Use of massage as related to treatment of individuals with CFS and signs of fibromyalgia.

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This article will address the use of massage as it related to treatment of individuals with Chronic Fatigue Syndrome who showed signs of Fibromyalgia. Many doctors claim that FMS (Fibromyalgia Syndrome) is simply one of the symptoms of CFS ( Chronic Fatigue Syndrome), while others insist that they are separate and distinctly different illnesses. As I researched both illnesses, it became clear that many of their symptoms overlap, thereby leading to the discrepancy in doctors' opinions. It is my belief at this point that they are different illnesses that share many of the same symptoms and possibly a common cause; it is also possible for a person with CFS to have Fibromyalgia and visa-versa. For the massage practitioner it is important to be able to identify the key similarities and especially the differences before beginning massage treatment, as each illness must be approached differently. I will attempt to give the reader a brief understanding of these illnesses, their recommended treatments, as well as the most current findings of a leading massage authority in Northern California.

First and foremost, let us address some of the similarities in symptoms that both illnesses share. Those suffering from these illnesses share the following symptoms: muscle pain, multi-joint pain without swelling, headaches, sore throat, tender lymph nodes, persistent and recurrent periods of unexplained fatigue, sleep disturbance (unrefreshing sleep), blurring of vision, dizziness, rashes, tingling sensations in the extremities, irritable bowel syndrome, cognitive difficulties such as short term memory loss and double concentrating, and emotion al difficulties such as depression, anxiety and panic attacks. With so many similarities, it becomes clear why it may be difficult to differentiate between the two illnesses.

For a massage practitioner or any doctor attempting to treat someone with the above listed symptoms, it becomes important to search for the clues that differentiate the two illnesses. In order to do so, we must first determine the most severe symptoms of the individual. The National Foundation for Fybromyalgia uses the following two criteria for diagnosis: widespread pain for at least three months, and a number of tender points (11-18) found in precise locations on the body. People with FMS' number one complaint is that they "hurt all over". Many people with FMS cannot sit or maintain any position for longer than twenty minutes without becoming stiff. Morning muscle stiffness can be especially difficult. In contrast, the Center for Disease Control in Atlanta and the CFIDS (Chronic Fatigue Immune Dysfunction Syndrome) Association of America use the following criteria for diagnosis: 1. Unexplained and persistent fatigue lasting for six months or more. A sudden and rapid onset of symptoms. 3. The concurrent occurrence of four or more of the following symptoms: short term memory loss, difficulty concentrating, swollen or tender lymph glands, sleep disturbance, night sweats, low grade fever, muscle or joint soreness.

By reviewing the criteria for diagnosis, we discover that people with FMS are primarily plagued with muscular pain, while those with CFS are plagued with a sudden onset of symptoms, the most predominant one being fatigue. Another key distinction is that patients with FMS can usually be helped with low levels of exercise, while those with CFS experience a worsening of symptoms.

The medical communities have yet to find definite causes for either CFS or FMS, and therefore most treatment is still considered experimental and aimed at alleviating the symptoms. Our concern is the usefulness of massage as a form of therapy. For those individuals that primarily display symptoms of Fybromyalgia, massage is indicated as a possible treatment for short term pain relief. For individuals that display primarily the symptoms of Chronic Fatigue Syndrome, massage is contraindicated for any patient that is experiencing muscular pain along with their fatigue. This contraindication is the uniform opinion among the leaders of CFS research and treatment; the reason is that massage is very similar to exercising a muscle, and many patients have experienced a relapse in health after treatment.

Recently, a well seasoned and highly respected massage therapist in Northern California, Jocelyn Oliver, surveyed a group of individuals with FMS and CFS. She discovered what she believes to be a common cause for both illnesses as well as the most appropriate form of treatment. After surveying a fairly large group, she discovered that all of the ill individuals had experienced some form of intense childhood trauma, and some were still experiencing ongoing emotional trauma. These traumas, she believes, lead to a biological anxiety and a biologically based tension in the body; this would constitute an ongoing hyper-arousal of the sympathetic nervous system and a hyper-tonic muscular state. As a result of this biologically based anxiety and tension, most individuals end up with what is known as "leaky gut syndrome", in which the integrity of the intestinal tract has been compromised and the individual is more susceptible to developing allergies. Doctors agree that both FMS and CFS patients display more allergies to food, airborne allergens and their environment as a whole. Jocelyn's recommended course of treatment would be for the ill individual to begin some sort of body oriented stress and trauma relief therapy. Because the trauma has become a biological component of these patients' "make up", the trauma must therefore be released from the body. Therapists that encourage "talk therapy" and "analysis" will be of little help. As far as bodywork is concerned, Jocelyn recommends light palpation and nothing more. Deep tissue work is contraindicated.