Everyone will react differently so there is no one way to treat a client with fibromyalgia.
Fibromyalgia is a very debilitating, and often misunderstood, condition. Because there is no single test for it, and there are no outward physical signs of the illness, it can be difficult to diagnose.
Diagnosis:
A final diagnosis can only be made following analysis of the symptoms experienced and all other conditions being ruled out. Fibromyalgia is becoming more commonly known as fibromyalgia syndrome but has also been known in the past as unspecified rheumatism and muscular rheumatism. The growing body of medical opinion points to it being a disorder of the central nervous system; research is ongoing. It is a condition that affects many people, with estimates of seven million sufferers in the US alone and over one million in the UK.
Symptoms:
The symptoms of fibromyalgia are many and varied but three of the central problems are chronic pain (and hypersensitivity to pain), chronic fatigue, and cognitive dysfunction.
The chronic pain will usually be widespread; it may feel to sufferers as if they have just run a marathon or are coming down with flu, or it can instead be a sharp, intense arthritic pain. The pain can also be experienced as stabbing, shooting, or burning, for up to 24 hours a day, every day. This in itself is extremely debilitating, and if added to chronic fatigue to the extent where the limbs feel as if they are made of lead, and every movement takes immense amounts of energy, then a fuller picture comes together.
“Brain fog” or “fibro-fog” is common, as cognitive function is impacted by the condition, with sufferers experiencing difficulty in concentrating and being easily distracted, and that can also lead to problems in decision making, memory, speaking properly, or even remembering which task the sufferer was halfway through.
Sleep Disturbance:
Sleep disturbances are to be expected, which compounds the chronic fatigue. Medical research undertaken in the US has uncovered where exactly in the usual sleep patterns this disturbance occurs. There are “specific and distinctive abnormalities in the Stage 4 deep sleep” of fibromyalgia patients. During sleep, individuals with fibromyalgia are constantly interrupted by bursts of awake-like brain activity, limiting the amount of time they spend in deep sleep.” In practice this means that the fibromyalgia sufferer is not benefitting from the deeper, healing sleep that the rest of the population experience, making it difficult for the body to repair itself.
Muscular Tension:
Muscular tension, waking with stiff and sore muscles, digestive disorders, and recurrent headaches may all be experienced by the person with fibromyalgia. Many will also experience balance problems, which can result in painful falls; digestive disorders; and itchy and burning skin-all these making up the difficult package of fibromyalgia symptoms.
Fibromyalgia and Massage:
How, then, can massage help a person who may be experiencing both hyperalgesia-feeling more pain than would be usual from what would normally be a mildly painful event-and allodynia-feeling pain from a stimulus that would not usually be painful at all?
In presenting the initial symptoms it seems that massage would be contraindicated; however, fibromyalgia self-help networks show that massage is the non-drug treatment of choice for the fibromyalgia patient. There are, however, some very clear guidelines for safe and successful massage for people with this condition.
Specific Contraindications:
The most important factor with any massage is to start treatment very gently. Even the lightest touch may be excruciatingly painful, so it is essential that you start very gently and perhaps build depth as sessions progress, and as you are able to receive feedback from your clients as to how their body has responded to the treatment.
That said, it is also important to be “sure” in your touch; tentative or nervous contact may stimulate the skin too much and cause pain. Be gentle but confident.
It will be best to work in short sessions to begin with; this can be built upon as both therapist and client learn how the fibromyalgia will respond to massage. Everyone will react differently so there is no one way to treat a client with fibromyalgia.
If you are working in a "friends-and-family" context at home, even 10 minutes’ work may help, while avoiding overstimulating the receiver.
In a professional context it would be better to start with a 30 minute session and build on this over time. It would be rare to achieve a session length of over an hour but, again, see how your individual client responds.
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