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Traditional Thai Massage for Short-Term Back Pain Management

    Traditional Thai massage, or TTM, is part of traditional Thai medicine. This massage includes deep pressure massage with sustained compression on a muscle. Passive stretching is included at the completion of the massage. Previous research on TTM has found a variety of benefits, ranging from increased flexibility and decreased muscle tension, to reduced pain. The traditional massage is guided by lines on the body, called the Sen Sib. These imaginary lines serve as directions for the massage therapist, who applies pressure to points across these lines. The Sen Sib, however, falls on most of the trigger points on the body, which may explain its effectiveness.

 
    Researchers Buttagat, Narktro, Onsrira, and Pobsamai (2016) wanted to look into the effectiveness of TTM, specifically concerning myofascial pain syndrome. Myofascial pain syndrome (MPS) is not an uncommon condition. It is characterized by localized pain and may include a decrease in range of motion, problems with sleep, and the presence of myofascial trigger points. Skootsky, Jaeger, & Oye (1989) found that MPS occurs most often in the upper body, and Rachlin and Rachlin (2002) elaborated further, explaining that the most common areas affected are in this order: the trapezius, levator scapulae, and axial postural muscles.

 
    While previous research has looked into the effectiveness of TTM on myofascial pain syndrome, the researchers felt like there needed to be more concrete evidence on its efficiency. For their 2016 study, they used electromyography (measurement of muscle energy) to measure the effect of TTM on muscles.

 
    The researchers conducted a single-blind, randomized clinical trial consisting of 50 participants. These participants had to have suffered from upper back pain for at least three months prior to the study, with the presence of at least one myofascial trigger point in the upper trapezius muscles. The researchers noted that, “the criteria used to diagnose MTrP described previously by Buttagat et al. (2016) was as follows; the presence of a tender nodule that causes a referred pain within taut bands of muscle in areas which the patient identified as painful.”

 
    The 50 participants were randomly assigned to one of two groups, TTM or control. For the TTM group, participants lay down on their side while fully clothed. For 30 minutes, the massage therapist used the thumb or another digit to apply body weight onto different points of the upper back, slowly increasing pressure for a duration of 5 to 10 seconds per point. At the end of the massage, the massage therapist would passively stretch the participants’ muscles. The control group did not receive any actual treatment. The researchers set up a micro-wave therapy machine next to the participant. The machine was turned on, but was kept in standby mode as a form of placebo therapy. This intervention also lasted for 30 minutes.

 
    The researchers measured EMG activity as well as participants’ ratings of perceived muscle tension and pain intensity. These variables were measured both before and after intervention.

 
    Participants in the TTM group showed a significant decrease in all three variables – EMG activity decreased, as did reported muscle tension and pain intensity. The control group had almost no change to EMG activity or reported pain, but the control group participants did surprisingly report a decrease in muscle tension.

 
    Traditional Thai massage seems to provide beneficial results for patients with upper back myofascial pain syndrome. These results support the findings of existing research on the benefits of TTM. The researchers indicate that long-term studies on the effect of TTM would be ideal, but that based upon the results of the study, TTM is “a useful intervention for promoting physical relaxation and decreasing muscle tension and pain in MPS patients.”

 
References
Buttagat, V., Narktro, T., Onsrira, K., & Pobsamai, C. (2016). Short-term effects of traditional Thai massage on electromyogram, muscle tension and pain among patients with upper back pain associated with myofascial trigger points. Complementary Therapies in Medicine, 28, 8-12. doi:10.1016/j.ctim.2016.07.004

Buttagat, V., Taepa, N., Suwannived, N., & Rattanachan, N. (2016). Effects of scapular stabilization exercise on pain related parameters in patients with scapulocostal syndrome: A randomized controlled trial. Journal of Bodywork and Movement Therapies, 20(1), 115-122. doi:10.1016/j.jbmt.2015.07.036

Rachlin, E., & Rachlin, I. (2002). Chapter 11 – Trigger Point Management. In Myofascial Pain and Fibromyalgia (2nd ed., pp. 231-258). St. Louis, MO: Mosby.

