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Fibromyalgia is a syndrome that affects 2-4% of the population of any country with a variety of associated conditions and a complicated diagnosis that involves a process of elimination. Fibromyalgia is diagnosed through a set of criteria laid out by the American College of Rheumatology (ACR) and includes an assessment of pain at 19 sites spread across the four quadrants of the body, as well as a symptom severity scale that measures symptoms – such as fatigue, headache and abdominal pain (Gerwin, MD, 2013).
Symptoms of fibromyalgia include pain and tenderness in all four quadrants, for longer than three months: headache, sore throat, stomach pain, memory problems, fatigue and sleep problems, along with numbness, burning and tingling in the arms and legs, and sensitivity to temperature, loud noises and bright lights (American Medical Association, 2014). Other conditions associated with fibromyalgia include migraines, tension-type headaches, temporomandibular joint disorder (TMJ), irritable bowel syndrome, depression, waking up tired, pelvic pain disorder, prostatitis, dysmenorrhea and hypothyroidism (Gerwin, MD, 2013).
Recent Research on Fibromyalgia
Recently, Li, Wang, Feng and Sun (2014) have completed and published a study establishing evidence that massage therapy over a period greater than five weeks results in decreased pain, anxiety and depression in patients with fibromyalgia (Li, Wang, Feng, & Sun, p. 1). They conducted a systematic review of current research and completed a meta-analysis of the evidence of all research they found that was published in English or Chinese. The reviewed electronic databases such as PubMed, EMBASE, OVID-MEDLINE, SPRINGLINK, CNKI (China Knowledge Resource Integrated Database), Weipu Database for Chinese Technical Periodicals, Wan Fang Data, ProQuest Dissertations and Theses A&I, and searched using the terms massage, manual therapy, Tuina, fibromyalgia, fibrositis, myofascial pain (Li, Wang, Feng, & Sun, 2014). Out of 433 relevant publications, six were included in the study, the rest excluded due to issues of bias, allocation concealment, blinding and incomplete outcome data or selective outcome reporting (Li, Wang, Feng, & Sun, 2014).
The results of this study provide us with an evidence based treatment option for fibromyalgia: massage therapy.
This review of randomized control trials (RCS) updated a 2006 meta-analysis confirming once again that massage is a viable treatment for fibromyalgia. Massage therapy was shown to decrease pain, anxiety and depression, but did not impact on sleep disturbances. While there were no adverse reactions, massage therapy certainly has been shown to help with pain management for those suffering.
Family and Caregivers Benefit from Massage Therapy
There are others who would benefit greatly from massage therapy: the family of and caretakers to those with fibromyalgia. People with fibromyalgia suffer greatly from this disease, and they are not alone in this suffering. Family members of those with fibromyalgia often feel neglected, isolated and overburdened in coping with and supporting those with the disease. Children or dependents of those with fibromyalgia feel abandoned, as their sick parent cannot do for them or cannot offer them what they should be getting in emotional and physical support – while marriage partners and significant others, friends and peers feel frustrated because the fibromyalgia patient is chronically absent. They are physically absent, as the disease limits their movements, and emotionally absent, too, as they withdraw into their own world of pain.
According to Goldberg-Arnold, Fristad and Gavazzi (1999), the caretaker’s stress is three fold: “situational stress arising from interaction with the ill individual; societal stress arising from negative attitudes and lack of social support; and iatrogenic stress, arising from inadequate or misinformed service providers (Goldberg-Arnold, Fristad, & Gavazzi).” We see here, they must deal with the ill family member, they must deal with the negative attitudes and lack of social support around the family, and then they must deal with inadequate medical and support services. This is probably even more accurate of fibromyalgia than it is for other illnesses such as cancer, as there is little understanding and a great deal of skepticism for fibromyalgia patients.
All of this can become overwhelming very quickly, and even the strongest family members can quickly become both emotionally and physically taxed by these stresses. Three warning signs of burnout in the caregiver are “emotional exhaustion, a feeling that one lacks the energy to engage in any human relationship; depersonalization, due to their inability to ‘save’ the sick person they depersonalize in an attempt to distance themselves; and low levels of personal accomplishment, or feeling very little satisfaction in caring for the patient (Ybema, Kuijer, & Hagendoorn, 2002).”
Back, et.al. (2009) found that massage therapy reduced “anxiety, blood pressure, and heart rate…and reduced anxiety and depression with a course of multiple treatments providing benefits similar in magnitude to those of psychotherapy (Back, Tam, Lee, & Haraldsson, 2009).” Massage was also credited with increasing serotonin and dopamine levels, if not the reduction of cortisol (Back, Tam, Lee, & Haraldsson, 2009). Just as massage therapy has been proven to reduce anxiety and depression in fibromyalgia patients, it has been shown to reduce those symptoms in others, including the family members of those who are ill.
Family members and close friends may need the proven benefits of massage therapy just as much as the diagnosed patient, as they are dealing with this disease almost as much as the patient themselves. It is important that we do not allow the family of fibromyalgia patients to be forgotten. There is a great deal of misunderstanding around fibromyalgia, with patients’ complaints being dismissed by those around them because they do not “look sick.” If patients are being dismissed, imagine then how much more so their family members are written off as naïve for believing and catering to their diagnosed family member.
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