Massage + Fibromyalgia

What is Fibromyalgia?

Fibromyalgia is a disorder characterized by widespread muscle pain and tenderness. Other common symptoms associated with FM include fatigue, tension headaches, cognitive difficulties and irritable bowel syndrome.

Interestingly, more of the research on FM is starting to suggest that the condition is actually a central nervous system disorder, even though muscle pain is one of its primary symptoms. More specifically, evidence points to the idea that FM is a disorder of central nervous system pain processing pathways instead of a primary auto-immune disorder of the peripheral tissue, as once believed.1 “There were studies that showed the association between stressors and FM,” explains Stephen Perle, Professor of Clinical Sciences at Bridgeport University. “For example, fMRI has shown that people with FM, when exposed to non-painful stimuli, have activation of the brain in areas that are normally activated only by painful stimuli.”

Who Gets Fibromyalgia?

The short answer to this question is that women are much more likely than men to develop fibromyalgia—but it is more complicated than that. The likelihood that someone will develop FM isn’t well-known, but there are two variables that seem to be related: genetics and personal trauma. Genetics is fairly straightforward. FM tends to run in families.

Trauma, however, is a bit more complex. There seems to be a link between FM and post-traumatic stress disorder, though one does not necessarily cause the other. A 2001 study of 600 participants with FM showed “an extremely high prevalence of past emotional, physical and/or sexual trauma associated with the onset of FM symptoms.”2 A review of the FM research literature by Dr. Michael Schneider, Associate Professor at the University of Pittsburgh and the author of multiple studies on FM, suggests that the connection between personal trauma and FM may be that trauma often causes a person’s limbic system to go into overdrive, contributing to the central nervous system hypersensitivity.1 Remember, not everyone with FM is going to have experienced trauma, but you should keep the possibility in mind when working with clients with this condition.

How Massage Helps

Of all the alternative therapies available, more and more research is showing that massage therapy provides real benefits to people dealing with a number of health conditions, including fibromyalgia. A study in 2011 showed that massage therapy caused reductions in sensitivity to pain at tender points in patients with FM, as well as lowering anxiety levels and increasing quality of sleep.3 Another study from 2014, which systematically reviewed nine other studies about massage therapy and FM, found that massage therapy had immediate beneficial effects on improving pain, anxiety and depression in patients with FM.4

Massage therapists working with clients with fibromyalgia do need to keep the following in mind:

Pressure: Using the right amount of pressure is going to be imperative, so it is important to clearly communicate with the client both before and during the session and adjust when necessary. Remember that deep pressure will likely be too much for these clients. “If they’re hypersensitive, then the idea is you’re going to have to go really light with them and kind of coddle that client and be a little more gentle with them,” says Schneider.

Flexibility:  “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.” 

Communication: Checking in with a client after a massage therapy session is also a good idea, and that sometimes means following up a few days later. “You may need to change your approach to massage after the first visit,” says Joseph Swinski, a massage therapist from Rhode Island who regularly works with clients with chronic conditions such as FM.. “This is why I contact my clients after the massage. If the results were not what we expected, I reassure them that there are other approaches that we could take in their next visit.”

Further Reading

Keep up on the latest research being done on how massage therapy can help people with fibromyalgia.

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.

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