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

  • Massage for Runners … its all about optimising recovery

    We are introducing a new service: Runners Massage a special service to assist runners to optimise their recovery the massage will

    • flush out all the waste products in the tired muscles
    • address micro tears in the muscles
    which rejuvenates the tired heavy muscles making them feel light. The goal for runners is to first and foremost prevent the kind of wear and tear that comes with putting physical demands on your body. Yes; running is fantastic and ultimately good for your overall health, but if you are going to push your body to its limits you must prepare it and maintain it to avoid potential injury. With strenuous running, your muscles can lose their ability to relax and they become shorter and tighter.   Chronically tight muscles will lose their flexibility and that is really asking for trouble, as it makes you so much more susceptible to injury.  If your muscles lose flexibility, they can easily pull or tear, and tight muscles become very sore. Blood flow is poor through tightened muscles (ischemia) and that also cause pain.  Massage stretches the muscles in a much more specific way than stretching after a run, to regain lost flexibility. Click here to book your runners massage  

  • What happens to your intervertebral discs when you sit?

    Sitting in office chairs for long periods of time not only affects your muscles but impacts the disks in your spine. In humans over 5 years of age, there is no direct blood supply to the jelly like nucleus of the intervertebral discs. The intervertebral discs therefore rely upon fluid inflow and outflow for their nutrition: when you lie down, the pressure comes off the discs and they expand, absorbing water and nutrients as they do so (rather like a sponge expanding and sopping up a spill on the floor). Unloaded Disc Filling with nutrient rich liquid Disk_Unloaded When you stand up, the discs are compressed and their watery component is squeezed out, thus removing waste products at the same time. Loaded Discs Being Compressed Disk_Loaded Similar squeeze/expand cycles are occurring every time that we move, both day and night. This means you must move in order to “feed” your discs and keep them healthy. The disc squeeze/expand cycle is crucial to spinal health.  It is well proven that your degenerative disc "disease" progresses faster over time if your discs can't alternate compression with expansion.  As sitting more than half the time at work is associated with herniated discs (or slipped discs) and sciatic nerve pain in those older than 35, so try to get up and move as much as possible.

  • Tai Chi and Chronic Pain

    Tai chi is a ancient chinese mind-body exercise that is low impact, that is like a moving meditation.  You move in slow-motion to stretch and strengthen muscles. The phyisical benefits of Tai Chi are that it improves balance, flexibility, coordination, muscle strenght and stamina hence why some people think it helps them stay young.  On the mental side, Tai Chi helps releive stress, improves body awareness and when done in a group setting reduces social isolation. Some recent research shows Tai Chi can help benefit people with ongoing painful conditions suchs as

    • osteoarthritis
    • fibromyalgia
    • rheumatoid arthritis
    • tension headaches
    In one trail, 66 people with fibromyalgia were randomised into two groups: one took tahi chi classes twice weekly, the other group attended wellness education and stretching classes twice a week.  After 12 weeks, those in the Tai Chi group reported
    • less pain
    • fewer depresession symptoms
    • better sleep
    when compared to the control group.  This study suggest that Tai Chi may assist those who have an ongoing painful condition manage their pain and improve their general sense of wellness. References Wang C, Schmid CH et al, 2o10, A randomized trail of Tai Chi for Fibromyalgia, New England Journal of Medicine, 363(8):743-54