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A Fibromyalgia Primer
Fibromyalgia (FM) is a chronic musculoskeletal condition expressed in widespread pain over the entire body. FM patients
(a higher percentage of whom are women than men) also suffer from tension headaches, fatigue, stiffness and sleep disorders.
It is estimated that 7 million Americans are afflicted with fibromyalgia -- their pain and fatigue in some cases being so
severe that the individual spends entire days in bed.
We believe that FM is actually a fibromyositic pathology.
Fibromyositis is a chronic, low-grade inflammatory condition of the muscle, fascia and other connective tissue. The main cause
of fibromyositis is the accumulation of pathological hypertonus in muscles over a prolonged period of time. This can be triggered
by post-traumatic phenomena, stress, sleep disorders, hormonal changes (thereby explaining the high incidence of women), toxic
chemical exposure and other factors.
Finding a New Theory
In order to better understand how massage can help in cases of FM, a short discussion of anatomy and pathology
is appropriate. As we all know, muscles are surrounded by fascia. This connective tissue plays an important role in the determination
of the extent of muscle stretch and contraction. It is very important to understand that fascia also provides pathways for
nerves and blood vessels. In cases of FM, due to the prolonged pathological hypertonus in muscles, fascia becomes tense causing
compression of muscle fibers, nerve tissue and blood vessels. This kind of irritation first initiates, and later brings about
the development of, fibromyositis. The condition of constant muscle tension in FM cases creates an overload (strain) on muscles
and tendons. Strain always leads to the development of inflammation.
Treating Fibromyalgia
We
recommend beginning the first 10 massage therapy treatments on a two procedures per week basis. Remember that FM clients complain
of sharper levels of pain in certain regions (such as neck and upper back, or lower back, including the buttocks regions,
etc.). We believe that in such cases, massage therapists must focus on those regions. However, the full-body massage treatment
should be considered after the first three to four treatments. Also keep in mind that lying on the stomach for more than 12
minutes at a time is not recommended for the FM client, because the pressure on the rib cage transmitting to the rib attachments
can cause additional tension in the muscles. Therefore, consider treating the neck and upper back region in a side-lying position,
with a towel placed between the neck and pillow. When the client is prone, we recommend placing one pillow under the stomach
and two pillows under the chest. Do not treat FM clients using a massage chair.
Originally
published in Massage & Bodywork magazine, February/March 2004.
Copyright 2003. Associated Bodywork and Massage Professionals.
All rights reserved.
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