Sunday 24th April, 2022

The best massage for fibromyalgia: practical science based advice

Woman suffering from fibromyalgia
In this article we will you the best massage for your fibromyalgia

According to the results of many clinical trials massage can give great relief for fibromyalgia. However, while some massages worked well there is always the potential for the wrong massage to hurt or cause fibromyalgia to flare up. Further, the trials show that while individual massages can give temporary relief, to get long term improvement you need regular massages over time, so cost and convenience means we at least look at some self help options.

In this article we will look at:
  1. your best massage options
  2. how to get the best results

Your best massage for fibromyalgia

An overview of what you need

The following is what we learned when we looked at the clinical trials, other scientific information and the clinical considerations. For details on these please see below.

Trigger point therapies work best

While general massage techniques can give some relief, techniques that target trigger points (tender lumps in your muscles) target the underlying problem and give better results. In this article we discuss how scientists found that trigger points are the biggest cause of fibromyalgia, and treating them gives great relief.

Due to sensitivity start slowly and build up

Fibromyalgia sufferers are highly sensitive so you need a technique that causes minimal pain, and it needs to start conservatively then increase as you become more tolerant.

You will need a very large number of treatments

You will need a very large number of applications of therapy. All the trials bar one used from 10 to 30 applications, but the relief was still incomplete. Also once the massage is stopped the symptoms gradually return. This means you will need to continue with regular therapy indefinitely.

You will need prolonged massages

The muscular conditions that need massaging are usually widespread on your body, therefore fibromyalgia massages tends to be prolonged “whole body” massages.

It will be very expensive if you don’t include self massage

Because of 3 & 4 at least some therapy will need to be self therapy, or it will be extremely expensive and inconvenient.

Vibration massage
Vibration massage is highly effective and the only massage that fits all the needs for fibromyalgia

Your best option: vibration massage

The only massage that fits these well is vibration massage. This is where the head of a vibration massage machine is placed over the muscle to be massaged and the vibrations are allowed to penetrate and have their therapeutic effects. There are very large advantages in doing this. Because it is the vibrations that penetrate rather than any physical pressure:

  1. vibrations can penetrate much deeper and easily get to parts that cannot be reached with conventional massage.
  2. there is usually no pain,
  3. there is far less risk of causing any injury or damage, and
  4. you do not need any special skills- so it is very easy to do on yourself.

In the next section we will show you how to choose a vibration massager and how to use it to get the best results.

How to get the best massage result for fibromyalgia

In this section:
  • how to choose a suitable massager
  • how to use it to get the best results

How to choose a massager

Here we will outline what you need to look at when choosing a suitable vibration massager to treat fibromyalgia, then show the two DrGraeme massagers that are ideal. For more information please see our article How to choose a massager

What you need

You will need a strongly built massager that gives professional standard therapeutic vibration massage. Here is what to look for.

Vibration speed

You will need a massager that can deliver therapeutic vibrations from 30-50 hz (cycles per second). Speeds are often quoted as RPM, so this is 1,800-3,000 rpm.

Note:

Please note that you will see machines with things like buttons, multiple speeds and led indicators. This is just pure gimmick and something that can easily fail. You are better off with a simple variable speed control like you would find on a quality power tool

Handle

You will likely need to massage places that are hard to reach so for self massage you will need a proper ergonomically designed handle. You will not be able to do this with a “Massage gun” shaped machine.

Heads

To transmit the therapeutic vibrations you need a comfortable flattish head. Manufacturers often include a variety of different heads, including shaped hard plastic ones that are designed to drive into the muscles rather than transmit vibrations. This is the last thing you need with fibromyalgia.

What to avoid

Percussion vs vibration massage
Percussion massagers

As we discuss in our article Vibration vs percussion massage, percussion massagers are designed to drive their heads in like jackhammers rather than to deliver therapeutic vibrations. Think of them as like meat tenderisers. They will give little therapeutic benefit while having a high probability of causing pain or a reaction.

“Consumer massagers”

As UK researchers found (1)⁠ manufacturers have a long history of concentrating on what their massagers look like on shop shelves rather than how they worked. Most are only marginally effective at best.

Our ideal fibromyalgia massagers

So our patients would have an effective massager to use at home, a few years ago we started building our own machines that had all of the desirable features of a fibromyalgia self massager and none of the things we need to avoid. These are now used, recommended and sold by a wide range of professionals across many countries, or available from us directly. For details please see our get a massager page.

