Questions about FMS

[zianuray]

I've had a couple of clients with FMS, and what one of them tells me is totally different than the other as far as pressure, etc.

One wants the very lightest touch possible, more a brushing with the fingertips, the other wants more pressure than I'd use on a cranky weightlifter!

I know some of you on my FL have Fibro, can you shed any light on this?  I had the notion it was a very tender condition, that a mild breeze could be too much some days, and this gal that basically wants all 350# of me balanced on one elbow over a pressure point scares me.  (So I "be the grownup" and go lighter than she says she wants, and she falls asleep anyhow so I take it I'm doing ok!)

Is there really THAT much difference in how it presents, or is she perhaps mistaken?  She had trouble remembering the diagnosis, and supposedly she's had it for over 15 years.  Seems odd, that.

What questions SHOULD I ask of clients presenting with FMS?   What is an intake question and what should be asked EACH time aside from the obvious like "What are you here for today, any special concerns"? 

And please, send anyone who can contribute to this post.

Comments

[carocrow.livejournal.com]

Hi... I am the owner/mod of Body_Work :-) If any of y'all are students, practitioners or instructors of bodywork or energywork you're welcome to apply to our forum. I would say if you don't get your answers here you're bound to get some from somebody there, we have some great experts on board.

[diermuid.livejournal.com]

Most people I've known with Fibro are self-diagnosed or they've gone to a doctor looking for a specific diagnosis, which makes it very difficult.

The cases of actual clinical fibro I've known tend to be pretty achey, although many also get relief though endorphin rushes (which is why a good number of people with fibro-like symptoms end up exploring BDSM) so it could be that the one person was pursuing a more conservative version of the 'hurt me good' concept. ;-)

[magpieweaver.livejournal.com]

I have had fibro for decades.It was diagnosed by an Army doctor doing research in to fibro. It does vary from person to person and sometimes hour to hour. Personally I can't take pressure.
In the past my fibro has gone into remission where I felt completely normal of months at a time. So either she doesn't really have fibro
It is in remission
or it really is atypical of most fibro.
All you can do is ask each patient each time and start gently and increase to where they feel comfortable. It is such a frustrating thing to deal with.

[stupidore.livejournal.com]

For me I can't stand pressure, but it varies so much I can't really comment on the second case.

[softlywhispered.livejournal.com]

LMT with Fibro..

A Fibro in flare is hard to take pressure, they might not want to be touched at all, or use just the slightest amount of touch, like applying lotion.. yay

But at times when it's just backed off.. use deep because they need to be reminded that it can feel good.

[marence.livejournal.com]

Pain is a very personal thing, as is pleasure. That being said, I think a light massage is useless, but too much pressure will make me jump and scream, and not in a good way.
The way I say it to therapists: " I have fibromyalgia. I used to like Swedish massage, but it's too heavy for me now. Something lighter, but still working." 4 of 5 therapists got it just right. The other was far too light, even when I said I'd need more pressure to get the shoulder knots out. (I left that session with knots still in my shoulders. But it was a hotel spa, and I won't be going back.)

[miintikwa.livejournal.com]

My friend heartbreakangel is like your second massage client. She likes the hard, deep rub. It helps to release the knots in her muscles, which can be really, really tight.

For me, it depends on the day and on the muscle. For some of my neck/upper back knots, I need harder pressure, too, otherwise you'll never release the knots. For some of my lumbar/lower back area, a light pressure is fine, because some of the harder pressure hurts badly.

It very much can change with the person-- ask, and go with what they tell you. It has been my experience that most knowledgeable people with fibro will communicat what they need.

[carocrow.livejournal.com]

My friend Jess referred me over. I have FMS, and the only places I want deep pressure are on active trigger points; I have a Theracane I use on a particularly aggravating one near my right scapula I've had for years. It makes me nauseous, but judicial deep pressure there often results in a release. Same for the occipital ridge.

Otherwise I am a total pain wuss and would pay good money to lie on a table and get nerve stroked for an entire hour. My hubs was an excellent MT and he had a gift for approach that I wish he'd been able to teach every other MT that has worked on me... he would begin light and gentle, then work his way in, and depending on the site would use either rocking/jostling or a sort of orthobionics (moving into the pain with pressure at the most intense point).

I'd say that most of us really don't know what kind of pressure we "need", but we do know what we "want" and what might leave us limping for days. I agree that a lot of FMS people have done so much research in their medical journey that they may be quite knowledgeable about the disorder, but even then it's a YMMV as far as personal pain tolerance. Bear in mind that you will run across some FMS people who are also having other issues like dissociation from former abuse, and they may need more firm and constant pressure also as light touch doesn't feel as "safe".

Hope this helps.

[carocrow.livejournal.com]

Oh, and cross-fiber friction... my fascia is tighter than the silver skin on a chicken, and when I'm in a flare it is almost, er, sticky. Drinking more water helps, and I do water aerobics. I even have to back off on something as mild as the WA when I'm flaring, though, because I feel as though I have the flu. That's the myalgia part in spades.

So if you have a client who's in a flare, remind them that taking a hot shower before and after the session may help, and that they need to go a little less far than they think they can tolerate because their wonky pain receptors will take care of the rest, later :-/

[miintikwa.livejournal.com]

Bear in mind that you will run across some FMS people who are also having other issues like dissociation from former abuse, and they may need more firm and constant pressure also as light touch doesn't feel as "safe".

Oh, yes, VERY MUCH THIS!!!!

I had not thought of that. Good point.