Chronic Pain & Massage: What You Should Know
“Defined as pain lasting longer than six months, chronic pain can take many different forms:
Mild or excruciating
Episodic or continuous
Inconvenient or incapacitating
A single location or spread throughout the body
Originating from muscle, soft tissue or nerves
Caused by a trauma, injury, infection or an unknown source
May spawn emotional problems or immune dysfunction”
Cited from: Cutler, L.Ac., Nicole. “What Massage Therapists Should Know About Chronic Pain.” Institute for Integrative Healthcare Studies, 23 Jun. 2011 .
“There are a wide range of treatment options to help relieve chronic pain. Some of the more well-known approaches include massage therapy, physical therapy, nerve blocks, medications, chiropractic, trigger point injections, acupuncture, biofeedback, surgery, radiofrequency neurotomy, and many more progressive techniques. While each case has the potential to benefit from different combinations of these pain relief approaches, many forget that lifestyle choices also have an enormous impact on any presentation of chronic pain.”
Cited from: Cutler, L.Ac., Nicole. “What Massage Therapists Should Know About Chronic Pain.” Institute for Integrative Healthcare Studies, 23 Jun. 2011 .
“As published in the March/April 2011 edition of Pain Research and Management, Canadian researchers examined the relationship between diet and lifestyle, and chronic widespread pain. Certain dietary and lifestyle habits have continually been associated with an increased risk of cancer and cardiovascular disease. Since those with these diseases also seem to be more vulnerable to chronic widespread pain, the researchers sought to identify a direct relationship between diet/ lifestyle habits and pain.
Upon analyzing data from over 8,500 participants on their diet and lifestyle at age 33 and 42, then having those individuals record their experience of pain at age 45, the researchers found that 12 percent of participants reported chronic widespread pain. Furthermore, they found the following:
Women with chronic widespread pain, compared with those without chronic pain, reported an unhealthy diet such as, fruit-and-vegetable consumption less than once per week, and fatty food and french fries at least once per day.
Women with chronic widespread pain were more likely to have a high body mass index, be unemployed or have an occupation involving high levels of physical exertion.
Similar relationships between lifestyle (but not diet) and the risk of chronic widespread pain were identified in men.”
Cited from: Cutler, L.Ac., Nicole. “What Massage Therapists Should Know About Chronic Pain.” Institute for Integrative Healthcare Studies, 23 Jun. 2011 .
“Smokers have an estimated 1.5 to 2.5 times greater risk of developing low back pain than non-smokers. However, all painful conditions are made worse by smoking since smoking reduces the oxygen supply necessary for optimal tissue healing and functioning.”
Cited from: Cutler, L.Ac., Nicole. “What Massage Therapists Should Know About Chronic Pain.” Institute for Integrative Healthcare Studies, 23 Jun. 2011 .
“Anxiety, depression, stressful responsibility, job dissatisfaction, mental stress at work and substance abuse can place people at increased risk for developing chronic pain.”
Cited from: Cutler, L.Ac., Nicole. “What Massage Therapists Should Know About Chronic Pain.” Institute for Integrative Healthcare Studies, 23 Jun. 2011 .
“Whether a change is needed in someone’s diet, body mass index, physical activity, physical exertion at work, smoking or emotional wellness, massage therapists can help teach their clients about how these factors exacerbate their pain. A skilled massage therapist may be able to produce some degree of pain relief, but educating their clients – especially baby boomers - about this additional dimension to chronic pain can transform a massage session into a dynamic healing event.”
Cited from: Cutler, L.Ac., Nicole. “What Massage Therapists Should Know About Chronic Pain.” Institute for Integrative Healthcare Studies, 23 Jun. 2011 .
“Clearly, the experience of pain encompasses phenomena larger than what can be explained in simple anatomical terms. By jumping outside of the confines of biology, physicists may have a firmer grasp of what pain actually is. Since Albert Einstein taught us early in this century that matter and energy are interchangeable, quantum physics has amply confirmed his theory. Despite this universally understood concept, conventional medicine continues to address the body primarily as matter. Fortunately, massage therapists and other complementary medical providers are able to bridge this disparaging gap in understanding pain with insight into the dynamics of energy.”
Cited from: Cutler, L.Ac., Nicole. “A Practitioner’s Influence on Client’s Pain.” Institute for Integrative Healthcare Studies, 21 Jun. 2008 .
“Using positive mental imagery for accomplishing a goal is nothing new. Professional athletes do it to prepare for a sports event and entrepreneurs write a business plan to ensure their goals come to fruition. Confirmed by quantum physics, acupressure theory and the therapeutic touch model, massage therapists can improve their clients’ outcomes by maintaining a positive mindset. By holding a mental vision of health for their clients, bodyworkers can assist in their transformation from congested energy and subsequent pain into a state with freely flowing energy that is completely pain-free.”
