Should everyone with fibromyalgia be booking regular visits with their massage therapist?
Or, does massage therapy do more harm than good for those suffering from chronic pain conditions?
When you develop sore muscles or wake up with a knot in your neck, what’s your go-to remedy?
For many of us, massage therapy is the first line of defense. There’s nothing like lying on the warm table as the experienced hands of your favorite massage therapist ease the muscle tension in your aching body.
However, not everyone’s body can enjoy a good massage. In fact, there are people for whom massage therapy may aggravate their symptoms. Complex pain syndromes like fibromyalgia involve pain signals from both the muscles and the nervous system.
Before discussing whether massage therapy can help with fibromyalgia, it’s important to define the two different types of pain patients suffering from fibromyalgia can experience.
Trigger point pain vs fibromyalgia pain
Trigger points are tight bands, nodules, or knots of muscle and/or fascia. These can be identified through palpation. A trigger point will generally feel like a lump or bump of stiff tissue. Putting pressure on a trigger point will often create radiation of pain to areas further away from the trigger point itself. This is known as referral pain.
If you’ve ever received a massage, you’re likely well aware when your therapist has found a trigger point. They hurt! Massage therapy is an ideal method for identifying and alleviating trigger points. However, fibromyalgia and trigger points are two very different conditions.
Patients with fibromyalgia experience chronic pain and tenderness in the muscles. However, this pain is not caused by any obvious tender masses or trigger points in the muscle tissue. The pain from fibromyalgia is thought to come about from the nervous system, not the muscles or fascia. (1)
That is not to say that those with fibromyalgia don’t get trigger points. They do. But the treatment patients with fibromyalgia receive should be differentiated from patients who do not suffer from this chronic pain syndrome.
The chief aim of a massage therapist working with someone with fibromyalgia should be twofold:
- Alleviate trigger points
- Calm the nervous system
If you’re dealing with fibromyalgia, it will be almost impossible to differentiate trigger point pain from fibromyalgia pain. They tend to blend or meld together. It is the job of the massage therapist to identify which areas of pain are related to trigger points and which are related to fibromyalgia.
Therapy should begin by identifying and alleviating the most uncomfortable trigger points. The remainder of the treatment should be focused on calming the nervous system. This two-pronged approach will bring about the most successful treatment outcome.
But is there an ideal type of massage therapy for fibromyalgia, and if so, what is it?
In 2015, scientists took a close look at a number of research experiments that had been done on the effectiveness of massage therapy with fibromyalgia. They combined the results of these studies through statistical analysis to come up with a number of conclusions. (2)
According to these studies, most forms of massage therapy provide an improved quality of life for those suffering from fibromyalgia. More information on the types of massage therapy that were studied, and which ones were found to be effective and not effective is outlined below.
What is the best type of massage for fibromyalgia?
Four different types of massage were studied. Each massage technique showed unique benefits in treating fibromyalgia. Below are the studied types of massage therapy:
- Myofascial massage
- Lymphatic drainage
- Swedish massage
Myofascial Massage & Fibromyalgia
Myofascial is a term used to describe the two tissue types worked on during the massage. Myo is in reference to the muscles. while fascial refers to the fascia. Fascia is a thin sheath of fibrous tissue located beneath your skin that encloses and separates your muscles from other organs. A myofascial massage looks to manipulate both muscles and fascia through consistent pressure.
There is increasing evidence showing that muscle and fascia pain in fibromyalgia patients may contribute to their pain symptoms. (3)
In this study, myofascial massage therapy was provided to half of the study’s participants. While a placebo – or, fake myofascial massage – was provided to others. In contrast with the placebo group, myofascial massage therapy was shown to have large, positive effects on pain. Myofascial massage also had a modest benefit on both anxiety and depression at the end of treatment. (4)
The myofascial massage also improved fatigue, stiffness, and quality of life approximately one month following the massage. The study concluded that myofascial massage is the most effective form of massage therapy for treating fibromyalgia.
If you suffer from fibromyalgia and book a myofascial massage to alleviate your pain, ensure your massage therapist focuses a portion of the treatment time towards calming your nervous system through breathing or relaxation techniques. This will add an even greater benefit to your treatment.
