Massage for most people is a leisure activity, something you enjoy when you’re vacationing in Cancun or perhaps in your hometown as a gift from a loved one. It is generally considered something pleasurable and relaxing. However, for those with fibromyalgia, traditional massage therapy can be a painful and counter-productive experience. Does massage still offer benefits for fibro folks? The answer is a resounding yes – if the proper modality (type) is used.
Problems with “Typical” Massage
The most common modalities of massage therapy today are Swedish and Deep Tissue. Swedish massage is what most consider a “regular” massage, and involves rubbing the muscles with long gliding strokes in the direction of blood returning to the heart. In addition, therapists apply pressure in a circular pattern using their hands and palms and engage in firm kneading, tapping, bending, and stretching.
Deep Tissue massage is basically a more rigorous form of Swedish massage characterized by the application of firm pressure and slow strokes to reach deep layers of muscle. It is often employed to treat specific injured areas such as a stiff neck or sore shoulders. The goal is to break up scar tissue and muscle “knots” using fingertips, knuckles, forearms, and even elbows if necessary.
Generally speaking, both Swedish and Deep Tissue massages are painful for those with fibromyalgia, for the simple reason that our bodies – especially our muscles and fascia (the connective tissue between muscles) – are extra sensitive to pressure. I’ve found this to certainly be true for me personally. If I go to a normal spa, I often have a hard time finding a therapist who truly understands how painful regular massage is for me. Even if I tell them beforehand to go extra gentle on me, it’s not uncommon that partway through they will forget and slide back into the normal techniques they are used to.
Better Modalities for Fibro Patients
It would be tempting to give up on massage altogether if you want to avoid the pain of traditional methods, but that would be a mistake. There are in fact types of massage therapy that are incredibly beneficial for fibro folks. The two most important of these work because they induce a relaxation response, which you’ll recall is the opposite of the fight-or-flight stress response that’s such a problem with fibromyalgia. These two modalities are called myofascial release (MFR) and craniosacral therapy.
The goal of myofascial release is to reduce the tension in the fascia, the connective tissue between muscles. With fibromyalgia, the fascia are extremely inflamed, causing painful knots known as trigger points. In addition, fibro patients often have an excess of collagen and immune cells in the fascia. In a myofascial massage session, the therapist will very gently stretch and apply sustained pressure to the fascia, which tempers the stressed nerves and sends a calming signal straight back up to the brain stem.
You may have to look for a trained and experienced MFR therapist to truly get the most out of this treatment. But the good news is that once you do, the benefits tend to persist for a long time, even months after the therapy has ended! Dr. Ginevra Liptan has found that a course of MFR consisting of two sessions per week for eight weeks is a sweet spot to get the most benefit for a reasonable investment. After the eight week period, you can go back to your therapist on an as-needed basis.
Another modality that elicits a highly beneficial relaxation response is craniosacral therapy. This unique method involves a specialist gently manipulating the base of your skull with their hands. With subtle wavelike motions, they get your cerebrospinal fluid moving, which pumps away the toxins and waste products which have accumulated in your brain. Most people find the process of craniosacral therapy very calming, almost like the sensation of slipping into a hot bath. Afterwards it’s not uncommon to feel a liberation of your body, including freedom of movement, that you didn’t realize was restricted before.
Here are just a few benefits of myofascial release and craniosacral massage therapy:
- Increased serotonin level
- Improved muscle tonicity (aid lethargic muscles and help restore strength)
- Decreased circulating stress hormones
- Decreased levels of substance P (a pain messenger)
- Decreased tender point pain
- Improved sleep patterns
- Improved mental clarity (including headache relief)
- Improved overall sense of well-being (lower depression & anxiety)
Other Tips to Get the Most out of Massage
Finally, here are a few tips to make your experience as effective as possible. It can be a bit difficult to find an MFR or craniosacral specialist, so try to do some research online beforehand to locate a qualified therapist in your area. You might also consider asking your doctor for a recommendation, especially if they are a fibromyalgia specialist themselves. If you can’t locate a MFR specialist in your town, when you go to a spa or treatment center, ask for the therapist at the center best known for giving “gentle” massages.
Don’t forget that less is more when it comes to fibro treatment. If you’re under a lot of pain during a massage session, tell your therapist to stop! Almost certainly they can change up their procedure to something less painful but also effective. Harder does not equal better.
When you’re finished with a session, be sure to drink a lot of water. The reason for this is that the treatment releases a lot of toxins that were tied up in your muscles and cerebrospinal fluids, and these need to be processed by your kidneys and other organs. Drinking a lot of water ensures these organs are operating at peak capacity.
It’s probably a good idea to not schedule anything too important or exhausting after a massage session to give your body time to decompress. In fact, I recommend laying down and/or taking a nap afterwards, which shouldn’t be too hard when your body is in such a state of relaxation anyway.
I hope this article has inspired you to give massage another try if you gave up on it previously. When you find the right fit, it can even be relaxing in the moment as it was meant to be! Are there other modalities of massage that you’ve found helpful to reduce your chronic pain? Anything else you’d recommend that others avoid? Please help the community by sharing your knowledge in the comments below so we can continue to face fibromyalgia together.
- The Fibro Manual by Dr. Ginevra Liptan (2016) http://www.drliptan.com/book/