Can you feel fibromyalgia areas?

[Mister B]

Ok, this may be such a dumb question that no one needs to ask it on here, but I'm going for it...head first.
Can you feel the tissue is "different" where a client is having fibromyalgia pain? I have a client that was diagnosed by her doctor recently and wanted to know if I could feel where she was hurting? The center of her back was "burning" but she wasn't sure if it was stress or the the fibromyalgia. Since some of her joints were bothering her she thought maybe it was the fibromyalgia. She's was diagnosed with a mild case and it's new to her.
I honestly, don't have any clients that have this so it's new to me. I work in a college town so my client base tends to be pretty young and healthy.
Thanks in advance.
P.S. I guess I should clarify this to say that I know they she's going to have tight muscles and tension but can you feel anything else?

 

[Pompal 09.]

SimplyBee,
There's no such thing as a stupid question, and I applaud your bravery in asking so that you can be the best therapist you can be. That being said, I'll be very interested to see how others with fibromyalgia experience answer this!

In general, we as therapists can only know when something "hurts" a client when they TELL us -- communication between therapist and client can't be emphasized enough. We can feel tight muscles, trigger points, fascial restrictions, etc, but when we encounter something we THINK would be painful for one person, they'll respond "no, I can feel the tightness/etc, but it doesn't hurt" and then another will feel pain with very light touch. Each client experiences massage differently. From what I've read on these boards and in MT mags, the same is true with fibromyalgia, ie, there's no 'one way' that people with fibromyalgia respond to massage.

Thanks for posting a great question. I like your logo, by the way!

 

[Donta]

I see a number of people diagnosed with FMS. To date, I've noticed no particular "this is FMS, this is not" indicators in their tissues. Every person is different, and may be completely different from one visit to the next.

Then again, I may be overlooking something that I don't yet have the ability to perceive.

 

[mahleezah]

Thanks, that's pretty much what I was wondering and 100% answered my question. I won't be expecting to "find" anything specific now.
She's a regular that has been coming in once a month and is now going to come every other week for awhile to see if it helps. It's new to both of us so we are both exploring it. I've always made it clear to every client that the session is about them so communicate and give me feedback. I always start each session with, "so, what are we doing different today"? "How did your ________ feel last time after the session"? "Do you think it was enough pressure?". That way it allows them to lead me without feeling like they are offending me. (you know how some clients won't speak up) Anyway, I tend to get more specific answers that way and the answers are waaaaay more helpful to me than, "everything was great".
Thanks for the kindness.
P.S. Thanks for the logo compliment.

 

[glurginuirm]

Speaking for my own mildly fibromyalgic body, sometimes there is the "puffiness" of inflammation around my L scapula, other times, the extremely stiff and yet mildly puff scalenes and SCM bilateraly. Yet others, my quad. lumborum is so unbearably tender to the touch, the gal who works on me regularly swears that she can feel the energies shooting out of them like "10 thousand @#$% little sparkling firecrackers!" [her quote not mine].

A good anecdotal book on the subject is "Fibromyalgia and Chronic Myofascial Pain Disorder" by Starlanyl and Copeland. One of the authors is an MD, the other, a psychologist. It helped me figure out the foods, etc that act as triggers for me, and, too, it helped me understand I wasn't crazy [well, at least when it came to having "weird" traveling symptomology, anyway.]

Just listen to your client, and work to where she is that day in particular. For FM people, each day is a new and "exciting" adventure.

Good luck.
J

 

[Valen]

In general, we as therapists can only know when something "hurts" a client when they TELL us -- communication between therapist and client can't be emphasized enough. We can feel tight muscles, trigger points, fascial restrictions, etc, but when we encounter something we THINK would be painful for one person, they'll respond "no, I can feel the tightness/etc, but it doesn't hurt" and then another will feel pain with very light touch. Each client experiences massage differently.

Very nicely put! I was just explaining that to a friend/client the other day, and I think the closest I got was "everyone has a different 'normal'" so I go by what a person reviews as pain." Do you mind if I use some of your words at some point, like on my website? Not now, I'm too lazy, but my next website update maybe.

 

[m&m&m]

There is a nice article on bodywork for FMS by Leon Chaitow here:
http://www.amtamassage.org/journal/cont_edu.html

You can sign up to get 2 CECs for it too.

 

[sweet.caroline]

Feel and treatment

Thank you for the link Jason. I will address the original question and apply a point from the article.
What you feel will be the same as what you can feel with any client. The client on the other side perceive more pain when in a flare of FM; that is what makes it FMS. If you normally feel trigger points in your clients, you will feel them in FM client but you may not be able to treat them even with the MET demonstrated in the article because the pain will not be tolerable or the after affects the next few days will be intolerable.
The quote:
The removal or deactivation of myofascial
trigger points and other local dysfunction
by minimally invasive methods,
combined with homeostatic enhancing
approaches (nutrition, relaxation methods,
hydrotherapy, etc.) would be additionally
useful alongside massage therapy.
When massage and movement therapy
were compared with relaxation
and movement for working with FMS
clients, there were far more benefits in
the group receiving both massage and
movement therapy. The greatest benefits
were noted in areas of mood and
depression, as well as in reduced pain
levels.
My application:
I use Strain-Counterstrain by Lawrence H Jones, DO or the more current version Structural Relief Therapy. This is basically finding the position of the joints involved where the pain is minimal [usually a shortened position of a muscle but with multiple muscles involved it can be anywhere along the spectrum] then holding that position for 1 1/2 too 2 minutes.
I originally learned this because a client came to me with Jones' book because her DO was not willing to spend an hour each time holding all these positions that she needed. I is not cost effective for Dr. or patient but it is for our client practitioner relationship.
When do such a session with a client in flare, they become extremely sleepy yet they can get op off the table and move freely. Both things necessary according to the article to restore the growth hormone that repairs the micro-tears and puts the FM into remission.
Then during periods of remission you can do deeper tissue work as necessary. That is my story.

 

[NatalieBeauty]

Hans,

I agree - my clients with fibro are very upfront at the beginning of each session in explaining what is happening with them. Some days they can handle a more stimulating, deep tissue or circulatory massage. Other days there are areas where the lightest pressure is too much. I find using essential oils that help with muscle tension and inflammation also help relieve flare ups non-invasively and within their tolerance levels.

Angela

 

[loves2cook]

Speaking for my own mildly fibromyalgic body, sometimes there is the "puffiness" of inflammation around my L scapula, other times, the extremely stiff and yet mildly puff scalenes and SCM bilateraly. Yet others, my quad. lumborum is so unbearably tender to the touch, the gal who works on me regularly swears that she can feel the energies shooting out of them like "10 thousand @#$% little sparkling firecrackers!" [her quote not mine].

I agree wholeheartedly with the posts that each client is individual in their manifestation of fibromyalgia but Anastasia, I swear what your therapist feels with you is the perfect way to explain what I feel with one of my FMS clients! Her hot spot is along her IC and hip flexors. Sometimes I cannot bear to keep my hand there. I always marvel at how intense the pain must be for her if it feels like that to me.

 

[Mailman Bob]

Grreat info!
AngEngland: what essential oils do you use?

 

[ChristianR]

Seebs - Thanks for the kudos, and please feel free to use any/all of what I said there.