The General Purpose Massager
The General Purpose Massager is very easy to use and effective for treating fibromyalgia causing trigger points

The General Purpose Massager

We’ve had this machine for over a decade and it’s proved to be extremely effective, economical and reliable. The only shortfall is that you are limited to massaging the region under the single head. More information about the General Purpose Massager

The Ultimate Quad Head Massager
Our Ultimate Quad head Massager will treat several trigger points at once

The Ultimate Quad Head Massager

This machine has the same ergonomic shape and effectiveness as the General Purpose Massager, but has four heads so it can massage a much larger area. More information about the Ultimate Quad Head Massager

How to use a vibration massager

General considerations

Vibration massagers are extraordinarily easy to use. We have complete details including precautions in our article How to use a massager. However, basically all you need to do is to sit the head on the part to be massaged and let the vibrations penetrate. There is no need to press in or move the machine around like you would do with conventional massage. A lot of people do this, but it actually lessens the effectiveness.

Special considerations for fibromyalgia

  1. Start very conservatively and gradually increase intensity as the condition improves. An effective treatment would be an application to each spot of 50 hz vibration for about 30 seconds. Therefore you might start with applications of about 30 hz for 10 seconds to just some parts of your body.
  2. Treating muscular trigger points can involve some complications and fibromyagia adds to this. Because of this we recommend that you:

Appendix: evidence we looked at when making our recommendations

Clinical trial trial findings

We found 10 clinical trials that tested massage for fibromyalgia. The results are summarised below. They used the following types of massage.

  • Swedish massage
  • Shiatsu
  • Combined styles
  • Connective tissue massage
  • Myofascial release
  • Friction massage

It is not possible to directly compare because they use different numbers of treatments and measured things differently, but looking at them in total the following things are clear.

Which massage gave the best results

Myofascial release tended to give the best results overall, and produced better results than Swedish massage when when they were directly compared. Friction massage (painful) gave no benefits.

How many sessions are needed

All but one of the trials used from 10 to 30 sessions of massage. On trial that monitored patients after the treatments had finished. They found that patients improved over the course of 15 massages, but those improvements gradually diminished over the six months.

Extensive therapy needed

The massage sessions were generally quite long with large areas of the body massaged.

What else science tells us about massage for fibromyalgia

As discussed in a separate article scientists have found that one of the main causes of fibromyalgia your nervous system being bombarded by pain from tender lumps in your muscles called (myofascial) trigger points over a long period of time. They found that stopping this pain greatly relieved the fibromyalgia. This would be why the massage technique that targeted trigger points (myofascial release) gave better results.

Clinical considerations

If you have fibromyalgia your nervous system will be sensitised. Therefore you will be less tolerant of painful therapies, and these could easily cause your condition to flare up. Also, fibromyalgia sufferers tend to have issues throughout many of their muscles. This is why the trials used long duration and “whole body” massage sessions.

Your trigger point therapy options

We have a separate article that examines the various trigger point therapy options. We will briefly discuss the main ones here.

Myofascial release/pressure techniques

These are the massage techniques that gave the best results in the clinical trials. There are several variations, but they all involve finding the tender lump and applying pressure while that tenderness fades and the muscle relaxes. The down side is that these techniques are usually painful. Because fibromyalgia sufferers are extra sensitive these techniques need to be carefully applied and can easily cause a flare up.

Needles and laser

These both need to be professionally applied so regular indefinite courses of therapy, each covering most of the body, would be very expensive. Lasers don’t hurt, but regularly being needled over a large portion of your body may not be pleasant.

Vibration massage

This was not used in any of the trials, but based on our clinical experience and the science of trigger points it is as effective (if not more so) as any trigger point therapy. Further, it usually doesn’t hurt and with the right equipment can be easily self applied.

Professional at desk

Professionals

If you are a professional wishing to help your patients/clients with home trigger point therapy DrGraeme massagers were originally built by Dr Graeme for use in his clinic for this purpose and are now used by colleagues and other professionals for similar purposes. If you are a professional and wish to know more about this therapy, or possibly get a sample massager to trial please check out our practitioner page.

Appendix: Summary of clinical trials of massage for fibromyalgia

For your information we've summarised the results of the ten clinical trials of massage for fibromyalgia. As you can see they tended to use a large number of massage sessions and generally produced moderate relief. It is reasonable to believe that if care was continued the patients would continue to improve. The only trial where massage was not successful is where the painful therapy was used.

