Thursday, September 18, 2014

Massage and Fibromyalgia

Over 5 million Americans, nearly 90% of them women, currently live with episodes of disabling pain.  Many choose to take one of the myriad of designer pain medications that have recently flooded the market.  These drugs have familiar names as their makers have bombarded us with advertising. Some of those in pain experience relief, but many don't, and worse case scenarios do occur where suicidal depression and anxiety attacks are the price paid for tenuous pain relief. There are no "free rides," in the pharmaceutical world, and all synthetic medications come with potential side-effects.  Many people are forced to put their lives on hold as they "take it easy," and wait for these episodes to pass.  This disheartening picture is the story of fibromyalgia.

The symptoms are broad and intense. People with fibromyalgia often experience cognitive and memory problems (sometimes referred to as “fibro fog,”) sleep disturbances, morning stiffness, headaches, irritable bowel syndrome, painful menstrual periods, numbness or tingling of the extremities, restless legs syndrome, temperature sensitivity, and sensitivity to loud noises or bright lights.  Most of us experience at least some of these symptoms at one time or another but when a person experiences a significant number of these symptoms along with widespread pain in 18 specific places across the four quadrants of their body- they have met the criteria for the diagnosis of fibromyalgia according to the American College of Rheumatology.

No one knows for sure why people get fibromyalgia.  One theory is that mitochondria, the parts of our cells that create energy are not functioning correctly.  Some researchers believe that repeated nerve signals cause the brains of fibromyalgia sufferers to change, which in turn triggers an abnormal increase in certain neurotransmitters.  Fibromyalgia patients are thought to have a heightened "pain memory," resulting in intense sensitivity to pain.  Emotional pain and trauma are also linked to fibromyalgia and stressful events can cause flares. Additionally, certain illnesses and infections appear to trigger or exacerbate fibromyalgia. There also appears to be a genetic link. 

As a massage therapist I am frequently approached by fibromyalgia patients who want to know if massage can bring them relief.  Will it bring an immediate, opiate-like blissful relief? Probably not.  Will it help you and bring degrees of relief over time?  Absolutely.  It is not recommended that patients get massages while experiencing a flare, but the rest of the time it is safe and very helpful.  The most constant advice doctors give for fibromyalgia patients is to increase exercise and to try to relax more. Massage stimulates your muscles, including your heart providing a boost for your circulatory and lymphatic system-  in essence, exercise. Your massage therapist is exercising your muscles and increasing the circulation through your heart while you do what?  Rest and relax.  The best of both worlds.  

There are multiple studies supporting alternative therapies for fibromyalgia patients.  For example: 

 The Manual Therapy Benefits Fibromyalgia Patients. 

 This study involved two groups of patients, one of whom received 5 massage sessions. The group that received the sessions reported decreased pain intensity, decreased wide spread pain sensitivity, less symptoms in general with better quality of sleep and less depression. Gender differences were observed in response to treatment: women and men get similar improvements in quality of sleep and the number of areas they experienced pain, whereas women showed a greater reduction in pain and impact of symptoms than men, but men reported higher decreases in depressive symptoms and pressure hypersensitivity than women. (Published in the Clinical Journal of Pain and was conducted by investigators with the Department of Nursing, Physical Therapy and Medicine, Universidad de Almeria, Spain †Department of Physical Therapy, Universidad de Granada, Spain ‡Servicio Andaluz de Salud. Family Medicine Specialist. Granada. Spain Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain, and Esthesiology Laboratory of Universidad Rey Juan Carlos, Alcorcón, Spain.

Massage can be a valuable aspect of a comprehensive plan to manage your fibromyalgia.