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Fibromyalgia and Massage

I would like other opinions on this. I have several clients who suffer from this disabling condition and have found that a lot of therapist are using very deep massage I find this frustrating and would like other opinions.

Replies to This Discussion

Permalink Reply by Susan G. Salvo on October 6, 2009 at 12:07pm

Hey Katie,

Here is what I have in Mosby's Pathology for Massage Therapists. I hope it helps you.

It was reveiwed and approved by Dr Leon Chaitow and other massage experts.

Massage Considerations - Massage is one of the best treatments for fibromyalgia (moderate aerobic activity being the best).

Massage should be tailored to how the client is feeling at the time of the treatment because symptoms vary daily.

Evidence suggests that although many clients request deep pressure, this commonly provokes strong reactions for several days following treatment.

A very slow increment in depth of massage strokes, from session to session, and careful deactivation of tender areas is recommended.

Be sure to address any other medical conditions (Raynaud’s syndrome, rheumatoid arthritis, systemic lupus erythematosus) in the treatment plan.

Permalink Reply by Katie Whitmire on October 6, 2009 at 12:28pm

Thank you . The strong reaction is what I commonly hear. And it does go on for days. What is your opinion on a class for this subject?

Permalink Reply by Susan G. Salvo on October 6, 2009 at 12:46pm

Katie,

You are correct - it can linger days.

A class on the topic is a good idea since FMS is one of the most common conditions affecting muscles, with at least 6 million people in the US currently diagnosed (it is speculated that there are an additional 6 million undiagnosed cases).

75-80% of people with FMS are women with 20-50 being the age range of onset.

Lots of folks suffering.

Katie Whitmire said:

Thank you . The strong reaction is what I commonly hear. And it does go on for days. What is your opinion on a class for this subject?

Permalink Reply by Gloria Coppola on October 6, 2009 at 1:57pm

Katie,
Many years ago when FM first came on the scene I had MANY clients with this diagnosis. I was also on a board/panel of multi-disciplinary health care practitioners (including MD's), who went around to speak on this topic at universities, hospitals and community centers.

DEEP tissue is NOT the way to go as previously thought. It creates re-bound effects. The nervous system is already being attacked so more aggressive stimulus is not beneficial.

After ALOT of research from around the world, light touch aka cranio sacral therapy, lymph drainage etc., was much more beneficial. Clients, themselves expressed this to all of us.

Another interesting bit of research, most FM patients are Type A and don't know the word "no", they also don't eat well for the most part. Usually on the run and high carb foods. Getting them to change their diet is crucial too. Less "white" foods , less sugar. I could go on and go. Hope this helps you and others out. Want to chat more, contact me personally. massageproce@gmail.com, Gloria

Permalink Reply by Mitchell R. Mosher, DPM, LMBT on October 11, 2009 at 9:05am

Hi Katie: I do and teach Bowen Therapy plus-- I have found that as gentle as Bowen is, about 50% of F.M. patients have lots of pain for a day or 2 after their session. The other 50 % have relief. I learned early on to ask them how a massage feels. If they say, "it hurts" I back off. If they say "massage feels good",I go for it. If they don't know, I do a little to see their response. A Bowen group in Fair Oaks Calif. did a study on F.M. If you would like a copy contact me @ bowenfootdoc@yahoo.com.
For anyone interested I am doing a free 2 C.E. hours seminar on bowen Technique @ southeastern Institute Sat. Nov 7th.

Permalink Reply by Jackie Wilson on October 18, 2009 at 10:38am

Hi! I have several fibromyalgia clients too and I do not do deep pressure on them..they are just fine with lighter strokes, just to warm up the muscles and make them feel a little better..

Permalink Reply by Mary Ellen Derwis-Balaz on October 28, 2009 at 5:24pm

Why not have the best of both worlds. Perform deep tissue massage in its original form. Deep tissue DOES NOT mean you have to create pain. Follow the true Rolfing model of going in slowly and deeply as tissues allow and lengthen muscles involved within their time frame. This takes time and patience. It works wonders for fibromyalgia Sometimes as therapists we forget that when a modality is first introduced it is with respectful moderate pressure. In time that gets misinterpreted and mistreanslated as a deep tissue painful massage. Go back to the basics. Your clients will thank you!

