Articles

Jane had just been diagnosed with fibromyalgia. She was happy to have a name for the mysterious, traveling pain she had felt for some time, but she was still worried about how to deal with it. She'd done research on the Internet, but the information left her more confused. "There are so many causes and ways to treat it," she said. "I don't know what to do." A friend of Jane's recommended massage as part of her treatment plan. "She said it helped her," Jane said, "so I'm willing to try."

For fibromyalgia sufferers, muscle pain, tightness, and general body discomfort can all too often become a way of life. But what is fibromyalgia, and what can be done to help?

What is Fibromyalgia?-
Fibromyalgia, which literally means "connective tissue muscle pain," causes severe tenderness in multiple points throughout the body as well as persistent fatigue, morning stiffness, and non-refreshing sleep. Fibromyalgia is found in about 2 percent of the adult population, and women are five to seven times more likely to have it than men.

Theories about the cause of fibromyalgia include thyroid imbalance, sleep disorders, genetic predisposition, allergies, trauma--especially whiplash injuries--and possibly even viruses. Many who have fibromyalgia syndrome have other conditions as well, including depression, irritable bowel syndrome, chemical sensitivities, intolerance to exercise, restless legs syndrome, extreme sensitivity to cold, and seasonal affective disorder.

Factors At Play-
Jay Goldstein, MD, a leading researcher and clinician, identified three common factors in people who are susceptible to fibromyalgia. It's helpful to consider these factors when planning a treatment approach:

1. Biochemical factors, such as hormonal disturbances, allergies, frequent colds and viruses, and nutritional deficiencies.
2. Biomechanical factors, such as congenital deformities (one leg longer than the other or scoliosis, curvature of the spine) or functional conditions (poor posture, overuse syndromes, or poor breathing patterns).
3. Psychosocial factors, like depression, anxiety, or difficulty coping with stress.

Bodywork Can Help-
Fibromyalgia is best treated using a multidisciplinary approach, and bodywork can be a key part of healing, recovery, and management. Depending on your specific needs, any or all of the following methods may be helpful.

Swedish Massage-
Because stress is such a strong component of fibromyalgia, regular massages for relaxation and stress reduction can be beneficial to your program. Swedish massage is the foundation of training for most massage therapists. Its primary goals are to gently relieve muscle tension, improve circulation, and restore the balance between mind and body.

Rolfing-
This whole-body approach is designed to restore postural alignment and ease. Rolfing--and other related forms of bodywork under the umbrella of structural integration--helps to free soft tissue tightness and remove the structural imbalances that create stresses and strains on the body, restoring biomechanical function. Whiplash and other types of neck injuries are commonly seen in fibromyalgia cases. Rolfing aligns the body so the head and neck can rest more easily.

Lymphatic Massage-
The lymph system is the body's primary way of eliminating waste at the cellular level. When the lymph system is backed up, tissues can get bogged down and become irritated, inflamed, and swollen. Biochemical disturbances are a key factor in fibromyalgia, so restoring the mechanical function of the lymph system can be important. Lymphatic massage is a specific form of therapy designed to improve circulation, remove waste, and reduce swelling in the tissues. It's often a good way to start a bodywork session.

Neuromuscular Therapy-
Trigger points--pivotal body points that hold and release pressure--become small areas of extreme tenderness and tightness for fibromyalgia patients. Neuromuscular therapy is a specific form of bodywork designed to free these trigger points along with the fiber in the surrounding tissues. Neuromuscular therapy encompasses many different techniques, but the system is designed to relieve the tightness in the deep soft tissues and to eliminate trigger points.

Considerations-
Sensitivity to touch varies greatly for fibromyalgia patients. Some people prefer very deep work, while others are sensitive to the lightest pressure. It's important that you establish good communications with your massage therapist so you can explain what feels comfortable to you and what doesn't.

When you're in an acute flare-up, limit your bodywork to more gentle techniques. When you're feeling better, deeper work intended to eliminate trigger points or work on posture may be more appropriate. Partner with your therapist to find the best approach.

You may be sore after a session. A moderate level of soreness can be expected, but should only last about forty-eight hours as your body adapts to the changes. If it lasts longer or is more severe, bodywork may be too aggressive or the session may be too long. Start out slowly, learn what works best for you, and let your therapist increase the time or intensity as you progress.

Fibromyalgia is a soft tissue condition, and bodyworkers are experts at working with soft tissues. By including massage in your care, you can expect to manage and improve your fibromyalgia.

