So how does massage reduce pain? – Part 1

I said in a previous post that scientists are interested in finding out how massage works.  So if we accept that massage reduces muscle pain, that leaves the question, “How does massage reduce muscle pain?”.

In 1965, Ronald Melzack and Patrick Wall outlined a scientific theory about psychological influence on pain perception; the ‘gate control theory’.  According to the gate control theory, pain signals are not free to reach the brain as soon as they are generated at the injured tissues or sites. They need to encounter certain ‘neurological gates’ at the spinal cord level and these gates determine whether the pain signals should reach the brain or not. In other words, pain is perceived when the gate gives way to the pain signals and it is less intense or not at all perceived when the gate closes for the signals to pass through.

Cutaneous mechano-receptors are stimulated by touch (massage) and transmit information within large never fibres to the spinal cord.  These impulses block the passage of painful stimuli entering the same spinal segment along small, slowly conducting neurons.

This theory gives the explanation for why someone finds relief by rubbing or massaging an injured or a painful area. For example, the pain gate theory explains “how”  a child feels better after mum or dad intuitively rub their knee when they have fallen over.

In summary massage produces short term pain relief by being a particularly effective trigger for the pain gate process.

References

Melzack R, & Wall PD (1965). Pain mechanisms: a new theory. Science (New York, N.Y.), 150 (3699), 971-9 

Moayedi M, & Davis KD (2013). Theories of pain: from specificity to gate control. Journal of neurophysiology, 109 (1), 5-12

Jacobs M. (1960) Massage for the relief of pain: anatomical and physiological considerations.  Physical Therapy Review, 40: 93-8

Melzack R, Wall PD. Pain mechanisms: a new theory. Science. 1965 Nov 19;150(3699):971–979.

Wells PE, Frampton V, Bowsher D. (1988) Pain: Management and Control in Physiotherapy.  Heinemann Medical.  Chapter 13.

Watson J. (1982) Pain mechanisms: a review.  1. Characteristics of the peripheral receptors.  Australian Journal of Physiotherapy.  27:135-43

Related Posts

  • How to test if you have good posture

    We all know that we need good posture.  So today I wanted to share with you how to test if you have good posture.

    The Wall Test - Stand with the back of your head touching the wall and your heels six inches from the baseboard. With your buttocks touching the wall, check the distance with your hand between your lower back and the wall, and your neck and the wall. If you can get within an inch or two at the low back and two inches at the neck, you are close to having excellent posture. If not, your posture may need professional attention to restore the normal curves of your spine.

    The 'Jump' Test - Feel the muscles of your neck and shoulders. Do you find areas that are tender and sensitive? Are the buttock muscles sore when you apply pressure? What about the chest muscles?

    If any of your muscles feel tight, sore or achy then why not book in for a massage.

  • How do your friends impact your health?

    In my last blog article, I explored how your social network including your friends and family impact your motivation to be healthy. Being part of a group, or better yet, lots of groups is good for your health.  The kind of groups doesn't seem to matter - it could be a family group, friendship group, religious or spiritual group, tennis or book club.  What is important is that you identify with it and see it as a meaningful part of your life. Here are five good reasons why?

    1. It can help you live longer
      • "As a rule of thumb if you belong to no groups but decide to join one, you cut the risk of dying over the next year in half" R Putman, Bowling Alone.
      • An adequate social life provides health benefits on a par with quitting smoking
      • The benefits of social ties are akin to those of exercise once you retire.  In one study retirees belonging to two social groups had a 2% risk of death but if they lost touch with both groups it jumps to 12%.
    2. It can protect your heart
      • Heart disease is generally lower for those who are members of a social group.
      • The risk of death from heart disease diminishes if you belong to more than one social group.
    3. It can cut your risk of a cold
      • Those belonging to a wide range of social groups e.g family friends, work, recreation or religious groups are least likely to come down with a cold.  Six or more types of diverse groups cut the risk of a cold more than four times.
    4. It can alleviate depression
      • The more social groups you belong to the less likely you are to suffer from depression.
      • If you are depressed, joining a group can help you recover and cut the risk of a relapse by nearly a 1/4 if you join one group or by almost 2/3 if you join three.
      • If you are a member of a religious or spiritual group you are less likely to have depressive symptoms and more likely to have feelings of well being.
    5. It motivates you to be healthy
    References J Holt-Lunstad, T B Smith, J B Layton (2010) Social Relationships and Mortality Risk: A Meta-analytic Review, Plos Medicine NK Steffens, T Cruwys, C Haslam, J Jetten, S A Haslam Social group memberships in retirement are associated with reduced risk of premature death: evidence from a longitudinal cohort study, BMJ Open Volume 6 Issue 2 D Reed, D McGee, K Yano, M Feinleib (1983) Social Networks and coronary heart disease among Japanese men in Hawaii, American Journal of Epidemiology 117(4) 384-96
    DC Classen, SL Pestotnik, JF Lloyd, JP Burke (1997) Adverse drug events in hospitalised patients.  Excess length of stay, extra costs and attributable mortality JAMA   Jan 22-29;277(4):301-6.
    F Tabassum, J Mohan, P Smith (2016) Association of volunteering with mental well-being: a lifecourse analysis of a national population-based longitudinal study in the UK BMJ Open 6(8)
    A Moe, O Hellzen, K Ekker, I Enmarker (2013) Inner strength in relation to perceived physical and mental health among the oldest old people with chronic illness Aging Mental Health 17(2):189-96.
    M P Aranda (2008) Relationship between religious involvement and psychological well-being: a social justice perspective Health and Social Work 33 (1): 9 - 21
    M Tarrant, K Warmoth, C Code, S Dean, V A Goodwin, K Stein, T Sugavanam (2016) Creating psyhcological connections between intervention recipients: development and focus group evaluation of a group singing session for people with aphasia BMJ Open 2016; 6(2)

  • A type of bread IBS sufferers can tolerate

    We all know that fibre is an essential part of everyone's diet, but for IBS sufferers  it can be a challenge to get enough fibre into their diet. Researchers from the University of Helsinki gave two types of Rye bread - the standard loaf and a rye loaf that was low in FODMAPs (fermentable olgi-, di and monosaccharides and polyols) to 87 IBS suferers for four weeks.  Then after a break of four weeks, switched the two breads for another period of four weeks. As expected the standard Rye bread caused all the usual symptoms assocaited with IBS:

    • abdominal pain
    • diarrhoea
    • constipation
    but there were much milder when they ate the low-FODMAP bread.  However to be completely symptom free researches suggest that IBS sufferers have to make other dietary changes e.g. excluding fruit and grains. The modified Rye loaf may be one way for IBS sufferers to get more fibre into their diet. Reference R. Laatikainen, J. Koskenpato, S.-M. Hongisto, J. Loponen, T. Poussa, M. Hillilä and R. Korpela; 2016; Randomised clinical trial: low-FODMAP rye bread vs. regular rye bread to relieve the symptoms of irritable bowel syndrome.  Ailment Pharmacology and Therapeutics; Vol 44; Issue 5; pg 460–470