Permalink Reply by Hank Krebs on December 1, 2009 at 12:22pm

Hi Katie- Such a fantastic site!
Don't use deep tissue for many reasons. but have found success with fibros through a protocol of work which requires them to be involved with their getting better first. Sleep is #1 , exercise nourishment and diet, structural alignment
, lymphatic work to get fascia free , electro static massage is touchless and marvelous, I use a lot of reciprocal inhibition as it is pressureless also.
After 5 years attending the local support group I've found every Fibro I've seen or heard about has Mortons Toe(MT) and its problems problems. ( L Chaitows Journal of Bodywork and Movement Therapy has an article depicting the influences and problems with this condition called by another name causing a warped frame resulting in these: plantar fascitis, ankle , knee, low back , sciatic, neck& shoulders, TMJ, TOS and headaches). I believe MT to be a pre-cursor of Fibro and must be corrected to ever achieve any lasting relief.
In His Hands Massage- Hank

Permalink Reply by Frank J on February 27, 2010 at 9:26pm

I too have come to find through experience that deep pressure is not always the best when it comes to this condition. I have a client educate me on things about FM that i didnt know and it prompted me to do my own research. Now I have two clients that have this and one prefers the deep pressure but the other I have come to find that deep pressure doesnt work well with her. I believe that the moderate very slow pressure; releasing some fascia may have helped her a some. I also know a therapist who has a client and says that she felt relief from the hot stones, which i found interesting.

Frank

Permalink Reply by Hank Krebs on June 14, 2011 at 7:49am

Katie- add two books to your fibro must read list-"Overcoming THyroid Disorders" by David Brownstein,MD and "The Sinatra Solution" by Stephen Sinatra MD. Have 3 from 8s& 9s to 2/3s doing 21 days of massage , diet & other things.

Permalink Reply by Bethany Reed on October 2, 2011 at 9:13pm

Hi Katie,

Here is my take on Fibromyalgia with everything I've studied, experienced, & observed. Deep tissue massage is fine, for some. Light work is fine, for some. Fibromyalgia changes like the weather in Illinois lately, lol. One day a client can comfortably handle deep tissue work, the next they can barely stand touch at all. Tender points are scattered over the body (mainly upper arms, back of neck into shoulders, tops of hips, glutes, & thighs... with of course, respect to the calves if afflicted with RLS) & trigger points sit along the spine & shoulders.

I have clients who suffer from fibro, my mother suffers from fibro, and I suffer from fibro. The treatments for fibro involve multiple disciplines & patience. Here is why, fibromyalgia is considered a central nervous system problem. For some reason the sensation of pain refuses to shut off like it's supposed to. Nerves are excessively sensitive & reactive to things they shouldn't be... imagine allergies... a vast overreaction to an allergen causing a severe histamine response, only nerves. Fibromyalgia is also characterized by poor micro-circulation (which of course massage can help with) & "side-syndromes" as I call them (Restless Leg Syndrome, Irritable Bowel Syndrome, Interstitial Cystitis, Migraines, Sleep Apnea, Depression, etc.).

The cause of fibromyalgia is still unknown. But it is believed that someone can have a genetic predisposition (mother/daughter) & that a traumatic or excessively stressful situation can trigger it (surgery/loss). There is currently no cure for it, only treatments & coping methods. For a while fibro was used as a blanket diagnosis for "unknown pain". I've met some that were diagnosed with it, only to show severe tension or muscular spasms, no other symptoms of fibro. But as more research is emerging, a Fibromyalgia diagnosis has taken a whole knew light. The brain actually shows differently on scans than a non-fibro sufferer.

The best treatments I've seen, heard of, & experienced involve multiple disciplines. Massage being a key factor. Medication is common, but the problem is that a fibromyalgia sufferers brain actually does not respond to pain medication like it should. So though 1 Vicodin can make my mother-in-law loopy, for me it does nothing. One of the biggest problems for fibro sufferers is sleep. Many suffer from sleep apnea as well, but worse is that most fibro sufferers don't actually make it to restorative REM sleep. This is why massage can be so beneficial. It becomes less about trying to work-out the kinks, and more about resetting the central nervous system & helping that client to get restorative sleep.

The best advice I can give to any therapist working with a Fibromyalgia sufferer is to communicate & empathize. All too often people who suffer from fibro are treated, talked to, & considered nuts. That it's all in their mind. But that's not the case, just telling someone who suffers from fibromyalgia that you believe them & that they aren't crazy, that will put you in their corner. The next step is to communicate to them that they NEED to inform you if the pressure is at all uncomfortable, even a little. "It hurts so good" is fine as long as they know they will probably be sore the next day, but feel better in 2. After that, grab some water and get ready for the long haul.