East Bay Massage: Fibromyalgia and Massage

Fibromyalgia  is diagnosed in about 7 million Americans yearly but still presents a challenge for doctors, health care team members, and patients alike. Massage and other forms of bodywork can play an important role in helping clients manage the condition and generalized pain associated with it.

Fascia is a sheath of tissue that surrounds and encapsulates muscle groups. When healthy, fascia helps muscles glide over one another for effective musculoskeletal function. If you have ever cooked a chicken breast, you are familiar with the white, filmy tissue that covers the meat. That’s fascia.

While experts are still gaining in knowledge about fibromyalgia, many have come to believe that it is a condition that stems from low-grade inflammation of muscle and fascia brought on by chronic hypertonicity associated with prolonged stress-responses. Basically: stress causes people, via the sympathetic nervous system, to contract their muscles almost imperceptibly. It is a function of the “fight or flight response” that gets the body ready to respond to stuff that stresses us out. Nowadays, we are more likely to feel stressed out about our bosses or rush hour traffic and less so about being eaten by a saber-toothed tiger, but there is a part of our brains that does not know the difference. Our bodies respond to stress by getting ready to fight back or to run away, and if we have chronic, low-grade stress in our lives, our bodies may be stuck in a chronic stress-response. Over time, this can cause the muscle tension (hypertonicity), strain, and inflammation that results in the painful condition we see today as fibromyalgia.

When the body is in a constant state of high-alert, the brain is sending messages to the muscles to contract– and this uses up ATP (adenosine tri-phosphate), or the energy that we need to live. Muscles also need to use some ATP to relax, and when the body is depleted of it, the muscles actually become incapable of fully relaxing. This produces an unfortunate cycle in the body– contract! I can’t fully relax! contract! The nervous system becomes overwhelmed and we have seen that over time, this loop produces a decrease in serotonin production– a neurotransmitter necessary to a sense of well-being, but also found in the gut for proper digestion and smooth muscle contraction.

“Tender points” are sometimes used to help diagnose fibromyalgia– discreet spots on the body that are painful and that are generally in the same point from patient to patient. But fibromyalgia is also characterized by many psychological factors, as well. Depression, sleep disturbances, and wicked fatigue are all common in patients with fibromyalgia. Studies show that the decrease in serotonin levels could account for these symptoms.

As you can see, fibromyalgia is a complicated condition. The good news is that massage helps on several fronts. Assisting the muscles and fascia to relax, increasing serotonin production, and guiding the body into a parasympathetic response (the part of the nervous system whose job it is to relax) are all benefits from massage for clients with fibromyalgia.

A final note on the use of pressure with fibromyalgia clients: the first session with a new CMT should employ light to moderate pressure. Pressure is actually quite a subjective concept, so care should be taken to avoid arousing the sympathetic nervous system further by straining the muscles through too much depth of pressure. This doesn’t mean that clients with fibromyalgia cannot enjoy deeper pressure, however! It means that care should be taken to avoid discomfort– not only for the health of the tissues, but to encourage the body out of the stress response. Generally, this means going slow, checking in, and communicating about the client’s experience on the table.

Thank you for visiting East Bay Massage!

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