Massage therapy for fibromyalgia symptoms

Department of Physical Therapy, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Rheumatology International (Impact Factor: 1.52). 03/2010; 30(9):1151-7. DOI: 10.1007/s00296-010-1409-2
Source: PubMed


Massage therapy is widely used by patients with fibromyalgia seeking symptom relief. We performed a review of all available studies with an emphasis on randomized controlled trials to determine whether massage therapy can be a viable treatment of fibromyalgia symptoms. Extensive narrative review. PubMed, PsychInfo, CINAHL, PEDro, ISI Web of Science, and Google Scholar databases (inception-December 2009) were searched for the key words "massage", "massotherapy", "self-massage", "soft tissue manipulation", "soft tissue mobilization", "complementary medicine", "fibromyalgia" "fibrositis", and "myofascial pain". No language restrictions were imposed. The reference lists of all articles retrieved in full were also searched. The effects of massage on fibromyalgia symptoms have been examined in two single-arm studies and six randomized controlled trials. All reviewed studies showed short-term benefits of massage, and only one single-arm study demonstrated long-term benefits. All reviewed studies had methodological problems. The existing literature provides modest support for use of massage therapy in treating fibromyalgia. Additional rigorous research is needed in order to establish massage therapy as a safe and effective intervention for fibromyalgia. In massage therapy of fibromyalgia, we suggest that massage will be painless, its intensity should be increased gradually from session to session, in accordance with patient's symptoms; and the sessions should be performed at least 1-2 times a week.

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Available from: Leonid Kalichman, Oct 29, 2015
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    • "Studies were identified by searching MEDLINE, SCiELO, EMBASE, ISI (Web of Knowledge), PEDro, SPORTDiscus, CINAHL, Cochrane CENTRAL and LILACS (last access: 31 May 2013). Additional records were identified from reference lists of other reviews (Kalichman, 2010; Kong et al., 2011) or indicated by the review authors. "
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    ABSTRACT: The systematic review aimed to evaluate the effectiveness of massage in fibromyalgia. An electronic search was conducted at MEDLINE, SCiELO, EMBASE, ISI, PEDro, SPORTDiscus, CINAHL, Cochrane CENTRAL and LILACS (Jan1990-May2013). Ten randomized and non-randomized controlled trials investigating the effects of massage alone on symptoms and health-related quality of life of adult patients with fibromyalgia were included. Two reviewers independently screened records, examined full-text reports for compliance with the eligibility criteria, and extracted data. Meta-analysis (pooled from 145 participants) shows that myofascial release had large, positive effects on pain and medium effects on anxiety and depression at the end of treatment, in contrast with placebo; effects on pain and depression were maintained in the medium and short term, respectively. Narrative analysis suggests that: myofascial release also improves fatigue, stiffness and quality of life; connective tissue massage improves depression and quality of life; manual lymphatic drainage is superior to connective tissue massage regarding stiffness, depression and quality of life; Shiatsu improves pain, pressure pain threshold, fatigue, sleep and quality of life; and Swedish massage does not improve outcomes. There is moderate evidence that myofascial release is beneficial for fibromyalgia symptoms. Limited evidence supports the application of connective tissue massage and Shiatsu. Manual lymphatic drainage may be superior to connective tissue massage, and Swedish massage may have no effects. Overall, most styles of massage therapy consistently improved the quality of life of fibromyalgia patients.
    Manual Therapy 10/2014; 20(2). DOI:10.1016/j.math.2014.09.003 · 1.71 Impact Factor
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    • "In a recent narrative review all studies showed short-term benefits of massage, and only one single-arm study demonstrated long-term benefits. All reviewed studies had methodological problems [13]. This resulted in a negative recommendation in a present S3-guide- line on FMS [2]. "
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    ABSTRACT: The objective of this study is to assess the safety of treatment with vibration massage using a deep oscillation device and the effects on symptom severity and quality of life in patients with primary fibromyalgia syndrome (FMS). Outpatients with FMS performed an observational prospective study with visits 2–4 weeks after the last treatment (control) and after further 2 months (follow-up). Patients were treated with 10 sessions of 45 min deep oscillation massage, 2/week. Primary outcome parameters were safety and tolerability (5-level Likert scale (1 = very good)) (after each treatment session and at control visit). Secondary outcome parameters were symptom severity (Fibromyalgia Impact Questionnaire (FIQ), pain) and quality of life (SF-36). Seventy patients (97.1% females) were included. At control visit, 41 patients (58.6%) reported 63 mild and short-lasting adverse events, mainly worsening of prevalent symptoms such as pain and fatigue. Tolerability was rated as 1.8 (95% confidence interval: 1.53; 2.07). Symptoms and quality of life were significantly improved at both control and follow-up visits (at least P < 0.01 ). In conclusion, deep oscillation massage is safe and well tolerated in patients with FMS and might improve symptoms and quality of life rather sustained.
    Evidence-based Complementary and Alternative Medicine 10/2013; 2013(6):679248. DOI:10.1155/2013/679248 · 1.88 Impact Factor
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    • "Two single-arm studies and six randomized controlled trials have assessed various massage techniques including Swedish massage, shiatsu, mechanical deep massage, connective tissue massage, and manual lymphatic drainage. All of these studies found short-term reduction in FM symptoms, but only one single-arm study showed long-term benefits (Kalichman, 2010). Recently the pain-generating role of fascia in maintaining FM symptoms has been suggested, raising the possibility that manual therapies that specifically target the fascia may provide more effective FM pain reduction (Liptan, 2010). "
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    ABSTRACT: Fibromyalgia (FM) is characterized by widespread muscle pain and soft tissue tenderness. However, a lack of definitive muscle pathology has made FM both a diagnostic and a treatment puzzle. Much of the evidence for pathology in FM lies in the central nervous system - in particular abnormal amplification of pain signals in the spinal cord - a manifestation of central sensitization. An emerging body of evidence posits that peripheral pain generated from the muscles and fascia may trigger and maintain central sensitization in FM. Since FM patients so frequently seek manual therapy to relieve muscle symptoms, the present study compared two different manual therapy techniques in a parallel study of women with FM. Eight subjects received myofascial release (MFR) while four subjects received Swedish massage, 90 min weekly for four weeks. Overall symptom burden and physical function were assessed by the Fibromyalgia Impact Questionnaire Revised (FIQ-R). A unique challenge for the manual therapist in treating conditions involving central sensitization is to determine if localized pain reduction can be achieved with targeted therapy in the context of ongoing widespread pain. Localized pain improvement was measured by a novel questionnaire developed for this study, the modified Nordic Musculoskeletal Questionnaire (NMQ). Between-group differences in FIQ-R did not reach statistical significance, but the total change scores on FIQ-R for the MFR group (mean = 10.14, SD = 16.2) trended in the hypothesized and positive direction compared to the Swedish massage group (mean = 0.33, SD = 4.93) yielding a positive Aikin separation test. Although overall modified NMQ scores improved in both groups there were no consistent focal areas of improvement for the Swedish massage group. In contrast, the MFR group reported consistent pain reductions in the neck and upper back regions on the NMQ. These data support the need for larger randomized controlled trials of MFR versus other massage techniques and support the assessment of localized pain reduction in future manual therapy studies in FM.
    Journal of bodywork and movement therapies 07/2013; 17(3):365-70. DOI:10.1016/j.jbmt.2012.11.010
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