Chronic pain is pain that has outlived its usefulness as a sensation. Pain is meant to alert an individual to trauma or injury in a part of the body. Chronic pain has either lasted much too long to be useful as an alert, or there is no underlying condition to be found, and the cause of pain is a mystery. While there are various types of treatment available, and we’ll mention some common ones, we’re going to focus on the use of massage for pain relief.
Chronic pain is usually defined as pain that lasts over six months. Pain varies widely in duration and severity. It can be severe or mild, continuous or periodic, and so it can be inconvenient and irritating to completely incapacitating. No matter what, you will need to find ways to manage it, either through traditional methods or more radical means.
There are also a variety of places on the body where chronic pain can occur. The syndrome can refer to headaches, sinus pain, back pain or other kinds of pain. It can arise from clear trauma or from an underlying condition. The cause of pain can also be a total mystery. It might arise from a poorly understood condition, like fibromyalgia, or from a completely unknown source.
What to Expect
The syndrome is called chronic pain, so it’s no surprise that pain is the most obvious symptom that most people will notice. However, pain is not the only symptom, and often the following will accompany the pain and make management even more of a challenge:
- Fatigue
- Sleeplessness
- Withdrawal from activity and increased need to rest
- Weakened immune system
- Changes in mood which might include hopelessness, fear, depression, irritability, anxiety, and stress
- Disability
Chronic pain can also take an enormous toll on your emotional well-being. This often leads to a vicious cycle. Emotional difficulties often lead to a worsening of your pain symptoms. Feelings interact in complex ways with your bodily systems and so bad emotions and mental state can often lead to more or worse pain, which can then, in turn, lead to a more fragile emotional state.
Though a connection between emotions and the immune system is recognized, it is not well understood. The emotional stresses of chronic pain can also lead to other conditions or disease by suppressing the entire immune system. Massage is able to put you in a better head space, and this is just one of the ways that it can help you.
Chronic pain also impacts your relationships with loved ones and friends. Again, as with your emotional state, this can lead to another vicious cycle where you have difficulty maintaining relationships at the same time as you need the strength and stability that solid relationships provide. Of course, these problems can then often cause emotional difficulties which will then lead to further pain symptoms. How to Understand Someone with Chronic Pain.
What to do
Pain treatment takes a variety of forms, from oral drugs to alternative methods like massage. We’ll briefly talk about different treatments however we’re going to focus primarily on the role that massage can play in pain management. The major types of treatment that are often pursued in pain treatment are drug treatments, surgical treatments and physiological treatments.
Painkillers and other drugs
Drugs prescribed for pain relief fall into several categories, from opiates, other painkillers, anticonvulsants and antidepressants. There are also topical treatments for pain relief.
In many ways, opiates can be seen as a big, blunt instrument. They will definitely do the job of relieving pain, but they also carry many risks and side-effects that patients will often find prohibitive. Generally opiates are a kind of last resort, and they’re taken either as support with other treatments, or as a measure to take when other options have been exhausted.
Other painkillers like acetaminophen, ibuprofen and aspirin might be prescribed. These household drugs might be familiar as from the drugstore shelves as remedies for mild headaches and other mild aches and pains. While these drugs might be familiar in their low-dosage forms, the same drugs will have their dosages and other properties changed to treat chronic pain conditions.
An anticonvulsant like Gabapentin might also be prescribed. These drugs prevent calcium from entering neurons and causing a biochemical reaction which can result in neuropathic pain. While different drugs have different side-effects, Gabapentin’s main side effects are drowsiness, dizziness and diarrhea.
Antidepressants are also sometimes used to treat chronic pain. Some of the chemical triggers for pain result from an imbalance of certain neurotransmitters. The same imbalance can act as a trigger for depression, so these drugs have demonstrated some value to control chronic pain conditions. These might include older drugs called tricyclic antidepressants or newer drugs like SSRIs or SNRIs.
It is also possible to treat pain through topical solutions rather than pills. Lidocaine is a topical pain reliever that has a long history and has been around since the 1940s. It is very well known and understood. The drug works on neuropathic pain by blocking channels through which the nervous system sends pain signals to the brain. Typically, it’s prescribed in 5 percent patches to be applied to painful areas and worn for a day.
An alternative topical treatment is Capsaicin. The active ingredient in capsaicin is derived from chili peppers, and it also works, in the same manner as Lidocaine, by blocking the path of pain impulses. Capsaicin patches and creams are widely available over the counter for the deep-heating treatment of minor muscle pain. However, the dosages required for the treatment of chronic neuropathic pain are much higher and therefore require a prescription.
Surgery—the Last Resort
It’s not usually necessary to resort to surgical treatment for chronic pain, but it is possible. It’s usually only considered when all other treatments, including opiates, have been tried without success. It can be tried earlier if it is considered medically necessary for the condition and the underlying cause. However, in most cases it is the last option explored.