Skootsky, S., Jaeger, B., & Oye, R. (1989). Prevalence of myofascial pain in general internal medicine practice. Western Journal Of Medicine, 151(2), 157-160.

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Massage Therapy as Complementary Treatment for Parkinson’s Disease

    Parkinson’s disease (PD) affects approximately 1 million Americans, with nearly 60,000 new cases diagnosed each year. Worldwide, about 10 million people have been diagnosed with this disease. PD occurs when the brain begins to slowly stop the production of dopamine. This will affect a person’s ability to control his or her body and its movements, as well as emotions. The chances of developing PD increases with age and symptoms may not be too apparent at first, as this disease progresses slowly. PD’s physical symptoms can have a strong effect on a person’s quality of life, and may affect family members as well.
 
    Complementary medicine is often used in the treatment of PD, with massage therapy being one of the most popular. 54% of PD patients in the United States reported using complementary medicine, and cited massage therapy and aromatherapy as the most commonly used (Ferry, Johnson, & Wallis, 2002). A study by Japanese researchers Donoyama and Ohkoshi (2012) may provide positive insights for those affected by PD and considering complementary therapy.
 
    The researchers gathered 10 adults who had been diagnosed with PD. These participants had expressed interest in pursuing massage therapy in conjunction with their standard treatment. The researchers wanted to measure the participants’ walking disturbance and speed, range of motion for those suffering from frozen shoulder (pain and restriction of movement in the shoulder), hypophonia (difficulty speaking loudly or clearly), as well as other physical symptoms such as muscle pain and fatigue.
 
    The 10 participants received a single intervention consisting of a 30-minute full body massage. The massage consisted of traditional Japanese techniques by mainly using kneading (less stroking/pressing) with moderate-pressure while the participants were clothed. For participants suffering from frozen shoulder, a shoulder joint massage was incorporated. Attention was paid to both the more severe and less severe sides of the body.
 
    Results showed significant improvements for all measurements. Walking speed and ability both increased. The researchers noted that one of the participants took 95 seconds to walk 10 meters pre-test, but post-massage was able to walk the same distance in 21.5 seconds. All of the participants suffering from frozen shoulder had an almost full range of motion restored immediately following the massage. Hypophonia was also decreased in participants, with a difference of 18.8 points pre- and post-massage. Additional physical symptoms such as muscle pain and fatigue decreased as well.
 
    While the results provide significant improvements for the participants, it is important to note that the sample size for the study was very small. A larger sample size is needed to support the findings of the study. In addition to a larger sample size, a longitudinal study, or increasing the time of the study and amount of interventions, may shed light on the long-term effects of massage for those with living with PD. Lastly, a quality of life measurement should be incorporated so as to measure any emotional benefits PD patients may achieve.
 
    Nonetheless, this study has found that massage therapy does provide immediate physical benefits for those diagnosed with PD, and that massage therapy combined with standard treatment may provide significant alleviation of symptoms.
 
References
Donoyama, N., & Ohkoshi, N. (2012). Effects of Traditional Japanese Massage Therapy on Various Symptoms in Patients with Parkinson’s Disease: A Case-Series Study. The Journal of Alternative and Complementary Medicine, 18(3), 294-299. doi:10.1089/acm.2011.0148
 
Ferry, P., Johnson, M., & Wallis, P. (2002). Use of complementary therapies and non-prescribed medication in patients with Parkinson’s disease. Postgraduate Medical Journal, 78(924), 612-614. doi:10.1136/pmj.78.924.612

Massage Secrets for an Effective Massage

This quick video will give you Sean Riehl’s top 3 secrets for an effective massage! Watch and learn some of Sean’s most trusted techniques to evaluate and address the concerns of each client.

