Physiology and Treatment of Fibromyalgia

Aaron Gunn, instructor and program coordinator at Atlanta School of Massage, was recently interviewed by Rona Berg, former Beauty Editor of The New York Times Magazine and Editorial Director of ELLE. Aaron explains the physiological aspects involved with fibromyalgia and massage treatments that lend beneficial results and relief.

Many fibromyalgia sufferers suffer from the feeling that their skin is “stiff” or “sticky.” This is from the myofascial tissue stiffening. What is myofascial massage, and how does it work to help?

Myofascial massage caters to the connective tissue layers within and surrounding the muscles of the body.  The fascia of the body creates a hydrated space for neurovascular supply, which lubricates and nourishes the muscles.  Myofascial work promotes lengthening of the fascia by promoting circulation and holding plastic deformation.  Since fascia responds more slowly to change than muscles, myofascial work is slow and progressive, working from the most superficial layers to the deeper connective tissue.  By creating increased space and hydration of the myofascia, the body can focus on its own self-corrective mechanisms for pain and dysfunction.  Aside from the physical effects of the work, myofascial massage can address certain psychosomatic components of the dysfunction which can perpetuate holding patterns within the muscles and fascia.

I’ve heard that myofascial massage can help relieve the pain–can you explain how that works?

Myofascial massage tends to be less aggressive than some other massage modalities.  Patients with Fibromyalgia Syndrome (FMS) tends to have suppressed levels of the chemicals that allow the body to lower pain sensations associated with dysfunction.  Therefore, overly aggressive bodywork can potentially exacerbate the pain and symptoms of FMS.  Myofascial massage can promote elasticity and hydration of the tissues, allowing more vital nutrients and oxygen into the painful areas, while facilitating the removal of metabolic trash that can add to the pain or discomfort.

Can you explain why massage is such a great stress reliever in general?

Many forms of massage increase parasympathetic nervous system (PNS) activity.  The PNS is a division of our autonomic (involuntary) nervous system that allows the body to focus on repair, regeneration, and replenishing our resources.  Therapeutic touch can alter brain state and allow for fuller deeper breathing.  Massage can also help to achieve deeper and more restful sleep, especially if received closer to bedtime (FMS patients are often sleep deprived).  As the body increases its parasympathetic functioning, the opposing sympathetic response (stress) is lowered.  Heart and respiratory rates regulate, and digestion/absorption of nutrients becomes a greater priority.  Massage essentially promotes an environment that allows the body to heal itself and achieve balance.

A recent study at Cedars Sinai found massage therapy decreases levels of stress hormone called cortisol and increases the number of lymphocytes–white blood cells that are a part of the immune system. Can you comment on why that would be useful for treating fibromyalgia?

Cortisol is a primary stress hormone produced by the adrenal glands to help create an involuntary “fight or flight” response.  Its focus is to increase available blood glucose to be metabolized for energy; however, it also acts as an immunosuppressant.  By promoting relaxation, cortisol levels may be decreased, allowing for increased immune functioning.  FMS patients tend to have decreased levels of serotonin, a neurotransmitter that plays a role in immune activity and helps to modulate pain.  Given that clients with FMS are often fatigued and in chronic pain, immune functioning is potentially already lowered.  By reducing adrenal activity, this may help to increase the body’s overall recovery mechanisms and focus on whole-body wellness.