Fibromyalgia Relief Aided by Releasing Fear

Fibromyalgia Relief Aided by Releasing Fear

By Nicole Cutler, L.Ac.

Affecting an estimated 10 million Americans, fibromyalgia is increasingly being diagnosed in those with a chronic pain disorder. Although fibromyalgia is admittedly a complex, physiological syndrome, there may also be an emotional component that keeps victims locked in a cycle of pain. Remedial Massage therapists who recognize when fibromyalgia clients fall into a harmful ‘fear avoidance’ pattern can better assist affected individuals in breaking the never-ending cycle of pain perpetuating fear, and vice versa.

About Fibromyalgia

Also referred to as fibromyalgia syndrome, fibromyositis and fibrositis, fibromyalgia is a chronic arthritis-related syndrome primarily characterized by widespread muscle pain and tenderness. Technically, two criteria must be met to qualify for a diagnosis of fibromyalgia:

Duration and all four quadrants – A history of widespread pain in all four quadrants of the body (above the waist on both sides and below the waist on both sides of the body) for three months or more.
Positive tender points – Pain elicited with pressure at 11 of 18 tender point sites.

Although these criteria may appear to be straight forward, there are many complicating factors involved with fibromyalgia. A handful of those factors include:

According to the National Fibromyalgia Association, it takes an average of five years to get an accurate diagnosis of fibromyalgia.
Fibromyalgia can be a primary syndrome or it can be secondary to another autoimmune or rheumatic disease.
Severe fatigue or a sleep disorder affects an estimated 90 percent of those with fibromyalgia.
There is no blood test or X-ray that can detect fibromyalgia – and it manifests differently in each individual.
Often times, a psychological component accompanies the physical aspect of pain in clients with fibromyalgia.

What Is Fear Avoidance?

As described by Nicole Nelson in the February 2013 issue of Massage Today, fear avoidance is a psychological model that accounts for why certain clients may make the leap from acute to chronic pain. Fear avoidance suggests that it is overly fearful individuals who wind up suffering with chronic pain, to the degree that they avoid seemingly benign movement patterns so as to protect themselves from further pain.

Developing fear avoidance after enduring significant physical pain is a logical emotional response. According to John Fry, PhD, a psychologist in Newport Beach, CA and board member of the National Fibromyalgia Association, “Nobody likes pain. You know how bad it’s been in the past, you know how it’s weighed you down, how you ended up in bed. You become fearful of moving around.

You fear what it’s going to be like if it is an episode coming on.”

Study after study has repeatedly proven that exercise can relieve fibromyalgia symptoms. However, patients fearful of their pain are frequently reluctant to work out or even move around much at all, knowing that such activity could reignite their pain. The body then loses its conditioning, which results in greater pain. Thus, the patient gets stuck in a cycle of being afraid of aggravating his or her pain, which causes more pain due to inactivity – which just serves to justify the fear of pain.

Helping Affected Clients

First and foremost, compassion for those stuck in the fear-pain cycle is paramount. Because the path to fibromyalgia diagnosis often spans many years of suffering, those affected are likely to have been told their pain is all in their head. All too often, this patronizing cliché is spouted by practitioners who can’t explain the source of a patient’s pain.

Suffering from fear avoidance does not mean that a person’s pain is psychological. Instead, fear avoidance causes a de-conditioning of the body’s muscles, soft tissues and joints. The resultant inactivity is a physiological primer to musculoskeletal pain aggravation. Thankfully, helping ease clients’ fear of being active contributes to a reduction in their pain…as long as the therapist maintains respect and compassion for the client.

Here are some suggestions for helping fibromyalgia patients accept their pain (instead of fearing it):

Explain that some treatments may cause some pain in the short-term, but will lead to long-term pain relief.
Because there is no actual tissue damage with fibromyalgia, gentle, progressive exercise will not cause harm.
Give your client access to studies showing that regular exercise/movement is the most effective means for relieving fibromyalgia-related pain.
Work together on diaphragmatic breathing. Poor breathing practices can aggravate pain and contribute to fear.
Acknowledge the fear that clients will feel discomfort when increasing their levels of activity, especially if they have been sedentary. However, insist on a graded, appropriate exercise plan for eventual pain relief.
For those who remain stuck in fear avoidance, refer them to a cognitive behavioral therapist so that the client can confront their fears rather than be ruled by them.

