Individualized, Assessment-Based Manual Therapy to Reduce Chronic Pain and Increase Function: Case Study of a Patient with Fibromyalgia and Diabetes

Fibromyalgia is a medical condition characterized by chronic pain that is attributed to an imbalance in neurotransmitter function. It is now estimated to affect more than 10 million adults in the U.S. and 0.2-6.6% of the general population worldwide. Current treatment options include both pharmacological and nonpharmacological interventions, with massage therapy and physical therapy predominant among nonpharmacological approaches. We conducted a case study of a novel treatment modality, Medical Restorative Massage Therapy (MRMT®), which includes a detailed patient assessment and individualized treatment to address chronic pain. In this case, MRMT® was used over a 6-month period to assess and treat a female patient with fibromyalgia and diabetes. Assessments included patient perceptions of pain, therapist assessments of pain, and patient and therapist assessments of function. We found differences in levels of patient-perceived pain and therapist-assessed pain as well as differences in patient-assessed and therapist-assessed function ratings. These differences are suspected to be due to the psychological component of chronic pain that may impact patients’ perceptions of pain and function. The individualized MRMT® approach was successful in evaluating these differences, and helped guide treatment appropriately to reduce pain, improve function and increase activity. Treatments also resulted in improved control of diabetes, as measured by HbA1C levels and reduction in antidiabetic medication. This case study provides evidence that a care ful assessment of a patient’s condition (i.e., pain level and physical function), together with hands-on therapy and a patient education approach, can improve a patient’s ability to self-manage medical conditions through a targeted intervention that reduces pain and increases physical function.