Massage Treatment for Fibromyalgia

Some research has shown that massage leads to improvements in pain and symptoms for people who have Fibromyalgia, leading to reductions in anxiety, depression and salivary cortison.  People who have tried massage for Fibromyalgia also self report reduced pain, stiffness, fatigue and less difficulty sleeping.  

Massage therapy can help to improve circulation and encourage the body to rid itself of harmful toxins that increase pain.  You will probably want to select a massage therapist who is experienced in treating Fibromyalgia as people with Fibromyalgia tend to have increased sensitivity which may need special attention during their massage session.

Massage therapy benefits include:

  • increased blood circulation to the muscles, allowing for faster muscle repair
  • increased flexibility
  • increased range of motion
  • decreased stress and depression
  • reduced pain
  • reduced stiffness
  • improved sleep patterns

There is general agreement that massage is contraindicated during flare-ups (both by professionals and by those who do benefit from massage on a regular basis).  There are many different types of massage so it is worth having a bit of a look at the different options to see which one you would like to try.  One type of massage that is highly recommended for people with Fibromyalgia is Deep Tissue Massage.  Other popular offshoots of massage therapy include Craniosacral Therapy and Reflexology and Myofascial Release.

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Frequently Asked Question about Massage

What is a Massage Session Like?

Because of the many different types of massage therapy, this question can only be answered very broadly.  The experience can differ widely depending on the type of massage therapy you have decided to try.

During your first massage therapy session, you can expect that the massage therapist will gather some preliminary information.   They may ask you questions to identify your current condition/challenges, your over-all health and what benefits or results you want to gain from the massage therapy session. The massage therapist (particularly for types of therapeutic massage as opposed to massage purely for relaxation/enjoyment) is also likely to ask about your physical condition, medical history, stress levels, lifestyle, medications taken and any physical pain that they need to be aware of during the massage therapy session.

A typical massage therapy session will last between 40 and 90 minutes depending on the type of massage, the reason you are going for massage, your present condition and your desired result. Massage therapy generally requires you to undress (for some massage types you keep your underwear on, for others you undress completely - this option may also depend on your level of comfort with the massage and with undressing) but your privacy will generally be maintained with a light covering. You will be asked to lie face down under a sheet on a padded massage table. A light oil or lotion may be used and applied to your skin to start the massage. A full body massage usually starts on the back then eventually moves down to the legs then you will be asked to turn over face up to continue with the massage of your arms, legs and neck. During the massage session, you are under the sheet all the time and only part of the body being massaged or treated is uncovered.

Is Massage Therapy Painful?

Massage therapy should not hurt (with certain exceptions for types of massage therapy like deep tissue massage or Swedish massage). Occasionally there will be a mild ache when therapist applies pressure to body points, over "knots" and other areas of muscle tension but it should not be painful. Although the degree of pressure being applied varies widely with the type of massage, it is always a good idea to draw the attention of the massage therapist to any pain and they can then tell you whether that is to be expected with that type of massage or they can ease off on the pressure.

what Does Massage Therapy Cost?

The frequency of massage sessions will vary depending on the condition being treated. The cost per session also depends on the methods that will be used (i.e. Swedish, Deep tissue, etc) but other than luxury massages (i.e. at spas), the cost generally ranges from $30 to approximately $130 per session.

Is Massage Therapy Covered by Insurance?

Most extended health insurance plans in Canada and the United States cover some or all of the costs of therapeutic massage depending on the type of plan and massage.  Ask your employer or contact your provider for details on how the coverage works.  Massage for relaxation and enjoyment may or may not be covered.  Generally for the massage to be covered by your insurance, you need to be seeing a licensed Massage Therapist.

How to Select a Good Massage Therapist

There are a variety of considerations when selecting a massage therapist.  These include considerations about the massage therapist's training and certification, questions about their fit with you (i.e. chemistry - is this someone you will trust and be able to relax with), and possibly their answers to questions you may want to ask them.

Personal referrals from friends or health professionals are a great way to find massage therapists.  Equally, looking at reviews of massage therapists on can help you see what past clients have to say about the massage therapist.  Reading articles they have written can also give you a sense of their personality and degree of expertise and knowledge.  You can also ask the massage therapist questions that are important to you.  Some questions that you may want to consider include:

  • What certifications do you hold?  
  • How long have you been practicing?  
  • What types of oils or lotions do you use?  
  • What are your rates? Is there a payment option?
  • Do you have experience in providing massage to people with (my physical condition)?