Fibromyalgia is a complex, potentially agonizing pain syndrome. While the last thing someone with fibromyalgia needs is the additional musculoskeletal burden of being sedentary, the cycle initiated by fear avoidance can easily fuel a chronic pain cycle. Massage therapists with such clients can play an instrumental role in breaking this cycle – facilitating their freedom from fear and pain.

 Fibromyalgia Relief Aided by Releasing Fear
Posted on February 6, 2013 Massage Professionals
Fibromyalgia and Fear

http://www.themassagesource.com/articles/2013/02/fibromyalgia-relief-aided-by-releasing-fear/

Massages provide a measurable, therapeutic benefit to the immune system

 Study shows Massages  provide a measurable, therapeutic benefit to the immune system .

Massages are a great way to release tension and stress and promote relaxation. But a new study published in the Journal of Alternative and Complementary Medicine has revealed for the first time that massages also provide a measurable, therapeutic benefit to the immune system as well.

Dr. Mark Rapaport and his team of researchers from Cedars-Sinai Medical Center in Los Angeles, Calif., evaluated 53 people, 29 of which received 45-minute Swedish massages--one of the most common forms of massage used in the U.S.--and 24 who received gentler, light touch massages. Researchers took blood samples at intervals before and after the massages and found that those who received even just one Swedish massage experienced significant, positive changes in blood composition.

"This research indicates that massage doesn't only feel good, it also may be good for you," explained Dr. Rapaport in a press release. "People often seek out massage as part of a healthy lifestyle but there hasn't been much physiological proof of the body's heightened immune response following massage until now."

Besides experiencing a significant increase in lymphocytes, the white cells in the body that help fight and prevent disease, the Swedish massage group experienced lower cortisol levels as well. Cortisol is the hormone released by the adrenal gland in response to stress.

The Swedish massage group also experienced a decrease in arginine vasopressin, a hormone linked with aggressive behavior.

"European-style massage is often used to treat back pain, sleep disorders, and other stress-related disorders," explain Bradley J. Willcox, D. Craig Willcox and Makoto Suzuki in their book The Okinawa Program: How the World's Longest-Lived People Achieve Everlasting Health.

Learn more: http://www.naturalnews.com/029713_massage_immune_system.html#ixzz2K7IVEZSW

Adults demonstrate modified immune response after receiving massage.

Adults demonstrate modified immune response after receiving massage, Cedars-Sinai researchers show

Published: Wednesday, September 8, 2010 - 08:39 in Health & Medicine

Researchers in Cedars-Sinai's Department of Psychiatry and Behavioral Neurosciences have reported people who undergo massage experience measureable changes in their body's immune and endocrine response. Although there have been previous, smaller studies about the health benefits of massage, the Cedars-Sinai study is widely believed to be the first systematic study of a larger group of healthy adults.
The study is published online at http://www.liebertonline.com/loi/acm. It also will be published in the October printed edition of the Journal of Alternative and Complementary Medicine.
"Massage is popular in America, with almost 9 percent of adults receiving at least one massage within the past year," said Mark Rapaport, M.D., chairman of the Department of Psychiatry and Behavioral Neurosciences. "People often seek out massage as part of a healthy lifestyle but there hasn't been much physiological proof of the body's heightened immune response following massage until now."
In the study, 29 subjects received 45 minutes of Swedish massage and 24 received 45 minutes of light touch massage. Each participant underwent informed consent, a physical and mental evaluation and was deemed to be physically healthy and free of any mental disorder. Massage therapists were trained in how to deliver both Swedish and light touch using specific and identical protocols.
Prior to the massage, study participants were fitted with intravenous catheters in order to take blood samples during the study session. Then participants were asked to rest quietly for 30 minutes. Following the rest period, blood samples were collected from each person five minutes and one minute before the massage began. At the end of the 45-minute massage session, blood samples were collected at one, five, 10, 15, 30, and 60 minutes after the massage.
"This research indicates that massage doesn't only feel good, it also may be good for you," said Rapaport, the principal investigator of the study and the Polier Family Chair in Schizophrenia and Related Disorders. "More research is ahead of us but it appears that a single massage may deliver a measurable benefit."
Among the study's results:

