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Pitfalls and Pleasures of Therapeutic Massage for Fibromyalgia and Myofascial Pain

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By Celeste Cooper
In a 2015 review and meta-analysis of different styles of massage therapy for those of us living with fibromyalgia, Yuan SL, Matsutani LA, and Marques AP concluded "overall, most styles of massage therapy consistently improved the quality of life of fibromyalgia patients." But, it is difficult to know why certain types of therapy might be more advantageous. 
Determining the most beneficial type of therapeutic massage or bodywork relies on our understanding of the differences between fibromyalgia and myofascial pain syndrome. While these two disorders can occur together, they are vastly different and so are the therapies used to treat them. For instance, myofascial release targets restrictions in the fascia (connective tissue that covers and connects all of the muscles in the body), which is often attributed to the body-wide stiffness in fibromyalgia. And, specific, specialized trigger point therapies target the release of knotted up pieces of muscle fiber felt in a taut band of muscle, which cause restriction of movement and chronic pain of the muscle affected.
Let me be clear, the tender points of fibromyalgia are NOT the same as the trigger points of myofascial pain syndrome. It is imperative that we know this when choosing the right type of therapeutic massage. (See 6 Reasons Why Trigger Point Injections Aren’t Helping Your Fibromyalgia.)
What massage techniques can help in the treatment of fibromyalgia?
The goal of therapeutic massage for fibromyalgia is to release restrictions of connective tissue (fascia), improve mood through the release of feel-good neurotransmitters, promote feelings of overall well-being, and improve sleep.
Massage therapies you might find helpful are:

  • Traditional light touch massage, such as Swedish massage.

  • Rolfing©*

    *If done by someone skilled in using this form of massage on someone with fibromyalgia.

  • Myofascial release (MFR)

  • Shiatsu

  • Lymphatic Massage, which was noted by investigators to be most helpful for fibromyalgia.

  • Other massage techniques incorporating touch therapy include Hellerwork, acupressure, Alexander Technique, and Rosen Method.

It’s important that a therapist understands fibromyalgia and does not confuse it with myofascial pain syndrome. If your therapist tells you they feel trigger points or taut bands of muscle this is from myofascial pain syndrome, not fibromyalgia.
What massage techniques work for myofascial pain syndrome?
If myofascial pain syndrome (MPS) is present, as seen in many disorders such as fibromyalgia and chronic fatigue/myalgic encephalomyelitis, migraine, spinal degeneration, interstitial cystitis, irritable bladder, arthritic joints, post surgical scaring, etc., a specially trained therapist, such as a member of the National Association of Myofascial Trigger Point Therapists (NAMTPT), is recommended. 
Manual therapies for treating myofascial trigger points include: 

  • Myofascial trigger point therapy by a specially trained massage therapist or body-worker.

  • Spray and stretch.

  • Self-treatment.  (NAMTPT suggestions for books on self-care)

A good trigger point therapist will understand that fibromyalgia and myofascial pain syndrome can co-exist, but they are different. They will know that when both are present, their client needs specialized care. They are aware it takes effort not to overwhelm your muscles and your immune system, while restoring muscle fibers to their normal resting length and improving function. The good news is that when we find the right therapist, practice self-therapy, and pay close attention to preventative practices, myofascial pain syndrome can be treated successfully.
Not all massage is therapeutic for every condition that causes us chronic pain and no two of us are the same. When we know this, we can turn pitfalls into pleasures.

The American Massage Therapy Association's National Massage Therapy Awareness Week® is October 22-28, 2017!

Celeste Cooper, RN, is a frequent contributor to ProHealth.  She is an advocate, writer and published author, and a person living with chronic pain. Celeste is lead author of Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain and Broken Body, Wounded Spirit, and Balancing the See Saw of Chronic Pain (a four book series). She spends her time enjoying her family and the rewards she receives from interacting with nature through her writing and photography. You can learn more about Celeste’s writing, advocacy work, helpful tips, and social network connections at

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