Exploring the Benefits of Massage & Myofascial Release for Fibromyalgia

Fibromyalgia: a chronic pain condition

Fibromyalgia is a chronic disorder characterised by widespread musculoskeletal pain, fatigue, and tenderness in specific points on the body. The condition can significantly impact a person's quality of life, leading to emotional distress and physical limitations. It often goes hand-in-hand with cognitive issues, chronic fatigue syndrome, irritable bowel syndrome, migraines, and sleep disorders. While there is no cure for fibromyalgia, there are various modalities including breathwork, yoga, mindfulness, meditation and massage which have all been shown to be beneficial in managing symptoms. In this post, I want to specifically address the benefits of bodywork - massage and myofascial release.

Fibromyalgia: the facts

The exact causes of fibromyalgia are unknown but it is thought that it is related to abnormal levels of chemicals in the brain and changes in the way the central nervous system processes pain messages. It has been suggested that the cause may be generic. In many cases, there are physical and deeply emotional elements to the condition, like trauma, injury or stress.

Anyone can develop fibromyalgia, but it's more common in women than men. The condition typically develops between the ages of 25 and 55, but people of any age can get it, including children and older people. It is a difficult condition for doctors to diagnose, in part because of the ways Western medicine seeks to diagnose (blood tests, scans etc.,) but also because its key symptoms can also be found in a range of other conditions such as ME, chronic fatigue and depression (for an in-depth analysis of this do read this article on Body Reprogramming).

2% or around 160 million: the number of people in the world who have fibromyalgia
This figure includes 4 million in the United States, up to 3 million in the United Kingdom and 1 million in Australia
7 times: the increased rate at which women are diagnosed compared to men
40–60 years old: the age when most people receive a fibro diagnosis
5 years: the average length of time it takes someone to receive a diagnosis

Fibromyalgia can have a huge impact on a person's life including affecting personal relationships, their ability to work or hold down a job, their emotional well-being and overall quality of life. There is a 2x chance of being admitted to the hospital if you have the condition compared to the general population. 90% of sufferers have sleep issues, 80% have fatigue issues and 50% have cognitive and memory problems. On top of this it was for a very long time not taken that seriously, so many sufferers often had to battle to get a diagnosis or support. I'd like to think that now (as I write this in 2024) there is far more understanding and acceptance of what it is and how debilitating it can be.

What research tells us

Many studies have explored the effectiveness of massage therapy in managing fibromyalgia symptoms (see the references at the bottom of this post for more details). There are far too many studies to feature them all in this post, but what is clear from most of the studies is that regular massage has a beneficial effect on improving pain, anxiety, depression, sleep patterns and general quality of life.

A 2014 study looked at nine randomised controlled trials involving 404 patients. It showed that regular massage of five weeks or more had beneficial immediate effects on improving pain, anxiety, and depression.
A 2015 systematic review and meta-analysis of one hundred and fourty-five participants showed that myofascial release had large, positive effects on pain and medium effects on anxiety and depression. Narrative analysis suggested that myofascial release also improved fatigue, stiffness and quality of life. Furthermore, connective tissue massage improved depression levels and quality of life.
A 2020 study into massage therapy observed it to be helpful in some patients with fibromyalgia. Twenty-four adult fibromyalgia patients were assigned randomly to a massage therapy or relaxation therapy group. They received 30-minute treatments twice weekly for 5 weeks. Both groups showed a decrease in anxiety and depressed mood immediately after the first and last therapy sessions. However, across the course of the study, only the massage therapy group reported an increase in the number of sleep hours and a decrease in their sleep movements.
Thirty adult fibromyalgia subjects were randomly assigned to massage therapy, TENS, or a transcutaneous electrical stimulation no-current group (Sham TENS) for 30-minute treatment sessions two times per week for 5 weeks. The massage therapy subjects reported lower anxiety and depression, and their cortisol levels were lower immediately after the therapy sessions on the first and last days of the study. They also improved on the dolorimeter measure of pain and reported less pain the last week, less stiffness and fatigue, and fewer nights of difficult sleeping.
Seventy-four fibromyalgia patients were randomly assigned to experimental (massage-myofascial release therapy) and placebo (sham treatment with disconnected magnotherapy device) groups. The intervention period was 20 weeks. Pain, anxiety, quality of sleep, depression, and quality of life were determined at baseline, after the last treatment session, and at 1 month and 6 months. Immediately after treatment and at 1 month, anxiety levels, quality of sleep, pain, and quality of life were improved in the experimental group over the placebo group. Myofascial release techniques improved pain and quality of life in patients with fibromyalgia.