Lymphatic Massage & Fibromyalgia
Lymphatic massage, also called lymphatic drainage or manual lymph drainage, is a form of massage therapy that focuses on lymph nodes that have been removed or damaged. Lymph nodes are small glands located throughout your body that help move fluid, nutrients, and waste between your body’s tissues and bloodstream.
Lymphatic drainage is a technique that was developed in Germany for the treatment of lymphedema. Lymphedema is an accumulation of fluid that can occur after lymph nodes are removed during surgery. It most often occurs after a mastectomy for breast cancer as multiple lymph nodes tend to be removed. (5)
During a lymphatic massage, the therapist begins with a light massage on the surface of the skin over the affected lymph nodes. The massage then proceeds to lightly push the skin in the direction of the lymphatic system so accumulated lymph fluid can drain properly.
Lymphatic drainage was found to be a superior way to alleviate stiffness and depression, as well as improve the quality of life in patients suffering from fibromyalgia. (6)
Shiatsu Massage & Fibromyalgia
Shiatsu is a form of Japanese bodywork based on the theoretical framework of Traditional Chinese Medicine. Practitioners claim that it amplifies the body’s own ability to heal itself. (7) In the Japanese language, shiatsu means finger pressure. Shiatsu techniques include massages with fingers, thumbs, feet, and palms as well as assisted stretching and joint manipulation and mobilization.
During a shiatsu massage, pressure is applied to points on the body that will promote the flow of energy and correct imbalances. Shiatsu massage therapists and patients claim it regulates the autonomic nervous system as well as stimulating the circulatory, lymphatic and hormonal systems. (8)
When used on fibromyalgia patients, shiatsu massage was found to improve pain, pain threshold, fatigue, sleep and quality of life. (9) More than 90% of fibromyalgia patients who were treated with shiatsu massage twice a week for eight weeks reported satisfaction with this type of massage therapy. (10)
Swedish Massage & Fibromyalgia
Swedish massage is the most widely recognized and commonly used type of massage therapy. Clinical studies have shown Swedish massage to help reduce lower back pain, osteoarthritis in the knee and assist with managing stress.
The techniques used in Swedish massage vary from light to vigorous. Swedish massage uses five styles of strokes: (11)
- Sliding or gliding (effleurage);
- Kneading (petrissage);
- Rhythmic tapping (tapotement);
- Friction (cross fiber or with the fibers);
The primary goal of Swedish massage is relaxation for the entire body This is accomplished by applying the above techniques to the body in the direction of blood returning to the heart.
Although many massage patients report satisfaction and relaxation after a Swedish massage, when tested on patients suffering from fibromyalgia, it was not found to noticeably improve any of their symptoms. (12)
To offer greater benefit to those with fibromyalgia, Swedish massage therapists should focus on identifying and treating the most tender trigger points. Once the trigger points are alleviated, some form of relaxation technique should be used to end the treatment.
Why Massage Therapy Should Be A Go-to Treatment For Fibromyalgia
To conclude, massage therapy should be a regular part of treatment for one with fibromyalgia. In my experience, patients get the most benefit when massage therapy is scheduled on a regular basis. I personally recommend bi-weekly or monthly visits.
Regular massage allows progression. It is likely that through a series of visits you will notice fewer trigger points and tenderness. Massage therapy also has the added benefit of being relaxing. Do not underestimate how important this is in hte context of fibromyalgia.
Unfortunately, successful treatment is not as simple as booking a massage. Finding the right therapist is vital. Ask your doctor, specialist or support group for recommendations. When you find a therapist you trust, ensure they do not follow a set routine. If you notice each appointment looking identical to the previous one, it’s time to find someone else.
Fibromyalgia will not be remedied through massage therapy alone. A whole-body approach is required. At Flourish Clinic we have researched and written about other treatments and lifestyle modifications to help alleviate the symptoms of fibromyalgia. You can read more here:
- Should I Go To The Gym If I Have Fibromyalgia?
- The Fibromyalgia Diet: Weight Loss
- The Fibromyalgia Diet: Food Type
- The Fibromyalgia Diet: Gluten Free
Now, I want to hear from you!
How has massage therapy benefited you? What type of massage has been the most beneficial for you?
How often do you schedule your massages? And, what is your ideal frequency?
Leave your answers in the comments section below!
Also published on Medium.