Surgery can provide relief from pain, but it can also damage your ability to experience other sensations. The changes done by surgical means can hinder your ability to feel a light touch or changes in temperature, which is obviously not an optimal outcome. Surgery can also create a different pain in your body, and may result in an “out of the frying pan and into the fire” situation for you instead of providing the relief you seek.
Implanted pain control systems involve inserting devices under your skin or elsewhere in your body. The devices use drugs, electric current, heat, or chemicals to numb or block pain.
Decompression is a type of surgery used for nerve pain. The doctor makes an incision in your skin and moves blood vessels or other body structures away from each other and tries to ensure that none are pressing on nerves and causing pain.
Physical therapy and Massage
There are various physiological treatments prescribed for chronic pain, including physical therapy and complementary treatments like massage.
Physiotherapy uses either passive or active measures to try to alleviate pain. Some of the passive measures used include heat packs and ultrasound, and active measures include stretching and exercise to manage pain.
Heat or thermotherapy is directed at increasing blood flow in the painful area. This then helps to clear chemicals like lactic acid from the muscles in that area. These chemicals are responsible for pain in the muscles, and helping to clear them is an important aspect of therapy.
Ultrasound is the use of sound waves directed through the tissues and bones of the body to loosen muscles and joints and relieve pain. It has been a popular therapy since the 1950s and is almost a staple of physiotherapy.
Now that we’ve introduced various other types of treatment for pain, we’ll focus directly on the uses of massage in chronic pain management.
Massage
Massage therapy is becoming more widely accepted in the medical community as a credible treatment for many types of back pain and/or as an adjunct to other medical treatments. Generally massage is very rarely administered as the main or only treatment for pain management. It is generally used as a component of therapy and to help prepare the patient to participate in exercise or other interventions. Nonetheless, massage can be an important and effective part of your pain management regime.
Massage has been shown to be most effective in relieving back pain. Since back pain is a part of many different pain conditions, massage will often be useful. In addition, different kinds of massage will work for different parts of the body, and both acupressure and shiatsu are designed to treat different kinds of pain in different areas. Neuromuscular treatment is often helpful in alleviating “referred” pain, or pain that is triggered by one spot on the body, but felt in a completely different area.
Research shows that massage therapy has several potential benefits for pain sufferers, including:
- Increased blood flow and circulation, which brings needed nutrition to muscles and tissues.
- Increased endorphin levels are also often a result of massage. These chemicals are the “feel good” chemicals in the brain.
- Massage relaxes muscles for an improved range of motion. Pain often limits your ability to move in all the ways that you need, and the relaxation that massage provides helps you be capable of moving in the way that you would like.
- Relaxation of the muscles also helps with insomnia. Pain regularly makes sleep disorders and difficulties common. Massage can make it easier to fall asleep, stay asleep and wake up refreshed.
Swedish massage
Swedish massage is the type of massage that many of us are most familiar with and is that which is often referred to when the word “massage” is used. Most of the published trials on massage therapy have utilized Swedish or Swedish-type massage.
Swedish massage was invented in 1812 by Henry Peter Ling, a Swedish physiologist. This style of massage is gentle and uses long strokes, kneading, deeper circular movements, vibration and tapping to relax and recharge an individual. A practitioner will ensure that he or she works in the direction of the heart to properly aid in blood flow and circulation. This method is generally most strongly associated with relaxation, but it has also been used effectively to help relieve pain, especially in conjunction with other treatments.
The important thing to note about Swedish massage is that it is gentle. It does not utilise deep pressure or target specific pain points, like deep tissue massage or neuromuscular treatments. It is also non-abrasive, using very little friction and is therefore good for people with sensitive skin. A practitioner will often use oils to ensure that their contact with a patient’s body is smooth and nonabrasive.
Swedish massage is also, as is almost universally recognized, very relaxing. This can be good for sufferers in and of itself. The long duration of pain can often also cause a patient to become tense, and the ability of this kind of massage to relax a sufferer is valuable on its own.
Also, in spite of how gentle it is, it increases blood flow and can increase oxygen levels in the blood. Therefore, like neuromuscular treatment, it can help to remove excess lactic acid from muscles and thereby help to alleviate muscle pain.
Swedish massage generally requires the recipient to be nude and a practitioner then uses a towel or sheet to cover the patient. Only that part of the body which is currently being worked on will be exposed, so the patient is never completely uncovered. This practice is called draping. However, an individual might not be comfortable with complete nudity, under a sheet or otherwise. For this reason, it is often acceptable for a person to keep their underwear on.
There isn’t much point in undergoing what is supposed to be an extremely relaxing massage only to feel tense because of what you can or can’t wear. Swedish massage is worth a little daring, but if nudity is more than you can stomach, there are other forms of massage to explore.
