Question:
I have regularly mentioned that I train spouses and companions to do
massage with effectiveness and safety. In my opinion, the condition that
offers considerable challenge to the L.M.T is Fibromyalgia Syndrome. Most
of my training is with spouses and companions of people, generally women,
with this condition.
Strictly speaking, the word fibromyalgia simply means pain in the
fibrous muscle tissue. And fibromyalgia is in fact what we deal with when
we are doing therapeutic massage on sports injuries, general massage for
those 'tired, achy muscles' that have been overused and abused, etc.
But fibromyalgia syndrome(FMS) is a completely different, and often
frustrating, condition. The brain has caused the person's body to go into
an almost vegetative activity level, mainly by causing overall muscle
spasm. There are also modified mental acuity, digestive disorders,
metabolic reductions, frequent migraine headache patterns, disuse muscle
atrophy, and several other systemic dysfunctions. IT IS NOT THE SAME AS
SIMPLY HURTING ALL OVER. It is a system-wide response, rather than
simply a localized muscle pain condition.
And I give you warning. This is not a condition that lends itself to a
56 minute whole-body massage. In fact, you might find yourself spending
that time just 'clearing' one leg. And you may have started with that leg
being hardly touchable.
The worst thing you can do to the FMS patient is to steadfastly deliver
standard massage techniques, such as kneading, that do not address the
condition as one in which massive guarding responses have been set up. In
fact, the clinical determination of the FMS diagnosis is made by 'tender
points' being present at certain locations. These are specific sites of
tenderness that are extremely painful with just 10 pounds of pressure.
There are often associated trigger points, but not necessarily.
It is not a standard myotherapy condition. I do understand, however,
that Bonnie Prudden is getting a myotherapy book out for the FMS patient.
I am bringing this topic up for the purpose of initiating dialog among
ourselves on this condition. I am not at this time indicating how I train
the companion or therapist, because I want to hear from several of you
what your approach to this condition has been.
Any takers??
Answer:
to have a diagnosis of FMS you must be affected in
a minimum of 11 of the 18 trigger points. In Ontario (and all of Canada I
believe) the only professionals deemed qualified by the OMA to diagnose FMS
is a Rheumatologist or a Physiatrist (muscle and bone specialist - or
something like that). Unfortunately, too many physicians have been
diagnosing FMS when they shouldn't be and it has turned into a "diagnosis du
jour".
There are a number of really good sites on the web for information on FMS.
I haven't checked them out lately, but they have always been a great source
of information on new treatments etc - I still am better informed about FMS
than the specialists I see - it really pisses them off (hahaha). I will
confirm the site URL's and post them here later.
Any trauma to the body can have short or longer term effects. You mention
about your leg - I shattered my elbow when I was 13 and they did some pins
and plates and wires so my arm works pretty good (sets off alarms at
security check points - but it works good). That was 33 years ago and I
still have less feeling in that arm. It took a few years to lose the
sensation of the skin being numb - but it does get better - just give it
some time.
Back to FMS - to be diagnosed, not only does the patient have to meet the
trigger point requirement but also experience - chronic severe pain, chronic
fatique, have a sleep disorder, and could exhibit any number of other
symptoms including - chronic severe headache, memory loss (short and/or long
term), cognitive dysfunction, chronic depression, anxiety, mood swings,
irritable bladder and/or bowel, gout and/or pseudo gout, chronic stiffness &
muscle spasms, in addition to a constellation of other possible symptoms.
You must undergoe a plethora of blood tests, x-rays, scans, grams and
graphs - and when all the tests come back negative and you have the above
symptoms - then they can diagnose FMS. If you get a diagnosis without going
through all that I would suggest you get yourself a better doctor. Too many
physicians now take a cursory look, run a couple tests and because they
don't know what else to tell the patient they give them a diagnosis of FMS -
which oft times puts the patient at risk of having something else wrong.
Case in point - my ex-sister-in-law received a diagnosis of FMS - a year
later she found out she had to have a histerectomy(sic) - had it - within a
month she had no symptoms - go figure.
One thing to keep in mind - at present, FMS has NO CURE. Sometimes the
professionals can treat some symptoms but few have been able to profide long
term improvement. In my case - the doctors have not been able to give me
anything in over 3 1/2 years that reduces the pain, stiffness or muscle
spasms. My last resort is narcotic based drugs - but I won't take them
until I can no longer adjust to the increases in pain. They have never been
able to give me anything that helps with the depression, anxiety,
agoraphobia, memory loss, irritable bowel & bladder, chronic headache or the
cognitive dysfunction symptoms, etc., etc., etc....
The last thing I would wish for anyone is to be diagnosed with FMS....at
least most other diseases are, for the most part, treatable.
As I said, I will post some URL's for FMS sites in the next few days.
