Massage Therapy for Fibromyalgia

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Massage therapy has been used for thousands of years and references to its use can be found in ancient writings from China, Japan, India, Egypt, and Greece, among others. Its popularity surged in Europe during the Renaissance period, and it was first introduced in the United States in the 1850s by two American physicians who had studied massage therapy in Sweden. Popularity began to wane in the United States during the 1930s and 1940s, however massage therapy began to gain ground once again in the 1970s, in particular with athletes.

According to the National Center for Complementary and Alternative Medicine, approximately 18 million adults and 700,000 children receive massage therapy each year. It is commonly used for pain relief, rehabilitation from injuries, stress reduction, relaxation, relief of anxiety and depression, and to improve overall health and wellbeing.

Types of Massage Therapy

Massage therapy is not one technique, but rather is the parent term used to describe many different techniques that massage therapists can use. A few of the more common types of massage include Swedish massage, sports massage, deep tissue massage, and trigger point massage. Swedish massage uses long strokes, kneading motions, circular movements, vibration and tapping on the muscles. Sports massage is somewhat similar to Swedish massage but is tailored to the specific needs of athletes. Deep tissue massage works to relieve severe tension in, and realign deeper layers of, muscles and connective tissues. It is particularly useful for individuals who have chronically tense muscles. Trigger point massage concentrates on myofascial trigger points, which are muscle knots that are painful to the touch.

What to Expect

A few general consistencies apply across all forms of massage. The individual receiving the massage undresses to their level of comfort, in the absence of the massage therapist, and positions themselves on a specially-designed massage table. They cover with a sheet or blanket and will remain covered throughout the massage; only the area being worked on (e.g., arm, leg, back) will be exposed. A typical full body massage involves work on the back, head,  neck, shoulders, arms, legs, hands and feet.

The way massage therapy feels to a person depends on the technique that is used and an individual’s personal preference for pressure and massage style. There are many different types of massage and bodywork, and each uses specific techniques. The most common – Swedish massage – involves the use of long, flowing strokes that help calm the nervous system and relieve exterior tension. The therapist will gradually apply pressure as the individual becomes more relaxed. This increased pressure helps to target certain areas and relieve additional muscle tension deeper in the muscle. Light oil or lotion is typically used to help reduce friction.

How Does Massage Therapy Help Individuals?

Researchers do not fully understand how massage therapy works for so many people as a means to reduce stress, control pain, relieve anxiety and depression, and promote overall health and well-being. The physical pressure on the skin causes stiff muscles and connective tissue to loosen up. Massage technique that utilize heat also produce similar effects. Massage therapy has also been demonstrated to help the body release certain chemicals in the brain that help individuals relax. It is known to improve blood circulation and help the body rid itself of toxins. Finally, there may be a psychological link to explain why massage can help with so many conditions, as the touch and contact with the therapist often makes individuals feel better taken care of.

Scientific Research Related to Massage Therapy and Fibromyalgia

There is a lack of research on the general effectiveness of massage therapy, although there is some evidence to suggest that massage therapy may be beneficial to some patients. According to the National Center for Complementary and Alternative Medicine, however, “conclusions generally cannot yet be drawn about its effectiveness for specific health conditions.”

Nevertheless, some research in non-fibromyalgia populations has shown promising findings for many symptoms commonly experienced by fibromyalgia sufferers, including low back pain and neck pain. A 2008 review by Furlan et al. looked at the collective findings of 13 clinical trials that used massage as a treatment for low back pain. Overall, the researchers’ review suggested that massage may be effective for individuals with both acute (short term) and chronic (long-lasting) low back pain, however they cautioned that more research is needed. In 2009, Sherman et al. evaluated 64 patients with chronic neck pain and randomly assigned them to receive either massage therapy (10 massages over 10 weeks) or to utilize a self-care book. They followed each patient through phone interviews at four, 10, and 26 weeks after the study was over. After 10 weeks, the researchers found that more of the participants who had received massage therapy showed improvement in neck disability than did those who used the self care book (39% vs. 14%, respectively). Those who received massage therapy also showed twice the rate of improvement in the degree to which they reported their symptoms as “bothersome” (55% vs. 25%, respectively). The researchers did not, however, find any differences between the two groups at the 26 week interview. Their findings suggest that massage therapy may provide short-term relief for chronic neck pain.

Many people with fibromyalgia turn to massage therapy for relief of their symptoms, and a fair amount of research exists to support that massage therapy can be beneficial. A 2010 review by Kalichman looked at all available studies (with an emphasis on randomized controlled trials, which are the gold standard for research study design) that investigated massage as a treatment for fibromyalgia symptoms. Out of the eight studies identified, the researcher discovered that all showed short-term benefits of massage on fibromyalgia symptoms, and one study even suggested that long-term benefits were possible. The author concluded that additional “rigorous” research is needed in order to be able to definitively state that massage is a safe and effective treatment method for fibromyalgia. The author also recommends that when used to treat individuals with fibromyalgia, massage therapy should be gradually increased in intensity from session to session and in accordance with the wishes and pain level of the patient, and that sessions should be performed a minimum of one to two times per week.

Field and colleagues (2002) studied 24 fibromyalgia patients and randomly assigned them to receive either massage therapy or attend a relaxation therapy group. Treatments for both groups were 30 minutes, twice a week for five weeks. While both groups experienced decreased anxiety and depression immediately after the first and last therapy sessions, only the massage therapy group reported improvement in sleep duration and decrease in sleep movements throughout the course of the study. Patients in the massage group also reported fewer tender points during the course of treatment. An earlier study conducted by some of the same researchers also found that massage therapy was the most effective therapy for fibromyalgia patients when compared to a control group and a group that received transcutaneous electrical stimulation (delivery of mild electrical impulses to the skin) (Sunshine et al., 1996).

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References

1.        Furlan AD, Imamura M, Dryden T, Irvin E. Massage for low-back pain. Cochrane Database Syst Rev. 2008;Oct 8(4):CD001929.

2.        Sherman KJ, Cherkin DC, Hawkes RJ, Miglioretti DL, Deyo RA. Randomized trial of therapeutic massage for chronic neck pain. Clin J Pain. 2009;25(3):233-238.

3.        Kalichman L. Massage therapy for fibromyalgia symptoms. Rheumatol Int. 2010;30(9):1151-1157.

4.      Field T, Diego M, Cullen C, Hernandez-Reif M, Sunshine W, Douglas S. Fibromyalgia pain and substance P decrease and sleep improves after massage therapy. J Clin Rheumatol. 2002;8(2):72-76.

5.      Sunshine W, Field TM, Quintino O, Fierro K, Kuhn C, Burman I, Schanberg S. Fibromyalgia benefits from massage therapy and transcutaneous electrical stimulation. J Clin Rheumatol. 1996;2(1):18-22.

 

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