Massage for Fibromyalgia and Chronic Pain: What the Research Shows

Reviewed by Kyle Hierholzer, LMT, CPT, owner of Hand in Health and lead adjunct professor in the massage therapy program at Northeast College of Health Sciences. Updated November 2026.

At Hand in Health in Syracuse, patients with fibromyalgia and long-term pain often tell us the same thing. Their whole body feels sore, a hard day leaves them wiped out, and a firm massage somewhere else made them feel worse for days. That last part matters. With chronic pain, how we apply pressure matters as much as where.

Why chronic pain and fibromyalgia are different

Fibromyalgia causes widespread pain, tenderness, fatigue and often poor sleep. Researchers think the nervous system becomes more sensitive and amplifies pain signals, a process called central sensitization. Other chronic pain, like long-term back or neck pain, can work in a similar way over time.

That is why a treatment that pushes hard can backfire. A sensitized nervous system can read strong pressure as a threat and respond with more pain, not less.

What the research shows

Study	Who was studied	What it found
Li et al., 2014	9 randomized trials, 404 people with fibromyalgia	Massage for 5 weeks or longer eased pain, anxiety and depression right after treatment. Sleep did not improve. No follow-up data.
Yuan, Matsutani and Marques, 2015	10 trials of different massage styles in fibromyalgia	Myofascial release had the clearest benefit for pain. Evidence for other styles was limited, and Swedish massage alone showed little effect.
Ide et al., 2026	10 studies comparing myofascial release and connective tissue massage	Myofascial release reduced fibromyalgia pain. Connective tissue massage did not reach a clear benefit.
Crawford et al., 2016	67 trials across many pain conditions	Massage reduced pain compared with no treatment, and by a smaller amount compared with sham or other active treatments.
Skelly et al., 2020 (AHRQ)	233 trials of non-drug treatments for 5 chronic pain conditions	Massage was among the treatments that improved pain or function for some conditions at least 1 month after treatment ended.

• Short-term relief in fibromyalgia. A meta-analysis of 9 randomized trials with 404 patients found that massage given for 5 weeks or longer improved pain, anxiety and depression right after treatment. The effects were moderate in size. Sleep problems did not improve, and the review had no data on whether the benefits lasted (Li et al., 2014).
• Myofascial release has the most support. A review of different massage styles found myofascial release had large effects on pain and medium effects on anxiety and depression at the end of treatment compared with placebo, based on 145 patients. The authors rated the evidence as moderate for myofascial release and limited for other styles (Yuan, Matsutani and Marques, 2015). A 2026 meta-analysis also found myofascial release reduced fibromyalgia pain, while connective tissue massage did not show a clear benefit (Ide et al., 2026).
• Chronic pain in general. A large review of 67 trials across many pain conditions found massage reduced pain compared with no treatment. Compared with sham or other active treatments, the benefit was smaller, and the authors gave that a weak recommendation (Crawford et al., 2016).
• Some benefits outlast treatment. A 2020 review for the U.S. Agency for Healthcare Research and Quality looked at results at least 1 month after treatment ended. Massage was among the non-drug treatments that most consistently improved pain or function for some chronic pain conditions (Skelly et al., 2020).

What the research doesn’t show

Research doesn’t show that massage cures fibromyalgia or chronic pain, or that its benefits last on their own. The fibromyalgia trials are small, and most measured results only right after treatment (Li et al., 2014). Swedish massage alone showed little effect in the few fibromyalgia studies that tested it (Yuan, Matsutani and Marques, 2015). European fibromyalgia guidelines gave exercise the only strong recommendation among therapy-based treatments, and they described the effect of most treatments as relatively modest (Macfarlane et al., 2017). There is no Cochrane review on massage for fibromyalgia yet.

What a session looks like at Hand in Health

A chronic pain session starts with a conversation. Your therapist asks where you hurt today, how you felt after any past massage, how you slept, and what a flare looks like for you. Then pressure is scaled to your nervous system, not to a set routine.

• Good hurt, never wince or clench. Pressure should feel like tension releasing. If you wince, hold your breath or brace, it is too much.
• Scale back and start again. The moment your body starts guarding, your therapist eases off and builds back slowly so your body can feel safe.
• Slower, sustained techniques. Many of our therapists use myofascial release and other slow, steady techniques that fit what the research supports best.
• Check-ins throughout. You can ask for lighter pressure at any time. With fibromyalgia, less is often more, especially at first.
• Plan for after. Some soreness the next day can happen. Soreness that lasts several days tells us to go lighter next time.

For pain tied to an injury or a diagnosis, our medical massage focuses on the problem area and can work alongside your provider’s plan. If your main concern is your back, see our page on back pain relief.