Cited from: Cutler, L.Ac., Nicole. “A Practitioner’s Influence on Client’s Pain.” Institute for Integrative Healthcare Studies, 21 Jun. 2008 .
“Attitudes are changeable through developing coping skills. Affirmations can be used to support positive thoughts, encourage positive self-talk and to change negative attitudes into healthy ones. They are usually short comforting or inspiring statements, quotes, or reflections that one can repeat silently or aloud. They are in the present tense and they are stated in a positive manner, such as “I am healthy and happy.” The way one phrases their affirmation can empower them when they choose words carefully and consciously. It is important to remember not to rush or judge clients concerning their attitudes. It can be of great value to them to encourage and support them just where they are.”
Cited From: Chronic Pain Management program from the Institute for Integrative Healthcare Studies.
“The Relaxation Response (RR) – by Herbert Benson
1)Focus the mind on a repetitive phrase, word, breath or action.
2)Assume a passive attitude toward the thoughts that flow through the head.
Even though this technique is a natural bodily response, it is not automatic. It needs to be trained and practiced with mental techniques before it can quiet the body’s response to stress. It is not the same as experiencing quiet time while reading a book, listening to soft music, sleeping or enjoying friends.
Regular practice of the RR methods can decrease the body’s responsiveness to the arousal of the sympathetic nervous system, thus greatly affecting symptoms that are associated with chronic stress. Physical effects of RR include: immediate changes that come about while focusing on a repetitive word or phrase, and long-term changes that come about after daily practice for at least a month and are present even when one is going about their day-to-day activities. Immediate changes include lowered blood pressure, heart rate, rate of breath, and oxygen consumption. Long-term changes include a decrease in anxiety and depression, improvement in coping skills and possible modification in the body’s response to adrenalin.
Focused awareness is the key to experiencing the relaxation response. One method that can increase that focus is correct breathing. There are two types of breathing: chest breathing and diaphragmatic or abdominal breathing. Chest breathing can result from feelings of continued anxiety, stress and tension or it can result from societal training in which proper posture is thought to include a flat abdomen, both of which lead to a shallow breath.
Correct breathing is through the diaphragm as we can see from newborns and infants. It may need to be reintroduced to those who have forgotten it, especially those who are suffering from chronic pain. It can produce a feeling of calm and relaxation when it is performed in a deliberate and conscious manner. It is important to remind clients who are not familiar with breathing exercises that they must not perform an exercise if it worsens their pain in any way.
Another way of bringing focus to relaxation is through meditation. This attention can be focused inwardly on bodily sensations, outwardly on breathing or upon a word or phrase. Meditation can also help clients to observe emotions. It can counteract the effects of daily stress, which then increases daily effectiveness. It can also help clients to get in touch with their true inner radiance. For the best results, meditation must be practiced on a daily basis for at least 15 to 20 minutes. Many books and tapes can now be found that give basic meditation instruction.
Visualization is another, more specific means of focusing the mind on relaxation. Even though it may appear to look a lot like daydreaming, it can be deeply beneficial by creating a focused intention. When a client has the opportunity to listen to their body through meditation or visualization, they become more aware of their pain and how to use their body to change the sensations of their pain. They will also know when and how to better plan their activities by having the additional awareness.”
Cited From: Chronic Pain Management program from the Institute for Integrative Healthcare Studies.
“According to Louise Wensel, M.D., in Acupuncture in Medical Practice, more than 10,000 people have been treated at the Washington Acupuncture Center for differing forms of arthritis. Of these 10,000 people, more than 80% enjoyed significant improvement. Although treatment had to be repeated 5–10 times before people experienced relief, there was significant reduction in pain, swelling and stiffness by the 6th to 10th treatment. Some of the people remained without symptoms for up to 5 years and others with severe rheumatoid arthritis remained nearly symptom-free with weekly maintenance treatments. Dr. Wensel reports that the primary point of treatment for arthritis is near the hip joint.”
Cited From: Chronic Pain Management program from the Institute for Integrative Healthcare Studies.
“Chelation is a natural daily process of the body. Chelators are substances with extra electrons or negative charges that merge with the positive charges of a metal and move them through the body and in and out of cells. Internal environmental changes, such as temperature and acidity level, affect the grip of the chelator onto the metal and cause the release and exchange of metals where needed. For example, iron is a chelated metal in red blood. (Brown 2001)”
Cited From: Chronic Pain Management program from the Institute for Integrative Healthcare Studies. Also cited from: “Brown, Ellen Hodgson.Healing Joint Pain Naturally (New York: Broadway Books, 2001).”
