Does Massage Really Help Fibromyalgia?

Last Updated on October 1, 2025 by MASSAGE Magazine

Can massage therapy really help with fibromyalgia pain, anxiety, and depression? Absolutely, when done the right way and for long enough, it does make a noticeable difference. Regular massage sessions have been shown to ease muscle pain, reduce stress, improve mood, and even help with sleep problems that so many fibromyalgia patients face. While it’s not a cure, the right approach to fibromyalgia massage provides meaningful relief and improves quality of life.

One of the most well-known studies on massage therapy for fibromyalgia found that moderate-pressure massage twice a week for just five weeks reduced pain, fatigue, and tender points. Patients also reported feeling calmer, sleeping better, and having a more positive outlook. These results line up with what many massage therapists and clients experience in practice, consistent massage helps manage symptoms and promotes better day-to-day function.

In this article, we’ll explore what the research says about massage for fibromyalgia, the benefits of using techniques like Swedish massage and myofascial release, and how to build a simple plan that works. We’ll also look at how massage affects substance P (a chemical linked to pain), why session length and frequency matter, and how you can set realistic expectations for lasting results.

Quick Takeaways

Massage therapy twice a week for at least 5 weeks reduces fibromyalgia pain, anxiety, and depression. It also improves mood and relaxation, although research shows mixed results for sleep quality.
Research shows moderate improvements: A large meta-analysis found massage reduced pain (effect size 0.62), anxiety (0.44), and depression (0.49), which researchers consider moderate effects, meaning clients often notice real changes in daily function.
Current fibromyalgia guidelines (2025) recommend personalized, multimodal care. Massage is most effective when combined with exercise, cognitive behavioral therapy (CBT), good sleep hygiene, and medical management.
Fibromyalgia affects 2–4% of the population worldwide, causing chronic pain, fatigue, and lost productivity, making reliable, documented massage therapy outcomes valuable for long-term care plans.

How Massage Therapy Stacked Up Against Relaxation in Fibromyalgia Patients

What is Fibromyalgia?
The American College of Rheumatology defines fibromyalgia as “widespread chronic musculoskeletal pain of unknown cause and multiple tender points.” People with fibromyalgia also tend to have elevated levels of substance P, a neurotransmitter that amplifies pain signals in the nervous system.

How Was the Study Designed?
A group of 24 adults with fibromyalgia was randomly divided into two groups:

Massage Therapy Group
Relaxation Therapy Group

What Did Each Group Experience?

Massage Therapy: Participants received 30-minute massage sessions twice per week for five weeks. Each session included a mix of Swedish massage, shiatsu, and Trager® techniques, with moderate pressure applied to the head, neck, shoulders, back, arms, hands, legs, and feet.
Relaxation Therapy: Participants met for 30 minutes twice weekly for five weeks and practiced progressive muscle relaxation while lying quietly on a massage table.

How Were Results Measured?
To track immediate effects, researchers used the State Trait Anxiety Inventory before and after sessions on the first and last days of the study.

What Did They Find?
Both the massage and relaxation groups showed reduced anxiety and depressed mood immediately after their sessions, suggesting that both interventions had a short-term calming effect.

What Were the Immediate Effects?

Both the massage therapy and relaxation therapy groups showed a decrease in anxiety and depressed mood immediately after sessions, even from the very first day. This suggests that both treatments provided short-term emotional relief.

How Were Long-Term Results Tracked?

To get a deeper look at ongoing improvements, researchers used several methods:

The Center for Epidemiological Studies Depression Scale to monitor depressive symptoms.
Motion recorders worn at night to track sleep patterns.
Sleep logs where participants recorded their bedtimes and wake times.
Physician assessments of illness severity, medication use, tender points, and pain.
Saliva samples collected before the first and last sessions to measure levels of substance P, a neurotransmitter linked to pain.

What Did the Study Find?

Over the five-week period, the massage therapy group outperformed the relaxation group with clear benefits:

Decreased depression
Improved sleep quality
Reduced pain, fatigue, and stiffness
Better physician evaluations
Fewer tender points
Lower levels of substance P

According to the study’s authors, these findings “highlight the clinical significance of using massage therapy as a complementary treatment.”

How to Structure Massage Therapy for Fibromyalgia

Massage therapists can make a bigger impact when they follow a structured plan rather than a one-off session. Here’s a simple framework that aligns with research findings:

Frequency & Duration: Start with 30–45-minute sessions, twice per week, for at least 5 weeks. This is the same approach used in one of the most cited studies.
Assess & Adjust: Check in with the client at week 5. If they’ve experienced better sleep, less pain, or improved mood, consider shifting to biweekly or monthly maintenance sessions.
Flare-Up Strategy: During a fibromyalgia flare-up, shorter sessions (20–30 minutes) with very light, rhythmic techniques often work better than standard routines.
Techniques That Work: Swedish massage with moderate pressure, myofascial release, and light stretching are well-supported. Avoid heavy trigger point therapy or deep, sustained pressure on tender points.
Track Outcomes: Use pain rating scales, fatigue scores, or sleep logs to document progress and adjust treatment as needed.

Swedish massage is particularly effective for fibromyalgia because its long, flowing strokes promote circulation, reduce muscle tension, and encourage relaxation without overwhelming tender points. Myofascial release helps ease stiffness by gently stretching and loosening connective tissues, which often feel tight or restrictive in fibromyalgia clients. Shiatsu and Trager® techniques focus on rhythmic pressure and gentle movement, which calms the nervous system and improves overall body awareness, helping clients feel more at ease.