From the treatment room: why we don’t push through pain

“Patients with fibromyalgia often come to us worried that massage will leave them sore for days, or after a past massage actually did. I teach my students at Northeast, and coach our team at Hand in Health, that a sensitized nervous system can’t be forced to relax. Pressure should feel like a ‘good hurt’ as tension lets go, never something that makes you wince, clench or hold your breath. The moment we see the body start to guard, we scale back and start again. With chronic pain, the goal is to leave the body feeling safer than when you walked in, so the next session can do a little more.”

Kyle Hierholzer, LMT, CPT, owner of Hand in Health and lead adjunct professor in the massage therapy program at Northeast College of Health Sciences

Who may benefit most

• People with fibromyalgia who want a gentle, hands-on support alongside exercise and their doctor’s plan
• People with long-term neck, back or shoulder pain (see back pain relief)
• People whose pain comes with worry or stress (see massage for anxiety)
• People whose pain keeps them up at night (see massage for sleep)
• People whose pain affects their mood (see massage and mental health)

When massage isn’t right

Massage is safe for most people, but some conditions call for a conversation with your doctor first, or a change in how we treat you. Talk to your doctor before booking if you have:

• A suspected blood clot or deep vein thrombosis (DVT)
• A fever or a contagious infection
• Recent surgery, a fracture or an open wound, unless your provider has cleared you for massage
• A bleeding disorder, or you take blood thinners (we use lighter pressure)
• High blood pressure or a heart condition that isn’t well controlled
• Current or past cancer treatment. Every Hand in Health massage therapist is oncology trained, and our lymphatic massage therapists have additional specialized training. Let your oncology team know you’re getting massage, and tell your therapist about your treatment so we can adjust pressure and positioning.
• A high-risk pregnancy
• Osteoporosis (we avoid deep pressure)
• Pain, numbness or tingling that hasn’t been explained

Tell your therapist about any health changes when you book. They can adjust the session or suggest waiting.

When to see a doctor first

• You have widespread pain that hasn’t been diagnosed
• Your pain is new, getting worse, or wakes you up at night
• Pain comes with fever, unexplained weight loss, weakness, or loss of bladder or bowel control
• You have numbness, tingling or weakness in your arms or legs
• Low mood or anxiety is getting harder to manage

Frequently Asked Questions

Does massage help fibromyalgia?

It may help in the short term. A 2014 meta-analysis found that massage given for 5 weeks or longer eased pain, anxiety and depression right after treatment in people with fibromyalgia, but not sleep problems. No study has shown lasting benefits after treatment ends, and massage is not a cure.

What type of massage is best for fibromyalgia?

Myofascial release has the most research behind it. Reviews found it eased pain at the end of treatment in people with fibromyalgia, while Swedish massage alone showed little effect in the small studies available. Pressure should always be scaled to how sensitive your body is that day.

Should massage for fibromyalgia hurt?

No. Pressure should feel like a good hurt as tension releases, never something that makes you wince, clench or hold your breath. With fibromyalgia, too much pressure can leave you sorer for days, so your therapist starts lighter and checks in often.

Can massage help other chronic pain?

Research suggests it can help as part of a plan. A large 2016 review across many pain conditions found massage reduced pain compared with no treatment and, by a smaller amount, compared with sham or other treatments. A 2020 federal review found massage was among the treatments whose benefits for some chronic pain conditions lasted at least a month after treatment ended.

Is massage a replacement for my doctor’s treatment plan?

No. Massage is a complementary therapy. Fibromyalgia guidelines put exercise first and recommend a plan built with your care team. Massage can be one part of that plan.

Can I use my HSA or FSA for massage for chronic pain?

Often, yes, especially with a letter of medical necessity from your provider. Hand in Health accepts HSA and FSA cards. Check with your plan for its rules.

References

1. Li YH, et al. Massage therapy for fibromyalgia: a systematic review and meta-analysis of randomized controlled trials. PLoS One. 2014. https://doi.org/10.1371/journal.pone.0089304
2. Yuan SL, Matsutani LA, Marques AP. Effectiveness of different styles of massage therapy in fibromyalgia: a systematic review and meta-analysis. Man Ther. 2015. https://doi.org/10.1016/j.math.2014.09.003
3. Ide FC, et al. What are the effects of connective tissue massage vs. myofascial release on fibromyalgia pain? Systematic review with meta-analysis. Complement Ther Med. 2026. https://doi.org/10.1016/j.ctim.2025.103305
4. Crawford C, et al. The impact of massage therapy on function in pain populations. A systematic review and meta-analysis of randomized controlled trials: Part I, patients experiencing pain in the general population. Pain Med. 2016. https://doi.org/10.1093/pm/pnw099
5. Skelly AC, et al. Noninvasive nonpharmacological treatment for chronic pain: a systematic review update. Agency for Healthcare Research and Quality. 2020. https://doi.org/10.23970/ahqrepccer209
6. Macfarlane GJ, et al. EULAR revised recommendations for the management of fibromyalgia. Ann Rheum Dis. 2017. https://doi.org/10.1136/annrheumdis-2016-209724

This article is for general information and isn’t medical advice. Talk with your healthcare provider about your symptoms.