Repost from original ART Massage Blog, 7/24/13
Easing the Constant Pain,
by Karta Purkh Singh Khalsa — March 21, 2010
Pain, especially when it’s continuous, can make even the smallest activities seem gargantuan. But for people with fibromyalgia syndrome (FMS), pain is part of their everyday existence. “There was no place in my body that didn’t hurt. I went from feeling good and normal to hurting all over and being super sensitive to touch,” declares Mary Shomon, a fibromyalgia patient turned health advocate, from Washington, D.C. “In two months, I developed all the tender points. If someone touched my neck, it felt like she was sticking a knife in. Then, a trip to the grocery store felt like a mission to the moon.”
Chanchal Cabrera, author of a book on FMS and professor of botanical medicine at Boucher Institute of Naturopathic Medicine in Vancouver, British Columbia, understands. She describes the pain of FMS sufferers this way: “Imagine that last night you drank two glasses of wine more than you would have liked, but had no water and ate no food,” she says. “You went to bed late and got up early. You are stiff, achy and tired—all the time.”1
For all the pain, however, there is some promising research suggesting that a combination of treatments, including massage therapy, can help sufferers find relief.
Snapshot of Symptoms
FMS is an ordeal of pervasive, widespread and migratory pain and stiffness that strikes muscles and connective tissues, as well as tendons, ligaments, bursae and joints. The intensity varies depending on time of day, activity level, immune status, weather, sleep patterns and stress, and can extend over weeks or months, only to mysteriously improve after awhile.
Up to 90 percent of patients experience chronic headaches, and many have allergies, fatigue, hormonal imbalances, hypoglycemia, nasal congestion, vasomotor rhinitis and neurotransmitter dysregulation.
Almost all people with FMS have weariness, decreased endurance or exhaustion.
Transient cognitive difficulties are extremely common, including difficulty concentrating or engaging in simple mental tasks.
Some researchers say this is the most common, and for FMS sufferers the most bothersome, symptom. This “fibro fog” is marked by feelings of confusion, memory lapse, word mix-ups and concentration diffculties.2,3,4
Because FMS produces no definitive laboratory results, the diagnosis is one of exclusion. When all other possibilities have been excluded, FMS is what is left. The nomenclature is dense and confusing, but FMS is officially diagnosed when the following symptoms are detected5:
- A history of widespread pain in all four quadrants of the body, on both sides and above and below the waist, that is present for a minimum of three months.
- Pain in at least 11 of the 18 identified tender-point sites.
Many FMS sufferers experience their worst pain at several focal tender points, although the pain often radiates so generally that patients may be unaware of their presence until the point is palpated specifically.
On the whole, however, tender points are not very well understood, as defined locations don’t correspond to any particular set of nerve junctions or other obvious body structures, and other areas are often also tender.
Some specialists will make an FMS diagnosis with fewer than 11 tender points if several of the commonly reported associated symptoms are also present.6
Additionally, researchers find low skin temperature, vasoconstriction and hypoxia above tender points, so newer therapies are aimed at these problems.7,8 “Don’t just concentrate on the pain. You need a whole person approach,” explains Dr. Peter Abaci, medical director of the Bay Area Pain and Wellness Center in Los Gatos, California. “Most importantly, how do they function at home? You can’t separate the body from the brain and the mind. The whole brain matrix is involved in the pain—there is no ‘pain center.’”
John Combe, LMT, NCTMB and past president of AMTA’s Oregon chapter, tells us, “As a provider, a big obstacle is that clients have been told that they have fibromyalgia, but their doctor offers them no treatment plan—they have turned off the hope switch.”
Power of Touch
Massage, properly performed, seems particularly helpful in treating fibromyalgia. Patients consistently report that they find bodywork to be the top therapy for providing short-term relief and long-term improvement.18
In an effort to find out just what actually does help people feel better, German scientists took a look at various therapies and concluded that massage was ranked in the top four for patient satisfaction.19
A study in the European Journal of Pain evaluated connective tissue massage. The researchers treated 23
FMS patients and compared them to 23 controls. The subjects received a series of 15 connective tissue massage sessions, which reduced depression and use of pain medication and improved quality of life. The massage benefits gradually increased over the 10-week study, eventually reducing pain by 37 percent. Take note, though, that the patients’ pain had gradually climbed back to about 90 percent of the original level six months post-study.20
And therein lies the problem, as when pain is involved, being consistent can be difficult for some FMS sufferers.
“Therapy should continue for years,” adds Cabrera. “Hundreds of sessions might be indicated, and patient compliance is critical, though difficult to sustain. People know they will eventually feel better, but it might be difficult for someone in pain to get up and make the effort to go consistently.”
Lauren McNeal, an acupuncturist and bodyworker in Annapolis, Maryland, reminds us to be cautious and go slow. “Massage done too aggressively can hurt for three to four days afterward if it’s not in tune with their inner body,” she says.
Regrettably, many FMS patients, for whatever reason, don’t keep up with their massage treatments. One study of long-term FMS patients discovered a sizeable reduction in their use of all forms of hands-on therapy, despite the fact that 85 percent continued to have significant difficulty with their FMS, and 54 percent were taking over-the-counter drugs for pain and 39 percent were using antidepressant drugs.21
~~continued at https://www.amtamassage.org/articles/3/MTJ/detail/1839