How bodywork helps

Having grown up with a family member who suffered from fibromyalgia, I had somewhat of a vested interest in trying to understand the condition when I started training as a massage therapist. My final year project when training with MTI was fibromyalgia, and since then I have been fortunate enough to work with a number of people who suffer from the condition. It has given me valuable insight into what it is like to live with and how bodywork can help. And I firmly believe that bodywork does help!

Massage therapy and myofascial release are valuable treatment options for anyone suffering from fibromyalgia. I don't think that this should be surprising considering that our bodies are the vessels through which we experience and live our lives. Touch is a powerful medium for change, soothing the nervous system, and providing feedback to our brains which can lead to emotional and physical changes. I always think of massage as a place where 'we meet ourselves where we are'. And it is in this space that we can begin to heal ourselves. If we have chronic pain, we can meet it with some compassion and maybe develop some understanding; maybe we can begin to let it go a little. If we feel weary, we find deep rest. If our thoughts are scattered can can find focus through the feedback the brain receives from touch. And if we feel disconnected from our body, we can begin to gently experience it just as it is in the present moment.

Barbour, C. (2000). Use of complementary and alternative treatments by individuals with fibromyalgia syndrome. J Am Acad Nurse Pract. 12(8):311-6.

Castro-Sánchez, A.M., Matarán-Peñarrocha, G.A., Granero-Molina, J., Aguilera-Manrique, G., Quesada-Rubio, J.M., Moreno-Lorenzo, C. (2011). Benefits of massage-myofascial release therapy on pain, anxiety, quality of sleep, depression, and quality of life in patients with fibromyalgia. Evid Based Complement Alternat Med. 2011:561753.

Field, T., Diego, M., Cullen, C., Hernandez-Reif, M., Sunshine, W., Douglas, S. (2002). Fibromyalgia pain and substance P decrease and sleep improves after massage therapy. J Clin Rheumatol, 8(2):72-6.

Field, T., Hernandez-Reif, M., Diego, M., Schanberg, S., Kuhn, C. (2005). Cortisol decreases and serotonin and dopamine increase following massage therapy. Int J Neurosci. 115(10):1397-413.

Lee King Yuan, S., Matsutani, L. A., Pasqual Marques, A. (2015) Effectiveness of different styles of massage therapy in fibromyalgia: a systematic review and meta-analysis. Man Therapies 2015 Apr 20(2):257-64.

Lund, I., Lundeberg, T., Carleson, J., Sönnerfors, H., Uhrlin, B., Svensson, E. (2006). Corticotropin releasing factor in urine--a possible biochemical marker of fibromyalgia. Responses to massage and guided relaxation. Neurosci Lett, 403(1-2):166-71.

Sunshine, W., Field, T.M., Quintino, O., Fierro, K., Kuhn, C., Burman, I., Schanberg, S. 1996). Fibromyalgia benefits from massage therapy and transcutaneous electrical stimulation. J Clin Rheumatol, 2(1):18-22.

Wahner-Roedler, D.L., Elkin, P.L., Vincent, A., Thompson, J.M., Oh, T.H., Loehrer, L.L., Mandrekar, J.N., Bauer, B.A. (2005). Use of complementary and alternative medical therapies by patients referred to a fibromyalgia treatment program at a tertiary care center. Mayo Clin Proc, 80(1):55-60.

Yan-hui, L., Wang, F., Feng, C., Yang, X., Sun, Y. (2014) Massage Therapy for Fibromyalgia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials PLoS One, 20:9(2).

Yuan, S. L., Matsutani, L. A., Pasqual Marques, A. (2015) Effectiveness of different styles of massage therapy in fibromyalgia: a systematic review and meta-analysis. Manual Therapies. Apr 20(2): 257-64.