Neuromuscular massage
Neuromuscular treatment is related to a more aggressive version of Swedish massage called deep tissue massage. However, it is more medically directed than deep tissue massage or other traditional massage techniques and focuses on pain that arises from muscular issues. It is an attempt to loosen and relieve pain in the muscles of the back, so if a pain condition arises from muscular problems, then neuromuscular treatment can help.
Neuromuscular treatment or massage is also called “trigger point” massage because it targets areas of muscular spasm and tension in your back. The therapist applies pressure to the site and this therapy can often cause painful feelings at first, since instead of trying to avoid tender areas, it attempts to focus directly on them. Since it requires the manipulation of sensitive areas, it can feel painful at first.
It is important, at this point, to communicate effectively with your therapist regarding the amount of pressure being placed on your trigger points. While it is normal to feel a certain amount of pain from this therapy, it shouldn’t be overwhelming. A balance will need to be found between enough pressure to be effective and too much pressure.
However, once you get past the initial pain, neuromuscular massage can be very helpful. Painful muscles aren’t getting enough blood and consequently, they aren’t getting enough oxygen either. As a result, lactic acid is building up and being stored in your muscles. Neuromuscular massage releases built up lactic acid that has been stored in the muscle, and increases blood flow to the area, helping ensure that lactic acid won’t start building up again.
Once this “good pain” is done and the treatment is able to relieve some of your pain, then neuromuscular massage can relax and energize. The treatment is a much more strenuous method than Swedish massage, but it can deliver benefits beyond what other methods can, and is also capable of delivering some of the relaxation of Swedish methods.
Acupressure
Acupressure is stimulation of key points on the body to block sensations of pain and activate the body’s natural pain relievers. While different kinds of pressure have different results, the approach used for pain relief is generally to apply prolonged pressure on key points for one to three minutes.
The concepts behind acupressure and acupuncture are thousands of years old, stemming from traditional Chinese medical ideas. Both are based on the idea of finding meridians or channels in the body. Through these channels a vital energy called “qi” flows. There are twelve major meridians that run from the fingertips to the brain and then the associated organs. When these channels are blocked, then qi becomes unbalanced, and the body will suffer, so both acupressure and acupuncture work to open and clear these channels and thereby balance your vital energy.
This also releases the body’s natural pain killers called endorphins. These neurochemicals work to block pain signals from being sent to the brain. As a result, not only does acupuncture improve the movement of vital energy through the body, it also helps relieve pain through the more traditional or scientific means of manipulating the nervous system.
Unlike acupuncture, the practitioner of acupressure applies pressure using fingers, hands or other devices instead of actually piercing key points. Because the treatment doesn’t involve your body being pierced by needles, it is therefore more palatable to anyone hesitant about acupuncture.
It is also not necessary for a patient to completely accept every aspect of the ideology behind the treatment to gain benefit from it. In fact, there are strong correlations between those parts of the body that often act as “trigger points” in neuromuscular treatment are very similar to those points that acupressure focuses on. Relieving Pain With Pressure Point.
Shiatsu
The goals of shiatsu are primarily the same as those for acupressure. Shiatsu is an ancient Japanese variation on acupressure. The term literally means “finger pressure,” and uses many of the same sorts of techniques as the traditional Chinese method of acupressure.
Major differences include that there are more meridians identified in shiatsu, and also that the technique also regularly includes a certain amount of stretching rather than solely using pressure as in acupressure.
Unlike other forms of massage, shiatsu practitioners only use their fingers and not their entire hand to exert pressure. They also don’t use any type of oil, so a patient will remain fully dressed throughout treatment. You will be asked to wear comfortable clothing, but otherwise, your choices for clothing are unrestricted.
As with neuromuscular treatment, it is important with any type of massage that you are willing to communicate with your practitioner to ensure that they are using an appropriate amount of pressure in their treatment. All forms of massage utilize some amount of pressure on muscles, and it’s important that this is balanced between what a practitioner feels will be useful with what a patient feels might be too painful.
That said, massage is a very safe treatment. However, like any other type of pain management, it needs to be approached with diligence and care. There are a few contraindications for massage, and when it’s being undertaken for a medical reason, like pain management, it makes sense to discuss it with your doctor before you make an appointment.
For example, if a patient has any sort of skin condition, massage can generally take place, but precautions need to be taken. If a patient has a fever, then massage is not a good idea, since a massage increase blood flow, and that will just worsen your fever. People suffering from brittle bones or from a heart condition might be wise to avoid massage altogether.
Again, consult your doctor before undergoing any treatment including massage. Don’t let what ought to be a pleasant and relaxing experience cause you more pain or other complications.
References:
Manage Chronic Pain With the Help of a Physical Therapist
