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Fibromyalgia Demystified

Bodywork as a Key Therapy
Cathy Ulrich
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.

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.

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.