If you are considered about whether or not you will have to undress fully, you can also ask about that.

Licensing and training differs for massage therapists depending on 

  • the location you are in, and
  • the type of massage the therapist offers

Different countries, states and provinces have varying but usually similar requirements that need to be met before a massage therapist can be certified.  This usually involves a combination of training, practical experience and some type of certification and/or licensing. In most states in the US, Massage therapists are required to have a license to practice. Most states also require massage therapists to have at least 500 to 1000 hours of training which has resulting in them obtaining a certificate, diploma or degree depending on the school they attended. The Commission on Massage Therapy Accreditation (COMTA) is one of the organizations that regulates and works with massage therapy schools in the U.S.

The website of the American Massage Therapy Association (AMTA) provides a state-by-state guide to requirements for therapist education and experience and National Certification Board for Therapeutic Massage and Bodywork (NCBTMB).

Generally, it is advisable to seek a massage therapist who has trained at least 500 hours and to look for someone who is CMT (a Certified Massage Therapist).

Licensed therapists will have the initials LMT after their name (which stands for Licensed Massage Therapist) or LMP, which stands for Licensed Massage Practitioner.

In late 2007, the Federation of State Massage Therapy Boards (FSMTB) launched a new certification exam titled the MBLEx. To date, there are fewer than 10 states that are not regulated by the FSMTB.

Training for massage therapists consists of courses in body mechanics and motion, massage techniques, ethics and the study of organs and tissue.  

It is a good idea to talk with your massage practitioner about what their level of knowledge and expertise is related to Fibromyalgia.  Ideally you will find a massage therapist who is familiar with Fibromyalgia and can talk with you knowledgeably about what differences that may or may not make in their treatment of you.

It is also useful to ensure that they are aware of the physical sensitivities that are common to Fibromyalgia and that they know what changes they may need to make, or what they may need to be aware of when doing massage for someone with Fibromyalgia.  While some types of massage can cause short term pain for later relaxation, this is probably not a good idea if you have Fibromyalgia.  

During a flare up, you probably want to avoid deep tissue massage as well as any type of massage involving vigorous strokes or deep pressure can cause rebound tenderness, exacerbating pain. Prior to, and during flare-ups, certain areas may be too tender for deep work, and can result in further tensing of the involved muscles. Respected fibromyalgia researcher, Devin J. Starlanyl, MD, recommends avoiding deep tissue massage or neuromuscular therapy during these times.

History of Massage

No one really knows definitively how Massage Therapy started and where it originated. There is evidence and writings about massage that have been found in many ancient civilizations including China, Greece, Rome, India, Japan and Egypt, to name a few. The first known record of massage in China was during the second century in a Chinese book “The Yellow Emperor's Classic of Internal Medicine” and in Egypt there are paintings of people being massaged found in tombs. Massage Therapy was one of the popular methods used for relieving pain by Greek and Roman physicians. Regardless of the mystery of the exact origin, it is clear that Massage Therapy is one of the oldest traditional holistic treatments.

Over the years, many different types of massage therapy have been developed, refined and or named. In the early 19th century, for example, Per Henrik Ling (known as the father of therapeutic massage) developed a method of massage that is now called Swedish massage.

Massage began to become popular in the United States in the mid 19th century when it was introduced by two New York physicians.

There are many methods of massage that have been practiced from antiquity up until the present in different parts of the world.  A few examples include:

  1. Acupressure, a traditional Chinese medicine.
  2. Anma, a traditional Japanese massage which involves deep tissue work
  3. Ayurvedic massage comes from a natural health care system which originated and is widely practiced in India (using aromatic oils and spices) 
  4. Balinese Massage, in which the massage movements include skin folding, kneading, stroking and other techniques
  5. Deep tissue massage which focuses on the muscles located below the surface of the skin. 

Theory behind Fibromyalgia Treatment using Massage

People affected or suffering from Fibromyalgia frequently have symptoms such as muscle pains, joint stiffness and fatigue. These can also cause mood, sleep and memory problems. Massage may help alleviate the pain and improve the symptoms of the disease. It can also help to increase muscle flexibility and blood circulation and decrease stress hormone levels and anxiety.  Massage may be able to loosen areas of tension and knots and blockages.  It can also promote a feeling of relaxation and well-being.  Massage is contra indicated during a period of flare ups.