• People in the Swedish massage group experienced significant changes in lymphocytes ,(lymphocyte numbers and percentages white blood cells that play a large role in defending the body from disease.
• Swedish massage caused a large decrease (effect size -.74) in Arginine Vasopressin (AVP) a hormone believed to play a role in aggressive behavior and linked to helping cause increases in the stress hormone cortisol.
• Swedish massage caused a decrease in levels of the stress hormone cortisol.
• Swedish massage caused a notable decrease in most cytokines produced by stimulated white blood cells.

Source: Cedars-Sinai Medical Center

 

Aromatherapy Massage Benefits

Aromatherapy massage confers immunological and psychological benefits

Massage that includes the application of fragrant essential oils reduces anxiety and stress and is beneficial to the immune system, according to recent research.

“Immunological and Psychological Benefits of Aromatherapy Massage” was conducted by staff at the Kyoto Prefectural University of Medicine, Japan.

The study group comprised 11 volunteers who were healthy and did not take any daily medication. To establish baselines, the subjects first completed psychological assessment forms and gave blood and saliva samples. Physiological conditions were measured through palmar Galvanic skin response (GSR), finger skin temperature and finger plethysmogram amplitude using a biofeedback system.

With baselines established, subjects were then placed in reclining seats and allowed to rest for two minutes. Then they performed a serial subtraction task for two minutes, and rested again for two minutes while experimenters monitored their physiological response.

After that, the subjects took a footbath at 42 C (107.6 F) for 5 minutes with one drop of tea tree oil and received a 30-minute aromatherapy massage or control massage. The psychological and physiological conditions were then remeasured. Blood was drawn and saliva was collected again.

All subjects received both an aromatherapy massage and a carrier-oil control massage at an interval of at least two weeks. The first five subjects received the aromatherapy massage before the carrier oil massage. The other six subjects received the carrier oil massage first.

Each subject received the same standardized massage of the back, shoulders, arms, hands, lower legs and feet with or without essential oils for 30 minutes by the same therapist. For the aromatherapy massage, 10–15 ml of sweet almond oil containing 0.15 ml of lavender oil, 0.1 ml of sweet marjoram oil and 0.05 ml of cypress oil was used. For the control massage, only sweet almond oil was used.

Psychological responses to treatment were assessed as changes in anxiety and depression according to State-Trait Anxiety Inventory (STAI) and Self-Rating Depression Scale (SDS) results. State anxiety scores from the STAI were significantly reduced after both aromatherapy massage and control massage compared with the baseline obtained before the massage. Although both STAI and SDS showed a significant reduction after treatment with aromatherapy and carrier massage, no difference between the aromatherapy and control massage was observed for STAI and SDS.

Peripheral blood-cell counts were compared.

Aromatherapy, in contrast to control massage, did not significantly reduce red blood cell count or hematocrit. However, aromatherapy massage showed a significant increase in peripheral blood lymphocytes.

“In our preliminary study, both aromatherapy massage and control massage decreased state anxiety significantly, and only aromatherapy massage increased peripheral blood lymphocytes,” state the study’s authors. “These results suggest that aromatherapy massage is a valuable relaxation technique for reducing anxiety and stress, and beneficial to the immune system.”

— Source: Department of Microbiology, Kyoto Prefectural University of Medicine Japan, Department of Psychiatry, Kyoto Prefectural University of Medicine Japan, Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine Japan, Graduate School of Science for Human Services, Ritsumeikan University Japan, and Department of Research and Development, Hyper Plants Co., Ltd Japan. Originally published in Evidence-based Complementary and Alternative Medicine, 2005 Vol. 2, No. 2, pp. 179–184.