Do you remember the last time you had the flu? With it came aches, pains, stiffness, headaches, lethargy, disturbed sleep, inability to concentrate and discomfort. These symptoms no doubt went away after a few days, or a week at most.
Now imagine having the flu all the time.
For the fibromyalgia client, flu-like symptoms, with the exception of fever, can persist for weeks, months or years.
Some people live with these symptoms every day and night of their lives.
Because fibromyalgia is a syndrome, or a collection of symptoms and conditions, not everyone who has it possesses the same symptoms.
Although fibromyalgia’s characteristics are numerous, it usually includes widespread, chronic musculoskeletal pain, fatigue, sleep disturbances, depression and stiffness.
Massage therapy is particularly beneficial for the fibromyalgia client, as it can reduce heart rate, relax muscles, improve range of motion and increase production of the body’s natural painkillers.
One recent study showed massage therapy decreased pain, improved quality of sleep and eased depressive symptoms in fibromyalgia sufferers.
About 10 million people in the U.S. suffer from fibromyalgia, according to the National Fibromyalgia Association (NFA, www.fmaware.org), and 75 to 90 percent of those with the syndrome are female.
The cause of fibromyalgia is unknown, although brain imaging and neurosurgery have indicated fibromyalgia may be caused by “an interpretative defect in the central nervous system that brings about abnormal pain perception,” according to the NFA.
“An increasing number of scientific studies now show multiple physiological abnormalities in the [fibromyalgia] patient, including: increased levels of substance P in the spinal cord, low levels of blood flow to the thalamus region of the brain, [hypothalamic-pituitary-adrenal] axis hypofunction, low levels of serotonin and tryptophan and abnormalities in cytokine function,” a statement on the NFA’s website noted.
Medical experts believe a genetic predisposition to fibromyalgia is possible.
Many fibromyalgia clients also believe a traumatic experience—either physical or psychological—can be a trigger.
More research must take place before an official cause can be determined.
Muscle aches and pains are the most predominant symptoms a fibromyalgia sufferer may experience on a daily basis.
Pain levels can change from day to day and from morning to evening.
Changes in weather, level of stress and how much sleep we receive all affect this.
Fibromyalgia sufferers also have difficulty with activities of daily living, and suffer from muscle weakness.
The worst part of fibromyalgia is not knowing what symptoms may present the next day.
Muscle pain and stiffness are not the only symptoms of fibromyalgia.
Overexertion is the fibromyalgia sufferer’s enemy, but inactivity can cause just as much pain.
The adage use it or lose it fits perfectly.
The client with fibromyalgia might hear buzzing from neon lights and sometimes have itchy skin for no apparent reason.
She might suffer from mouth ulcers; restless legs; tingling or numbness in extremities or face; mood swings; panic attacks; lower-than-average body temperature; and sensitivity to odors, noise, medications, food and cold.
Some of the more annoying conditions that occur with fibromyalgia include yeast infections of the tongue and mouth, dry mouth—although this could be caused by medications—and “fibro fog,” or confusion and memory challenges.
Fibro fog happens at the most inconvenient times.
Trying to remember a word or name you should know, directions to a place you frequent, or why you came into a room are all part of everyday life for fibromyalgia sufferers.
Flares, or periods of time when pain and aches are at their worst, are common with fibromyalgia.
Memory tends to worsen during a flare, so it’s always helpful to call and remind a fibromyalgia client about her massage appointment.
A Difficult Road
In the past, people sometimes suffered for years not knowing what was wrong with them.
Families grew tired of hearing how bad they felt while appearing to be perfectly healthy.
Many physicians did not recognize fibromyalgia, instead believing it was all in the patient’s mind.
People with fibromyalgia were often labeled hypochondriacs, and often began to question their own sanity.
Today there still isn’t any one reliable medical test to diagnose fibromyalgia; instead, diagnosis is often a process of elimination.
A physician will check for thyroid, kidney and liver problems, and anemia and other blood disorders that can cause fatigue.
Another blood test, called FM/a, identifies markers produced by immune system blood cells in people with fibromyalgia, according to WebMD.
The physician should listen to the patient’s history, and perform a tender-point test based on American College of Rheumatology criteria.
Some physicians still question the validity of a fibromyalgia diagnosis.
According to the NFA, it can take up to five years for someone with fibromyalgia to receive a diagnosis.
By the time a fibromyalgia client finds a massage therapist, she may have run out of people who will listen to her.
Massage therapists can make a big difference in how the sufferer feels about herself.
A sounding board provided without diagnosis or advice might be exactly what she needs.
Massage is effective for fibromyalgia clients because it can break up muscular restrictions, knots and tightness.
Gentle effleurage in the direction of muscle fibers tends to be tolerated better, whereas acupressure can exacerbate pain.
Working easefully, layer by layer, will loosen muscles.
The shoulders, neck, hips and gluteal muscles tend to be most troublesome for clients with fibromyalgia.
Addressing those areas with a light initial touch works best, and then you can begin to work knots out slowly by lifting and palpating.
You do not have to do everything at once.
Massage is accumulative; it builds on itself.
People with fibromyalgia often take medication prescribed for pain or depression.
If a client receives massage or other complementary therapies concurrently with Western medical treatment, she usually experiences much better results than with allopathic care alone.
Along with massage, other beneficial therapies might include gentle exercise or stretching, chiropractic, myofascial release, cranial sacral therapy, hydrotherapy, homeopathy, guided imagery, heat therapy, manual lymphatic drainage, energy work and biofeedback.
One research study showed 12 weeks of thermal therapy, which consisted of time in a sauna and underwater exercise in a heated pool, resulted in a significant decrease of pain and symptoms, along with a significant increase in quality of life, among women with fibromyalgia.
Another study indicated a multidisciplinary approach of massage, pressure on tender points, thermal therapy and aerobic exercise produced pain relief for the fibromyalgia client.
Contraindicated therapies include high-impact exercise, cold water and deep-tissue massage, unless the client has received it in the past with desirable effects.
The next time you hear a client say she hurts all over, stop and listen to her.
It may very well be true, and she may live in pain every day.
A kind ear and talented touch could make a big difference in her life.
A referral to a physician, if the client hasn’t already seen one for a diagnosis, would be appropriate.
Clients with fibromyalgia frequently present for massage therapy, and a better understanding of the syndrome is needed.
Massage therapists can help clients have a better quality of life.
At the time this article was written, Sara Thomas Simpson, LMT, was a massage therapist in Yazoo City, Mississippi, who also had fibromyalgia. At that time, she taught about fibromyalgia, cancer and massage, cranial sacral therapy, reiki, reflexology and more.