Research of Fibromyalgia Treatment using Massage

Benefits of massage-myofascial release therapy on pain, anxiety, quality of sleep, depression, and quality of life in patients with fibromyalgia

Summary:  The purpose of this study was to determine whether massage-myofascial release therapy can improve pain, anxiety, quality of sleep, depression, and quality of life in patients with fibromyalgia.  It was done as a randomized controlled clinical trial where 74 people with fibromyalgia were randomly assigned to massage-myofascial release therapy or to a sham treatment for a period of 2 weeks.  Pain, anxiety, quality of sleep, depression, and quality of life were determined at when the study began, after the last treatment session, and at 1 month and 6 month periods after the end of the treatment.  Immediately after treatment and at 1 month, anxiety levels, quality of sleep, pain, and quality of life were improved in the group that received massage-myofascial therapy compared with the control group.  Six months later, there were only significant differences in the quality of sleep index. The study concludes that "myofascial release techniques improved pain and quality of life in patients with fibromyalgia."


Equivocal Support for Analgesic Effects in Fibromyalgia

Summary: This review looked at four different studies done related to the effects of massage therapy on fibromyalgia.  In one study, the group receiving massage therapy reported less pain, stiffness, fatigue and difficulty sleeping (as assessed via interviews), as well as improvements in dolorimeter test value and physician's assessment of clinical condition.  Another study examined compared the results of massage therapy versus progressive muscle relaxation for people with fibromyalgia. Both groups reported reductions in anxiety and depression immediately following treatment on the first and last days. By the end of treatment, the massage group evidenced significant reductions in self- and physician-assessed pain and symptoms, as well as reductions in the number of tender points and substance P levels.  A third study compared assigned people with fibromyalgia to groups that received either massage therapy or no treatment. Comparisons immediately after the treatments showed greater improvements in pain, depression and quality of life in the massage group relative to controls, but no differences in disability, sleep disturbance or anxiety.   30% of the improvement in pain had disappeared by the 3-month follow-up and 90% of the reduction in pain was gone by the the 6 month follow-up. The last study examined assigned 37 people with fibromyalgia to one of three conditions: massage, usual care, usual care with follow-up phone calls from a nurse.   However, only 16 patients completed the study and although the massage group showed a trend towards greater improvement in pain and self-efficacy for managing their condition, there were no between-group differences by the end of treatment likely due to the small sample sizes.  The conclusion of this review was that unfortunately the quality of the trials was poor, and that the positive effects did not appear to last.  While the researchers drew the conclusion that massage for Fibromyalgia could therefore not be recommended, for people suffering from the pain of Fibromyalgia and accepting of the benefits of even short term relief, this study does provide food for thought.


Massage therapy for fibromyalgia symptom

Summary: This review examined a wide range of studies related to fibromyalgia and massage, and concluded that all the studies reviewed showed short term benefits of massage for fibromyalgia with one single study demonstrating long-term benefits, but all the studies had methodological problems. Therefore this review concludes that "The existing literature provides modest support for use of massage therapy in treating fibromyalgia. Additional rigorous research is needed in order to establish massage therapy as a safe and effective intervention for fibromyalgia. In massagetherapy of fibromyalgia, we suggest that massage will be painless, its intensity should be increased gradually from session to session, in accordance with patient's symptoms; and the sessions should be performed at least 1-2 times a week."

Comparison of manual lymph drainage therapy and connective tissue massage in women with fibromyalgia: a randomized controlled trial

Summary: This study analyzed and compared the effects of manual lymph drainage therapy (MLDT) and connective tissue massage (CTM) in women with primary fibromyalgia. The study was set up as a randomized controlled trial with 50 women participating, who were randomly divided into two groups; one group receiving manualy lymph drainage therapy and the other group receiving connective tissue massage. The study concluded that both groups had signficiant improvmeents in pain intensity, pain threshold and quality of life, but that the Fibromyalgia Impact Questionnaire scores and the results in terms of morning tiredness and anxiety. The study concluded that both types of therapies yielded improvements in terms of pain, health status and health-related quality of life, but that manual lymph drainage therapy seemed to have some benefits over connective tissue massage.

Stories of Fibromyalgia Treatment using Massage

If you have used massage for fibromyalgia please share your stories here.

Questions and Comments about Massage for Fibromyalgia

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Sandra Miletello 2015-02-21 02:53
I am in an awful fibro flareup and don't know where to turn anymore.

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