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Lower Back Pain Treatment Through Ayurvedic Massage

    Lower back pain may be a familiar discomfort for you. It is one of the most common conditions in the Western world. Martin et al. (2008) explained that over 300 billion dollars are spent annually in the United States for the treatment of lower back pain. Chronic sufferers may not only experience debilitating pain, but additional symptoms such as headaches and depression. Kumar et al. (2016) wanted to research the effects of Ayurvedic massage on chronic lower back pain.

    Ayurveda is a traditional, holistic Indian medicine. It includes treatments such as nutritional guidance, thermotherapy, herbal medicine, and much more. It is not uncommon to find doctors in Southern Asia regularly using this medicine, especially for the treatment of chronic pain. Ayurvedic medicine has seen an increase in popularity across Western countries, specifically external treatments such as massage. This is the reason why the researchers decided to test Ayurvedic massage on patients with chronic lower back pain.

    For the controlled clinical trial, a sample of 64 adults was used. Participants were randomly assigned to one of two groups: an Ayurvedic massage therapy group or a standard physical therapy group. However, over the course of the study, some participants dropped out. The most common reason was inability to return to the research center, or a perceived lack of benefit from the study. 3% of the Ayurvedic group dropped out, while 22% of the physical therapy group was lost.

    The intervention lasted for a total of four weeks, where the first two weeks were spent undergoing therapy and the next two used for rest and observation. During the first two weeks, participants received six sessions of therapy. Six sessions were used as this is the average prescription within the German healthcare system, where the study took place. Researchers primarily measured for pain intensity, although they also measured quality of life, level of physical functions (or level of disability stemming from back pain), and psychological effects such as depression, anger, and fatigue. Measurements were taken before the intervention and during weeks 2 and 4 of the intervention.

    The Ayurvedic massage sessions lasted for a total of 65 minutes. The massage therapist first applied a warm, medicated oil (Sahacharadi Taila) while using light manual pressure. Next, stuffed cotton bags (Kizhi) were applied with rhythmic movements across the lower back and gluteal region. Lastly, a gentle massage was provided on the lower back, gluteal region, and any specific pain areas. Patients then took a warm shower and relaxed for 30 minutes. For the physical therapy group, participants were given heated packs to apply to the lower back for 20 minutes. Afterwards, they received a light massage. Participants in this group then also relaxed for 30 minutes.

Kizhi Treatment. Photo by naturoayur.com.au

Kizhi Treatment.
Photo by naturoayur.com.au

    After the 4 weeks of intervention, the Ayurvedic massage group reported a higher decrease in lower back pain at both weeks 2 and 4. The Ayurvedic group’s decrease in pain was 18.7 points better than that of the physical therapy group. For psychological effects, the Ayurvedic group also reported less fatigue and anger. For other effects and quality of life, no significant changes were found. The Ayurvedic group also reported an increase in physical functions, but these results were not found to be significant.

    Future research is suggested to confirm the findings of the study, especially for longer periods of intervention. In addition, the researchers note that massage is only one part of Ayurvedic medicine, and that applying additional aspects of Ayurveda may shed more light on the traditional medicine’s effectiveness. Overall, though, it appears that Ayurvedic massage may provide some much-needed relief for patients of chronic lower back pain.

References
Kumar, S., Rampp, T., Kessler, C., Jeitler, M., Dobos, G. J., Lüdtke, R., Meier, L., & Michalsen, A. (2016). Effectiveness of Ayurvedic Massage (Sahacharadi Taila) in Patients with Chronic Low Back Pain: A Randomized Controlled Trial. The Journal of Alternative and Complementary Medicine. doi:10.1089/acm.2015.0272

Martin, B. I., Deyo, R. A., Mirza, S. K., Turner, J. A., Comstock, B. A., Hollingworth, W., & Sullivan, S. D. (2008, June). Expenditures and Health Status Among Adults With Back and Neck Problems. JAMA, 299(6). doi:10.1097/01.brs.0000320200.72604.9f

