Fibromyalgia treatment plans

[pomparents?]

I'm interested in learning more about treatment plans you have utilized with fibromyalgia clients. I have been working with a client who was diagnosed with FMS shortly after a severe car accident.

I have been using a combination of myofascial release, post isometric relaxation and general swedish techniques. During our myofascial sessions she had some profound emotional releases that I've encouraged her to journal what has come up during these sessions.

She recently expereinced her first flare-up since we began working together and I'm wondering what techniques have been benefical during these acute phases.

 

[harmonograph]

Fibro sessions are really based on the client and the day of the massage. Clients with fibro can have sudden changes in what pressure they can take - what areas need work - what results they get.

I can use deep techniques on some fibro clients - medium on some and only light on some. Pressure can be handled on one area and not the another.

IMO, to get the best treatment fibro clients need to commit to massage on a very regular basis. At least once per week. With sessions lasting as long as they need to to get to all areas that need worked that day.

I assess the client each time and make my plan from there - frequency of massage seems to be the only thing I "plan" and suggest for them. The plan changes all the time - multiple techniques are needed.

HTH!

 

[Pompal 09.]

I work with this particular client twice a week for 90 minute sessions. Like you stated the pressure, technique and areas worked vary session to session.

I was just wondering what other techniques or approaches I could try with her.

I discovered early on in our sessions together that I could not approach the bodywork as I had for other chronic pain clients. I was fustrated that we weren't seeing "results". But the more I read about FMS the more I realized that it's not about results as much as maintaining a degree of function and mobility.

What are the triggers to flare ups? Stress? Illness? A certain type of massage? I haven't found much on this in any of the research I've read.

 

[13lunt]

I work with this particular client twice a week for 90 minute sessions. Like you stated the pressure, technique and areas worked vary session to session.

I was just wondering what other techniques or approaches I could try with her.

I discovered early on in our sessions together that I could not approach the bodywork as I had for other chronic pain clients. I was fustrated that we weren't seeing "results". But the more I read about FMS the more I realized that it's not about results as much as maintaining a degree of function and mobility.

What are the triggers to flare ups? Stress? Illness? A certain type of massage? I haven't found much on this in any of the research I've read.

Do you know trigger point at all? I use this on all my fibro clients.

I do deep work on the fibro clients that can handle it. Stripping and cross fiber friction mixed in the the trigger point work. I always finish with swedish and feathering. You just have to go session to session.

PNF or PIR is great. Really good results.

Flare ups can occur from many things. Yes, stress, illness, overdoing it one day, etc. They are already in a chronic state of injury so overdoing things is easy. What an average person can do (carry three grocery bags in from the car) many fibro sufferers can't.
Internal factors - IBS acting up
External factors - weather and weather changes. Missing a massage.
Massage that is too deep can cause flare ups so can stretching to far. You have to listen to what your hands are telling you especially more so for fibro clients.

If you are interested a book on fibro I recommend:
http://www.amazon.com/gp/product/1572242388/qid=1133805838/sr=2-2/ref=pd_bbs_b_2_2/104-6166242-2079923?s=books&v=glance&n=283155

Although there are hundreds more out there that I am sure a good also.

 

[katie.]

body organ deficiency

I have recently learned that pain with Fibro is caused by a bosy system deficiency. The body is unable to process sugar in the body so... it turns to lactic acid in the muscles and causes crepidus... sharp glass like "crunchies" in the muscles..
clients should REDUCE sugar intake immediatley.
see a nutritionalist: sometimes a chiropractor may offer this type of evaluation as well. and offer supplements like mine does.

Just a thought

 

[Musiclover]

Cellfood might help.
http://www.luminahealth.com
I am a convert of the cellfood drops and the spray vits - I feel great when I use them regularly. The person who turned me on to them has FMS.
Jill/sagetherapist

 

[Sarita]

My sister has fibro, so I do a lot of these as a volunteer from personal desire to learn.

The biggest thing I've seen is the fibro sufferers need routine. It's good for them to get on a regular schedule with everything in their lives.

Fibromyalgia is a very interesting disease, and there are several good books on the subject. For me, I find it interesting reading.

Good things for fibro people:
- Regular exercise. Severe sufferers may do well to start off with lighter, no-impact exercise, like light swimming.
- Supplements are helpful. Glucosamine/Condrotin/MSM and probiotics are some.
- Heat and massage are biggies.
- Journalling is a huge help for many.
- Muscle relaxers are needed by many at first, unfortunately.
- Even one hot meal per day can make a big difference in mood. Nutrition is very important. Like a previous poster said, sugar should be minimal, and I feel they should completely work their way off massageplanetfeine. Whole grains in higher quantities, like 5 grain breads, can be helpful for digestion in some, but may not be immediately tolerated by all.
- Early to bed, early to rise is a good sleep cycle to work into if possible.

Sleep cycles are really important for these patients, and they should set a specific bed-time and lie down to sleep even if they don't feel sleepy just to get into the routine. No massageplanetfeine, nicotene, computer, or tv 30-60 minutes before bed-time, and there are many ways to create a soothing sleep environment.

Fibro after an accident is a common one, but I've also seen it caused by things like:
- Infections
- Abusive relationships
- Bad body image
- Body trust issues (previous rape, sexual abuse, etc)
- Surgeries
- Post Partum issues
- Any long bouts of illness
- Serious betrayal (cheating spouse, etc)
- etc etc

...so letting them talk is good. Any emotional release on their part is great. I've found that simply acknowledging their suffering is really helpful! Like saying: It's not all in your head. You've been through a lot. It's ok to feel sad.

But I never try to go more aggressively in the treatment than the customer is ready for. All treatment for them should be safe and comforting.

Other than that, you should be able to treat however you feel appropriate given their current state. Any comforting touch, heat, stretching, and circulation is wonderful for fibro. It's good to communicate with them frequently during treatment in regards to their comfort level with muscle pain. Muscle spasms happen A LOT with some of them. I've noticed that erectors, lats, and QL's are commonly more sensitive, as well as the obvious places like the ITB.

Was that a rant? I think that was way too much info! Sorry...I have a real deep interest in the subject...

OH yeah, and facial/ear/scalp massage is good. Also, it's not always a good idea to use strong smelling analgesics or essential oils.