Making the Most of Your Massage

How to Prolong the Benefits of Bodywork

Barbara Hey

A massage works in wonderful ways, easing stress and pain, calming the nervous system, increasing circulation, loosening tight muscles, stimulating internal organs, and enhancing skin. The multiplicity of physiological responses sends a simple, clear message to the mind: Massage feels good. Of course, you want to hold on to that just-had-a-massage feeling -- total body relaxation, muscles relaxed and at ease, and fluid movement restored -- for as long as possible.

But how long that bliss lasts depends on the state of your body. If you're suffering from chronic pain or recovering from injury, then it may take more sessions and perhaps different modalities before optimal health is restored.

If massage is part of your regular health regimen, then it's more likely the effects will endure. In other words, the effects of massage are cumulative, like any healthy habit. The more often you get a massage, the greater and longer-lasting the benefits.

Massage Frequency-
How often you receive massage depends on why you're seeking massage. In dealing with the general tension of everyday commutes, computer work, and time demands, a monthly massage may be enough to sustain you. On the other hand, if you're seeking massage for chronic pain, you may need regular treatments every week or two. Or if you're addressing an acute injury or dealing with high levels of stress, you may need more frequent sessions. Your situation will dictate the optimum time between treatments, and your practitioner will work with you to determine the best course of action.

"You need to consider how you felt before the session and how you felt after, and then look at how long you maintain that," says Pieter Sommen, the chair of the eastern department in the Swedish Institute School of Massage Therapy in New York.

In general, experts say "regular" is preferable, but how regular depends on your situation. While daily massage would be delightful, practical considerations such as cost, time, and physical need likely determine the frequency of treatments. "It's best to maintain a schedule," says Eeris Kallil, CMT, a shiatsu instructor at the Boulder College of Massage Therapy in Colorado. "That way the body becomes conditioned and prepared for session at specific intervals."

Maintenance-
Whether you get a massage weekly, monthly, or just every once in a while, the following habits can maximize and extend the afterglow of treatment.

Water-
One bit of advice you'll hear over and over again is to drink plenty of water after a massage. Bodywork -- no matter the particular modality -- releases toxins, such as lactic acid and carbonic acid, that need to be flushed from the body. Massage also promotes circulation, increasing blood flow and oxygen and stimulating the lymphatic system, which helps rid the body of pathogens. After-massage hydration supports these functions, helping to eliminate released impurities, sooner rather than later.

Stretching-
Another helpful habit is stretching between massages to maintain joint mobility, prevent muscles from tightening up again, and keeping the life energy flowing. This may mean doing yoga or whatever specific or full-body stretches suggested by your practitioner. After a shiatsu session, for example, your practitioner may recommend "makko-ho" stretches, a series of six exercises designed to keep energy circulating. "This series of stretches take anywhere from 5 to 10 minutes a day, but really help keep the chi flowing through the body," says Kallil.

Exercise-
Working out can also help maintain the benefits of massage, and this habit should be continually cultivated. However, if you're receiving massage therapy to help speed muscle strain recovery, you may need to ease up on the exercise for a while and give the body time to heal -- particularly if you're recovering from a strenuous body-pummeling training regimen. "You don't want to over-work your body," says Kallil. That is, if running is taking a toll, try something more gentle and meditative such as swimming, walking, or tai chi.

Body Awareness-
After a massage, respect how your body feels. If your body seems to ask for rest, give in to that demand. This may mean backing off the to-do list, taking it easy, moving slower, and perhaps doing less for a while. And don't allow yourself to get fatigued because it will undermine the effects of massage. Get sufficient sleep to allow the body to absorb the effects and regain vitality.

Diet-
Finally, since you've just rid the body of toxins, support the body's renewed state by adhering to a healthy diet rich in fruits and vegetables, which will continue the detoxification process. Lay off the espresso and all adrenaline-challenges for a time -- which would short-circuit relaxation anyway -- and enjoy the calm.

The benefits of massage are many, including: increasing circulation, allowing the body to pump more oxygen and nutrients throughout the body, stimulating lymph flow and boosting immunity, relaxing overused or tight muscles, increasing joint mobility and range of motion, reducing recovery time after strenuous workouts or surgery, and relieving back pain and migraines, just to name a few.

After receiving a massage, clients feel rejuvenated, relaxed, and refreshed. By opting for a few lifestyle choices, you can extend these benefits and get the most out of your massage.