March 06, 2014
A recent article published in the journal, Evidence-Based Complementary and Alternative Medicine, described the "Benefits of Massage-Myofascial Release Therapy on Pain, Anxiety, Quality of Sleep, Depression, and Quality of Life in Patients with Fibromyalgia."
This article, authored by Castro-Sanchez and colleagues, defined fibromyalgia as "a chronic syndrome characterized by generalized pain, joint rigidity and intense fatigue. Other frequently associated symptoms are sleep alterations, headache, spastic colon, anxiety and depression." The authors suggest fibromyalgia often leaves patients feeling incapable of performing basic daily life activities, even resulting in painful symptoms and conditions such as, "myofascial trigger points, degenerative joint disease, inflammatory joint disease, bursitis, tendinitis, development alterations, hypermobility syndrome, neuropathic pain, injuries, traumas, repeated muscle pulls, visceral pain, disk herniation, spinal stenosis and recurrent cephalalgia (headaches)."
To date, there is no known cure for fibromyalgia, thus treatment is focused on symptom control. Myofascial release therapy is commonly used to treat the symptoms of fibromyalgia. Myofascial release therapy, a soft tissue therapy, uses palpatory feedback to release myofascial tissue (the fascia that surrounds and separates layers of muscle). This accomplishes increased circulation, lymphatic drainage and relaxation of contracted muscles by stimulating the stretch reflex of muscles and overlying fascia. The purpose of this study was to "determine the benefits of massage-myofascial release therapy on pain, anxiety, quality of sleep, depression, and quality of life in patients with fibromyalgia".
Castro-Sanchez and colleagues conducted a two-group (i.e., treatment and control) randomized controlled trial to determine the benefits of massage-myofascial release therapy in patients with fibromyalgia. Of the 64 fibromyalgia patients recruited, 59 participants completed the study; 30 in the treatment group and 29 in the control group. The treatment group received a 90-minute massage-myofascial release therapy session, weekly for 20 weeks. The treatment consisted of "massage-myofascial release at insertion of the temporal muscle, release of falx cerebri by frontal lift, release of tentorium cerebelli by synchronization of temporals, assisted release of cervical fascia, release of anterior thoracic wall, release of pectoral region, lumbosacral decompression, release of gluteal fascia, transversal sliding of wrist flexors and fingers and release of quadriceps fascia." The control group received a weekly 30-minute session of disconnected magnetotherapy for 20 weeks. Patients in the control group were unaware they were receiving a sham treatment.
Pain, anxiety, quality of sleep, depression, and quality of life were measured at baseline, after the last treatment session, and at one and six months after finishing treatment. Changes in scores for anxiety, pain, depression and quality of life were analyzed for group differences between the treatment and control group. After the twenty weeks of treatment, and when measured again one month post-treatment, anxiety levels, quality of sleep, pain and quality of life were significantly improved in the treatment group over the control group. At six months post intervention, there were only significant improvement in the quality of sleep measure.
Castro-Sanchez and colleagues demonstrated the effects of a 20-week massage-myofascial release treatment program for fibromyalgia patients, with significant improvements in pain, anxiety, quality of sleep and quality of life. Findings indicate the treatment reduced sensitivity to pain, particularly at the lower cervicals, gluteal muscles and near the greater trochanters. In this study the treatment resulted in no changes in depression scores.
Though this was a robust and rigorous study, the authors reported study limitations which should be considered when interpreting findings. First, the exclusion of eligible participants due to incompatibility of schedules may impact sample characteristics. Second, patients with less severe pain may have been able to improve more rapidly. Third, a longitudinal component with more than a six month follow up may be necessary for a more comprehensive analysis to examine the relationship between pain and depression in patients with fibromyalgia.
Despite study limitations, these findings provide important implications for this evidence-based practice. These findings suggest massage-myofascial therapy can be considered as an alternative and complementary therapy to achieve symptom improvement in patients with fibromyalgia. When marketing this treatment modality for consumers, practitioners can provide patients evidence of the benefits of massage-myofascial therapy in reducing pain, anxiety and improving quality of sleep and quality of life.
Castro-Sanchez and colleagues provide compelling data that in the case of fibromyalgia, where symptom control is the only current option, this evidence suggests patients can find comfort in massage-myofascial therapy.
Castro-Sanchez A M, Mataran-Penarrocha G A, Granero-Molina J, Aguilera-Manrique G, Quesada-Rubio J M, 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 Complementary and Alternative Medicine. 2011. doi:10.1155/2011/561753