by Nick Lakoff, CMT
Over a decade ago I had a client come see me for a massage. During the health history she mentioned that she had been diagnosed with a condition called Fibromyalgia. I had never heard of this condition and was unsure how to help her within the context of massage therapy. She said that she had been seeing a massage therapist for some time but she had retired from the profession and decided to get an appointment with me. She seemed very knowledgeable about this condition and what I learned from her and my own understanding of massage gave me the confidence that I could help her. After seeing her a time I noticed I was getting more and more clients who had this condition. It turned out that my client had shared with others afflicted with Fibromyalgia about her positive experience with me. This caught me a little by surprise but I was not daunted and decided to learn as much as I could about this condition.
Fibromyalgia (FM) is considered a syndrome, a group of symptoms that together are characteristic of a specific disorder, disease, or condition. The textbook definition of Fibromyalgia is “A syndrome characterized by chronic pain in the muscles and soft tissues surrounding joints, fatigue, and tenderness at specific sites in the body. Also called fibromyalgia síndrome (FMS), fibromyositis, fibrositis.”. This definition does not quite take in the scope of complexity of this affliction. There are a still a lot of unknowns about Fibromyalgia and we are still learning. Even just a few years ago most doctors misdiagnosed this condition as Rheumatoid Arthritis or Osteo Arthritis. What we do know now is the following: it affects mostly women between the ages of 40 and 55 (however cases of teens and young adults with this syndrome have been recorded), men account for 13% of overall cases, it can be dormant for long periods but can flare up at any time, areas affected can change from day to day even hours, the condition can surface after extreme trauma or periods of intense stress or hormonal changes.
The simplest and most accurate description of the mechanics of Fibromyalgia that I have encountered is that it’s a complete change in the role of hormones in the body as neurotransmitters. A gentle wind on your face and body now registers as pain, bright lights become painful even sound can be your enemy. Even worse is that FM co-exists with other conditions such as chronic fatigue syndrome and mimic the symptomology of a host of other conditions and diseases. In fact you have to eliminate almost every known pathology in medicine in order to come to a proper diagnosis. I was once told by a Rheumatologist that a proper investigation can take up to two years. According to current guidelines you must have widespread pain in all four quadrants of the body for at least 3 months and have 11 out of 18 of the specified tenderpoints. One of the reasons that a diagnosis is so difficult is that most of the time you rarely have 11 of the tenderpoints all at once. Regular tracking of the tenderpoints can lead to an average that corresponds to 11 out of 18. Another common symptom is depression and mistrust in the medical establishment. By the time someone like me sees an FM client they have run the gauntlet of doctors and other health specialists. Even more challenging for some is that some in the medical establishment strongly believe that FM is a psychological disorder. Very often just getting a proper diagnosis can substantially improve a patient’s outlook on life and empower them to take an active part in managing their symptoms.
Massage therapy can often lessen the pain related to FM but rarely completely eliminates it. It would be more accurate to say that it brings the pain to a more manageable level. Sometimes regular sessions can keep the flare ups in check but once a flare up occurs the effects can be substantially reduced. One thing that is essential to for a massage therapist dealing with a client with FM is flexibility since this conditions symptoms change from day to day sometimes even hours. I’ve had FM clients who’ve had me massage them so hard that I thought I would bruise them which made me uncomfortable but gave them much release and other times I’ve had to use feather light pressure on them.
I once attended a conference on FM and the guest speaker said that she had cured herself of her condition and hadn’t had a flare up in several years. She took drastic steps in order to nurse herself back to health. She quit her job, examined closely her diet and made changes where appropriate but there was one thing she said she did that changed her life; keeping an FM diary. In this diary, she kept critical data on everything relating to her life. She recorded the weather and temperature, all the meals she had, daily pain levels, areas that were painful, stressful events, etc…etc… Over time she started seeing a pattern with food she ate and flare ups. It turned out that immediately after eating peanut butter she would have a very severe flare up. This discovery led her to eliminate peanut butter and any peanut related items in her diet. Continuing other initiatives like eating better and exercising when she could, her condition got gradually better and better till she was symptom free. Certainly reducing her stress was part of the formula and there is nothing better to reduce stress than massage. If you’re suffering from FM you might consider throwing regular massage into the mix to manage your stress levels and pain.
Nick Lakoff is a certified practitioner in the following disciplines: Swedish Massage, Sports Massage, Reflexology, Acupressure, Myo-Fascial Release, Massage for Pregnancy, Swedish Chair Massage, Hot Stone Massage and Reiki.