Fibromyalgia — a non articular (affecting soft tissues such as muscles and connective tissues rather than joints), painful, rheumatic condition of at least 3 months duration. The disease is characterized by widespread muscular achiness and specifically the palpation of tender points at 11 of 18 prescribed locations on the body. Fibromyalgia is accompanied by fatigue, sleep, memory and mood issues. Researchers believe that fibromyalgia amplifies painful sensations by affecting the way the patient’s brain processes pain signals. Fibromyalgia affects 2-6% of the population.
Diagnosing Fibromyalgia
18 TENDER POINTS ( bilateral: 9 x 2 )
There are 18 symmetrical tender points of which at least 11 need to be found on examination to determine fibromyalgia. This distinguishes fibromyalgia from chronic fatigue syndrome, myofascial pain syndrome, arthritis, lupus.
POSTERIOR:
1.) Suboccipital mm insertion, inferior to occiput
2.) Upper trapz, midpoint of upper border
3.) Supraspinatus origin, medial near spine of scapula ( by the upper angle of scapula)
4.) Anterior glute medius
5.) 2 cm posterior to greater trochanter
ANTERIOR:
6. ) Anterior aspect of c5-c7
7.) Rib 2 at costochondral junction (sternum)
8.) Extensor digitorum, 2 cm. distal to lateral epicondyle
9.) Knee- medial collateral ligament
Causes of Fibromyalgia
- Immune abnormalities
- Genetic predisposition
- Fibromyalgia is Triggered / Aggravated by:
- Overexertion
- Lack of exercise
- Stress
- Anxiety
- Depression
- Lack of sleep / too much sleep
- Trauma
- Extreme temperature ( esp cold)
- Infectious illness
Fibromyalgia Massage: Symptoms of Fibromyalgia
- Generalized pain — 100% of people with fibromyalgia
- Stiffness, worse in morning and evening
- Moderate to severe fatigue, weakness
- Poor sleep
- Intolerance of cold, swollen feeling in tissue, anxiety, dry eyes and mouth, problems with memory and concentration
- Other conditions associated with fibromyalgia:
- Depression, chronic Headache, migraine, insomnia, TMJ Disorder, myfascial pain syndrome, irritable bowel or bladder, chronic fatigue syndrome
Fibromyalgia Massage Therapy CONTRAINDICATIONS
- Avoid deep work, overstretching muscle especially during the initial treatment. This might result in pain post treatment
- Do not fatigue the patient with long treatment
- NOTE: Some patients with fibromyalgia who come for massages regularly prefer deep tissue work and/or long treatment, which is why consent and communication (before, during, after) and feedback is important
- Modify massage techniques with patient taking muscle relaxants, analgesics
Fibromyalgia Massage Therapy TREATMENT
- Massage goals: (full body) Wellness and Relaxation context massage
- Diaphragmatic Breathing
- Level of pressure may vary from area to area and treatment to treatment — (patient feedback)
- Intersperse Swedish massage techniques with stretching, passive movement, joint play
- Key relaxation areas — head, neck , shoulders, abdomen, hands, feet
- The therapist may go over the tender points but don’t treat them like trigger points
Fibromyalgia Massage: SELF CARE
- Warm / hot hydrotherapy
- Self massage
- Diaphragmatic breating, meditation, yoga
- Perform exercise at time of day that they feel most energetic — stretch, strengthen, moderate aerobic activity
