How does massage help those in pain?
One of the most common reasons for booking a massage is pain relief, whether its
- Neck pain
- Shoulder pain
- Lower back pain
As a massage therapist to assist clients who are in pain, I reach into my tool kit which includes relieving tension, relaxing muscles and rebalancing your nervous system. Many clients come back to me because in the past I have assisted them with their pain particularly neck, shoulder or lower back pain. However it has always been unclear exactly how massage helps clients who are in pain.
Research has shown that massage works on our pain modulation system as well! Pain modulation refers to the process by which the body alters a pain signal as it is transmitted along the pain pathway – this is why some people might find something painful while others might not. Massage’s role in pain modulation is not totally agreed upon – some studies have proposed that it’s associated with the way it raises our serotonin and dopamine levels. Others have stated that it’s related to increases in plasma oxytocin and statistical decreases in β-endorphin.
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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
The Impact of Sitting All Day – Part 3
In part 1, I looked at the impact of sitting on your muscles, and in part 2 I started to explore the impact on the rest of your body. In this post I continue to explore the impact of sitting on your circulatory system including your heart. Heart Disease When sitting for prolonged periods of time, muscles burn less fat and blood flows more sluggishly, allowing fatty acids to more easily clog the heart. In 2012 Ford & Caspersen in their research paper, Sedentary behaviour and cardiovascular disease: a review of prospective studies (International Journal of Epidemiology, Vol 41, No 5 pages 1338 - 1353) showed that the people with the most sedentary time are more than twice as likely to have cardiovascular disease than those with the least. In 2012 Zedric and Hamilton found that just a few hours sitting suppresses a gene that helps keep your cardiovascular system healthy by controlling inflammation and blood clotting. T W Zedric & M T Hamilton, 2012 Identification of hemostatic genes expressed in human and rat leg muscles and a novel gene (LPP1/PAP2a) suppressed during prolonged physical inactivity (sitting), Lipids in Health and Disease, Vol 11 see http://www.biomedcentral.com/content/pdf/1476-511X-11-137.pdf Cholesterol Sitting also means that your large postural support muscles are inactive. When active these muscles produce a quite of beneficial molecules. One molecule skeletal muscles produce is an enzyme called lipoprotein lipase - which you can think of as a vacuum cleaner for fats in the blood stream. A study in rats showed that after 24 hours forced inactivity, their lipoprotein lipase acitivity was reduced by 90 - 95%, which led to a 75% drip in the ability of their muscles to remove fats from their bloodstream as will as a significant decrease in "good" (HDL) cholesterol. L Bay & Mark Hamilton, 2003, Suppression of skeletal muscle lipoprotein lipase activity during physical inactivity: a molecular reason to maintain daily low-intensity activity, Journal of Physiology, Vol 551, No 2 pages 673 - 682.See http://onlinelibrary.wiley.com/doi/10.1113/jphysiol.2003.045591/full
