1. Signs and Symptoms
  2. Myofascial Trigger Point Therapy
  3. Massage Therapy
  4. Massage Treatment Goals

Fibromyalgia (fi-bro-my-AL-ja) syndrome (FMS) is a very common condition of widespread muscular pain and fatigue. It is believed that seven to ten million Americans suffer from FMS. The term fibromyalgia literally means: Fibro - fibrous tissue; my - in muscles; algia - pain. More easily understood as pain in the muscles and fibrous connective tissues (ligaments and tendons). This condition is generally associated with pain in the neck, trunk, and hips. Stiffness is felt in the morning, followed by fatigue and lethargy.

Signs/Symptoms:

  • Tenderpoints: hypotonic areas that generate local pain with pressure, usually feel soft (mushy) to touch found in all four quadrants of the body.
  • usually diagnosed if they have pain for 3 months or more in 11 (or more) of 18 tenderpoints
  • Found more in females but also found in males
  • Don't wake up rested, no deep stage sleep, sleep apnea
  • Paresthesia: burning, tingling, pins and needles
  • Increased sensitivity to smells, sounds, lights, pressure, temperature
  • Worse in cold, damp weather
  • Allergies, bruises easily, restless leg syndrome, PMS, hormonal changes, teeth grinding
  • Depressed immune systems
  • Reduced mental capacity; loss of concentration, memory loss
  • Limited or restricted breathing
  • Adhesions
  • Improper posture - forward head, asymmetrical body,
  • Cramps, bloating
  • Asthma, sinus conditions, post nasal drip
  • Hypoglycemia, sugar imbalances
  • Dry, itching skin
  • Dizziness, clumsiness, motor coordination problems, ringing in the ears
  • Dry throat, eyes: problems swallowing,
  • Feels like the flu but it just doesn’t go away - including tight muscles, body aches, severe fatigue, headache, and nausea.
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Fibromyalgia cannot be diagnosed with x-rays or blood tests but by the following three criteria:
  1. History of widespread pain (on both sides of the body, above and below the waist)
  2. Present for at least 3 months,
  3. Pain in at least 11 of 18 "tender point" sites located in the neck, shoulders, hips, knees, elbows, and back of thighs. These 18 identified tender points are generally in areas where muscles attach to ligaments or bone.

MYOFASCIAL TRIGGER POINT THERAPY

In myofascial trigger point therapy (sometimes called neuromuscular massage), a practitioner uses deep finger or elbow pressure on certain spots on the body to release knots of tension or pain that may be causing pain in other parts of the body.

While this treatment can be helpful for fibromyalgia, and may lead to long-term relief, it can also cause more immediate pain if the pressure applied is too hard. Because manual release of a trigger point may take five minutes or more, it should be performed when the involved muscle is as relaxed as possible. If your muscle is in spasm or very tense, the treatment will be too painful.
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MASSAGE THERAPY

Massage therapy can be a wonderful means of reducing the pain of fibromyalgia. Research has found that massage lowers levels of the stress hormones, increases production of the mood-altering hormone serotonin, and improves sleep.

Too vigorous or too deep a massage can actually worsen your pain and increase your tension. A recent study from the European Journal of Pain found that massage helped relieve pain, reduce depression, and improve the quality of life in people with fibromyalgia over a 10-week period. Massage Therapy can be a welcome component in the treatment of Fibromyalgia. The pain associated with this condition can be specifically addressed with soft tissue manipulations. Massage Therapy also triggers the release of Neuropeptides* into the bloodstream, and this is a key component to addressing pain, insomnia and depression.

It is out of the scope of practice for a Massage Therapist to diagnose Fibromyalgia or any illness, if you suspect your client has Fibromyalgia you may suggest that they consult their family physician for proper diagnosis.
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Massage Treatment Goals:

  1. reduce stress
  2. induce relaxation and sleep
  3. treat tender points (slowly as intense may exacerbate condition)

see accompanying text for details
Eleven to Eighteen Specific Trigger Points


On the front of the body:

  1. On the neck, just above inner edge of the collarbone

  2. Still on the neck, a little further out from the last points, about four finger widths down

  3. On the inner (palm) side of the lower arm, about three finger widths below the elbow crease

  4. On the inner side of the knee, in the “fat pad.”

On the back of the body:

  1. Along the spine in the neck, where the head and neck meet

  2. On the upper line of the shoulder, a little less than halfway from the shoulder to the neck

  3. Three finger widths, on a diagonal inward from the last points

  4. On the back fairly close to the "dimples" above the buttocks, a little less than halfway in toward the spine

  5. Below the buttocks, very close to the outside edge of the thigh, about three finger widths.



*Neuropeptides - Any of various short-chain peptides found in brain tissue, such as endorphins. Endorphins reduce the sensation of pain and affect emotions.

Ref: Fibromyalgia and Chronic Myofascial Pain Syndrome, By: Devin Starlanyl, M.D. ,and Mary Ellen Copeland, M.S., M.A.


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