If you’ve worked on more than one client with fibromyalgia, you know that this isn’t a matter of saying, “if the client has X symptom, do Y technique.” It’s more a matter of knowing what questions to ask, which alterations might help, and knowing when to err on the side of caution.
The most important question, in my opinion, is “have you ever been hurt by a massage?” This is something that I ask anyone who is medically vulnerable or who has pervasive pain, and the answer is often “yes.” From there I want to find out more about how and why. While it’s often a matter of too much pressure or too much digging, it can also have to do with improper positioning, or even quirks of the client’s unique body. The only way to avoid repeating these past mistakes is to ask!