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Aromatherapy Massage and Inhalation on Pain and Anxiety in Burn Patients

    Burn patients make up 5% of hospital intakes, with over one million burn patients in the U.S. alone. In many developing countries, burn injuries are an increasing risk. Treatment for burns can be very painful, such as dressing and re-dressing wounds. In addition, scars left after treatment can affect the patient’s physical, social, and emotional health. Researchers Seyyed-Rasooli et al. (2016) wanted to investigate alternative therapy for burn patients in Iran, specifically through the use of aromatherapy. The researchers explain that many burn patients are treated with tranquilizers, which reduce pain and anxiety, but are expensive, slow, and addictive. Instead, the researchers set after relieving pain and anxiety through aromatherapy, with lavender and rose essential oils.

 
    The researchers describe lavender as both calming and antiseptic, an aroma that is widely known and used. While lavender has many benefits, it is not best for everyone. Women who are pregnant or anyone suffering from certain allergies should avoid lavender. The researchers also chose rose because it has chemicals that can alleviate anxiety, depression, tension, and headaches.

 
    Seyyed-Rasooli et al. conducted a single-blind clinical trial with a randomized sample. The sample consisted of 90 women who had burns covering less than 20% of their bodies. From these 90 women, 3 groups were established: a control group who received standard treatment in the hospital, an inhalation aromatherapy group who inhaled essential oils, and an aromatherapy massage group. The 90 women were randomly assigned to a group with each group consisting of 30 women.

 
    The intervention occurred only once for a 30-minute duration. Women in the massage group were brought to an isolated room, away from any noise and interruptions. The massage group received treatment with a blend of lavender and almond oil. Researchers massaged the women’s backs, which included: back surface stroking, back deep stroking, effleurage, re-effleurage, back deep stroking, then back surface stroking. Each segment lasted for five minutes.

 
    Women in the inhalation group were also brought to an isolated room. The researchers applied lavender and rose oils to cotton, which was placed near the patient’s nose for a total of 30 minutes. For both massage and inhalation group, scores for pain and anxiety were re-tested 10 minutes after the intervention.

 
    Women in the inhalation group had the largest decrease in anxiety, although the massage group was only shortly behind. For pain, the massage group reported the highest decrease, nearly double the decrease of the inhalation group. Nevertheless, both aromatherapy massage and inhalation had positive effects on pain and anxiety for the burn patients.

 
    With these results, the researchers argue that aromatherapy inhalation is best for the treatment of anxiety, especially because the patient can perform the treatment alone. The researchers continue to explain that aromatherapy massage would be best in the treatment of pain, as the treatment can reduce pain signals from sensory nerves and increase the release of endorphins.

 
    The researchers do acknowledge that the study was only conducted on female patients, and that further research should include men. However, it is important to note that the study is not without flaws. Perhaps most glaring of them all is that the researchers used a different blend of essential oils when treating the two different groups, which may have had an effect on the outcome of the results. That is, the essential oils used may have had more of a significant effect on pain and anxiety than the researchers anticipated. Considering the researchers did not investigate the effects of almond oil, it seems strange that this was substituted for the rose oil in the massage group.

 
    Regardless of this inconsistency, this study provides light on the impact that alternative therapies can provide patients. While standard care certainly does aid patients in many different areas of medical treatment, alternative therapies such as massage and essential oil inhalation can surely assist such treatments further.

 
References
Seyyed-Rasooli, A., Salehi, F., Mohammadpoorasl, A., Goljaryan, S., Seyyedi, Z., & Thomson, B. (2016, June). Comparing the effects of aromatherapy massage and inhalation aromatherapy on anxiety and pain in burn patients: A single-blind randomized clinical trial. Burns. doi:10.1016/j.burns.2016.06.014