“A much gentler oral chelation process is experienced with natural formulas. While they may take longer, they are just as effective as some prescription methods. Fresh organic cilantro, which is a leafy green herb, is particularly effective. Dried cilantro does not have the properties to make it effective. It is best to use fresh cilantro as a seasoning 4–5 times per week. It can also be made into a pesto by combining a small amount of water, sea salt, olive oil and fresh organic cilantro in a blender.
Spinach and broccoli contain a natural chelator known as Alpha Lipoic Acid or ALA. This substance merges with toxic metals which then aids the liver in optimum functioning. ALA is both water- and fat-soluble which allows it to travel to all parts of the body, including the brain, and permeate all the cells. Another natural chelator is the freshwater algae chlorella. Although its powdered form is most absorbable, tablets and capsules may be more convenient.
Other natural chelators are the chlorophyll in plants and vitamin C, as well as combinations of natural chelating ingredients such as: activated clays, co-enzyme Q10, garlic, L-cysteine, L-glutathione, methionine, selenium, sodium alginate and zinc gluconate. These formulas benefit people who suffer from arthritis and other autoimmune disorders. Although the effects may be felt in a few weeks, natural oral chelators are nutrients for the body and are beneficial if taken for longer periods of time. A new line of homeopathic products have been developed to safely neutralize heavy metal toxicity, dental work and environmental toxins. Even though they are best taken after the mercury has been removed from the teeth, they are effective while it is still in the teeth.
It is helpful to note that natural oral chelation can produce cleansing reactions, such as irritability, headaches and overall achiness. Decreasing the cleansing dosage and increasing water intake can lessen the detoxification symptoms.”
Cited From: Chronic Pain Management program from the Institute for Integrative Healthcare Studies.
“Both hot and cold water provide relief for painful joints. “Water is a natural medicine that benefits the whole body.” (Nikola 2005, p.7) Some of the benefits of water as a therapy include:
- relief of pain
- equalized blood and lymph circulation
- removal of toxins from the body
- enhanced immune system stimulated and soothed nervous system”
Cited From: Chronic Pain Management program from the Institute for Integrative Healthcare Studies. Also cited from: “Nikola, R.J., LMT. Creatures of Water, Hydro and Spa Therapy Textbook, (Salt Lake City, Ut: Europa Publishing, LC, 2005).”
“Water is an essential and often overlooked nutrient. Drinking water provides several benefits for the body when dealing with chronic pain. These include:
- flushing out wastes
- transporting nutrients
- regulating body temperature
- maintaining acid-alkaline balance
- keeping energy levels up
- alleviating some headaches and migraines regulating appetite”
Cited from: Chronic Pain Management program from the Institute for Integrative Healthcare Studies.
“Often those who are in chronic pain have a difficult time relating to their need for water in addition to their need for pain relief. In these cases it is of extreme importance that sufficient water be consumed. Several conditions can be exacerbated by chronic dehydration, according to Dr. F. Batmanghlidj, author of Your Body’s Many Cries for Water. These include:
- heartburn and ulcers
- diabetes
- depression
- allergies
- asthma
- rheumatoid joint pain
- back pain
- heart pain
- leg pain
- headaches
- high blood pressure
- high cholesterol levels
Symptoms of overhydration (water intoxication) include drunken-like behavior, electrolyte imbalance and, in some cases, shortness of breath (dyspnea).”
Cited from: Chronic Pain Management program from the Institute for Integrative Healthcare Studies.
“Basic Principles of Supplementation:
There is nothing like a diet full of fruits, vegetables and whole grains to supply the vitamins and minerals we need to stay healthy. Unfortunately, we do not always have access to this variety. The possible effects of stress, aging, lack of exercise, pollution and illness increase the importance of supplementation. Nutrients work in synergy with each other. While a single nutrient will not enhance immunity all by itself, the addition of vital nutrients to a diet can increase the body’s restorative functions. Encourage clients who are in chronic pain to talk with a health care provider before taking supplementation.”
Cited from: Chronic Pain Management program from the Institute for Integrative Healthcare Studies.
“In general, healthy people can experiment on a short-term basis with most herbal preparations sold in mainstream stores. However, many herbs have toxic effects over time. As herbs become more refined or concentrated they act more as drugs than as foods and they have more unwanted side effects and drug interactions. The longer herbal teas are brewed or steeped, the stronger their concentration becomes. Highly concentrated herbs also occur in many tinctures, tablets and pills. People who are under a physician’s care, who are very young, very old, pregnant or lactating should consult with a well-informed health professional before taking herbs.
The FDA does not regulate the quality of herbal products. Manufacturers are now required to list all ingredients on the label and they are not allowed to make unsubstantiated claims. However, at this time there are no uniform quality control standards required for herbal products, and product quality can vary widely.”
Cited From: Chronic Pain Management program from the Institute for Integrative Healthcare Studies.