Summary of clinical trails where massage was used to treat fibromyalgia

NOTE: You may need to scroll the table below left/right for more information

Study

Massage used

Duration, frequency, number

Outcome

2

Mechanical massage device called Cellu M6

Fifteen weekly 35 minute sessions

Improved pain, function and number of tender points points

3

Friction massage vs stretching vs analgesics

Uncertain

Friction massage not beneficial. Friction massage is a painful massage not suited for fibromyalgia

4

Compared Swedish massage with TENS machine

Ten 30 minute sessions @ 2 per week

Massage resulted in less pain, less fatigue, better sleep and lower anxiety

5

Connective tissue massage

15 sessions @ 1.5 per week

Massage gives pain relief, relieved anxiety and improved quality of life. After treatments finished improvements gradually diminished over 6 months

6

Swedish massage compared with standard physician care

Ten sessions over 24 weeks

Massage showed improvement, but only small numbers in trial

7

Combination of styles

30 minutes, twice a week for 5 weeks

Less, pain, less anxiety and better sleep

8

Myofascial release massage

Weekly 90 minute session for 20 weeks

Improved pain and quality of life

9

Myofascial release

Ten 60 minute sessions over 20 weeks

Less tender spots, improved physical function

10

Swedish massage vs myofascial release

90 minute session weekly for 4 weeks

Both produced pain reduction and improved movement. Myofascial release had better results

11

Full body Shiatsu

Sixteen 40 minute sessions @ twice a week

Improved pain, tenderness and sleep

References

  1. McDonagh D, Wilson L, Haslam C, Weightman D. Good vibrations: Do electrical therapeutic massagers work? Ergonomics. 2005;
  2. Gordon C, Emiliozzi C, Zartarian M. Use of a mechanical massage technique in the treatment of fibromyalgia: A preliminary study. Arch Phys Med Rehabil. 2006;87(1):145–7.
  3. Amanollahi A, Naghizadeh J, Khatibi A, Hollisaz MT, Shamseddini AR, Saburi A. Comparison of impacts of friction massage, stretching exercises and analgesics on pain relief in primary fibromyalgia syndrome: A randomized clinical trial. Tehran Univ Med J. 2013;70(10):616–22.
  4. Sunshine W. Fibromyalgia benefits from massage therapy and transcutaneous electrical stimulation. J Clin Rheumatol. 1996;2(1):18–22.
  5. Brattberg G. Connective tissue massage in the treatment of fibromyalgia. Eur J Pain. 1999;3(3):235–44.
  6. Alnigenis M. Massage Therapy in the Management of Fibromyalgia: A Pilot Study. J Musculoskelet Pain. 2001;9(2):55–67.
  7. Field T, Diego M, Cullen C, Hernandez-reif M, Sunshine W. Fibromyalgia pain and substance P decrease and sleep improves after massage therapy. J Clin Rheumatol. 2002;8:72–6.
  8. Castro-Sánchez AM, Matarán-Pearrocha GA, Granero-Molina J, Aguilera-Manrique G, Quesada-Rubio JM, Moreno-Lorenzo C. Benefits of massage-myofascial release therapy on pain, anxiety, quality of sleep, depression, and quality of life in patients with fibromyalgia. Evidence-based Complement Altern Med. 2011;2011.
  9. Castro-Sánchez A et. al. Effects of myofascial release techniques on pain , physical function , and postural stability in patients with fibromyalgia : a randomized controlled trial. Clin Rehabil. 2011;25(9):800–13.
  10. Liptan G, Mist S, Wright C, Arzt A, Jones KD. A pilot study of myofascial release therapy compared to Swedish massage in Fibromyalgia. J Bodyw Mov Ther. 2013;17(3):365–70.
  11. Yuan SLK, Berssaneti AA, Marques AP. Effects of Shiatsu in the management of fibromyalgia symptoms: A controlled pilot study. J Manipulative Physiol Ther. 2013;36(7):436–43.

We are continually adding more information on research and uses. Subscribe below to have us email them to you "hot off the press".

Dr Graeme

About Dr Graeme

Several years ago Dr Graeme, a Chiropractor practicing in Victoria, Australia was looking for a serious hand held massager his patients could use at home to get the extra quality massage they needed. The ones he found in the shops and on-line for home use looked nice but were not serious, and... read more



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