If you’re considering expanding your expertise, exploring the different types of massage therapists can help you identify modalities that complement fibromyalgia-focused care.

Tips and Contraindications for Fibromyalgia Massage

Massage can be incredibly soothing for clients with fibromyalgia, but every body responds differently. Here are some practical tips to ensure safe and effective treatments:

Listen to the client’s body. Clients know their bodies best. If a client is in the middle of a flare-up, start with very gentle techniques, especially if it’s their first session. It’s better to see how their body responds to lighter pressure than risk overworking their muscles.
Start slow and build gradually. Begin with moderate, gentle strokes and adjust pressure only if the client is comfortable.
Avoid over-treating tender points. Persistent or deep pressure on sensitive areas can increase soreness rather than relieve it.
Be mindful of coexisting conditions. Review any medical concerns or medications that could affect circulation, bruising, or inflammation. A thorough massage health history form can help you spot red flags and tailor treatments safely.
Stay communicative. Encourage clients to provide feedback during the session and follow up about how they felt after treatment.
Document responses and progress. Keep track of what techniques work best for future sessions. Using a detailed massage therapy intake form is an excellent way to track this information and monitor changes over time.

According to the 2025 fibromyalgia guidelines, massage therapy is most valuable when combined with lifestyle strategies such as gentle exercise, stress reduction, and sleep hygiene, a holistic approach that therapists can encourage during client sessions.

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Massage as a Game-Changer for Fibromyalgia Care

Massage therapy may not be a cure for fibromyalgia, but the evidence is clear, it can make a real difference in how patients feel day to day. From reducing pain, stiffness, and fatigue to improving mood and sleep quality, regular massage sessions, especially when done twice a week for at least five weeks, offer measurable benefits. The drop in substance P levels seen in the landmark study underscores how massage can target both the mind and body in ways relaxation alone cannot.

The real magic of massage therapy lies in how it complements other fibromyalgia treatments. When combined with exercise, stress management, good sleep habits, and other holistic approaches, it becomes a powerful part of a personalized care plan. As the 2025 guidelines highlight, fibromyalgia management isn’t one-size-fits-all, and massage is a flexible therapy that can be tailored to each person’s needs.

If you or your clients are looking for a natural way to ease fibromyalgia symptoms, massage therapy is worth exploring. With the right techniques, consistent sessions, and a focus on overall wellness, it can help turn daily challenges into manageable moments, and bring back a sense of comfort and control.

Protect Your Massage Career While Helping Clients Thrive

Working with clients who have chronic conditions like fibromyalgia requires not only skill but also peace of mind. Even the most experienced massage therapists know that accidents and misunderstandings can happen. Having reliable massage liability insurance protects your career and your reputation, so you can focus on helping clients feel their best.

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Source: Touch Research Institute. Authors: Tiffany Field, Ph.D., Miguel Diego, Christy Cullen, Maria Hernandez-Reif, Ph.D., William Sunshine and Steven Douglas. Originally published in the Journal of Clinical Rheumatology, April 2002, Vol. 8, No. 2, pp. 72-76.

After receiving massage twice weekly for five weeks, fibromyalgia patients experienced improved mood and sleep, and their levels of substance P, a neurotransmitter in the pain fiber system, decreased, along with the number of tender spots throughout their bodies, according to recent research.

The study, “Fibromyalgia Pain and Substance P Decrease and Sleep Improves After Massage Therapy,” was conducted by Tiffany Field, Ph.D., Miguel Diego, Christy Cullen, Maria Hernandez-Reif, Ph.D., William Sunshine and Steven Douglas of the Touch Research Institute at the University of Miami.

According to the American College of Rheumatology, fibromyalgia is defined as “widespread chronic musculoskeletal pain of unknown cause and multiple tender points.” Levels of substance P are significantly higher in people with fibromyalgia. Twenty-four adults with this condition were randomly assigned to either a massage-therapy or relaxation group.

Subjects in the massage group received 30-minute massages twice a week for five weeks. The sessions combined several types of bodywork, such as Swedish massage, shiatsu and Trager® work. The routine consisted of moderate pressure and stroking of the head, neck, shoulders, back, arms, hands, legs and feet.

Participants in the relaxation-therapy group met for a half-hour twice weekly for five weeks and were given instructions on progressive muscle relaxation while lying quietly on the massage table.

The State Trait Anxiety Inventory was used before and after sessions on the first and last days of the study to measure how subjects felt at that time.

Both the massage and the relaxation group showed a decrease in anxiety and depressed mood immediately after sessions on the first and last days of this study.

More long-term effects were also evaluated. The Center for Epidemiological Studies Depression Scale was used to measure depressive symptoms. Subjects wore a motion recorder at night to record activity during sleep and kept a log of the time they went to bed and awoke. A physician assessed participants’ illness, medication use, tender points and pain; and saliva samples were taken before the first and last sessions to measure levels of substance P.

The results revealed that, over the course of the study, the massage group, as compared with the relaxation group, experienced decreased depression; improved sleep; decreased pain, fatigue and stiffness; improved physician assessments; decreased tender points; and a reduced level of substance P.