massage low back pain

“Real-World” Massage for Chronic Low Back Pain

Lower back pain is no unknown culprit – many have found themselves battling this common condition. Yet, while most recover from this pain quickly, some are left with lower back pain for extended periods of time. Chronic lower back pain is experienced as pain in the sacral or lumbar regions with symptoms lasting over three months.

Massage is a common treatment option for chronic lower back pain relief. Massage’s effectiveness at treating this condition is well-known and well-documented; this explains why massage is commonly recommended. However, almost no empirical evidence exists supporting massage as a treatment option in “real world” primary health care. That is, those interested in chronic lower back pain treatment wanted to see more evidence of massage’s effectiveness in “real-world” scenarios.

Researchers Elder et al. (2017) recruited 104 participants with chronic lower back pain from their primary care physicians. 85 participants remained at the 12-week measurement, and 76 completed the full study after 24 weeks. Participants would receive 10 massages within 12 weeks then take measurements; they would then return 12 weeks later for a follow-up measurement.

Participants were assigned to licensed massage therapists in their respective communities. Massage therapists had to have at least five years of professional experience and had to schedule and develop treatment plans. Massage therapists were allowed to apply any massage technique they preferred; because of this, techniques varied widely, from the more common techniques like Swedish massage to the less common like lymphatic drainage or Reiki. By recruiting from participants’ actual primary care physicians, and assigning participants to local massage therapists, researchers were hoping to recreate an authentic experience, as would be experienced by an actual primary care patient.

The researchers measured for variables like pain, quality of life, and physical functionality/disability. At the end of 12 weeks (and 10 massages), participants reported clinically significant improvements across all measures. After 24 weeks, however, these improvements had begun diminishing. Although measurements did not return to baseline scores, they did begin to weaken. It is important to note, though, that improvements of disability/functionality and pain were still considered clinically significant at the 24-week measurement in comparison to the original, baseline scores.

The researchers also noticed that older participants were more likely to achieve better results than their younger counterparts. Participants age 50 and older were 3.75x more likely to achieve clinically significant improvements than their younger counterparts. Another interesting discovery was the effect of prescribed pain medications on score improvements. Researchers found that participants who were continuously prescribed at least one pain medication (including opioids) were 2.46x less likely to achieve clinically significant results.

It is important to understand that this study is only a pilot study – larger, more controlled studies will need to be conducted in order to determine that massage as a primary care treatment is beneficial, accessible, and feasible. Regardless, Elder et al. have established a foundation for future investigations into massage therapy’s effectiveness as a “real-world” treatment option for primary care physicians.

 

References

Elder, W. G., Munk, N., Love, M. M., Bruckner, G. G., Stewart, K. E., & Pearce, K. (2017). Real-World Massage Therapy Produces Meaningful Effectiveness Signal for Primary Care Patients with Chronic Low Back Pain: Results of a Repeated Measures Cohort Study. Pain Medicine. doi:10.1093/pm/pnw347

 

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Slow-Stroke Back Massage to Treat Leukemia

     Leukemia, sometimes referred to as blood cancer, affects the blood forming tissues in the body. This can make an individual prone to excessive bleeding and infection. Leukemia itself and its treatment can cause a cluster of symptoms, most commonly pain, fatigue, and sleep disorders. These symptoms are related in that: pain can interfere with sleep quality, lack of sleep can increase fatigue, and fatigue can increase sensitivity to pain. In addition, cancer-related fatigue is more severe than standard fatigue, and cannot be alleviated by more sleep.

     These symptoms can have a drastic effect on a patient’s quality of life. He or she may have difficulties socializing, may suffer from mood disorders, may be unable to carry out common, daily tasks, and more. Unfortunately, many treatments do not effectively treat this symptom cluster and many leukemia patients suffer daily.

     The rates of leukemia are increasing worldwide. Therefore, researchers Miladinia, Baraz, Shariati, and Malehi (2017) conducted research about massage’s efficacy of treating this symptom cluster. Currently, only one research study addressed the use of massage as an additional form of treatment in leukemia patients (Taylor, Snyder, & Bourguignon, 2009). Massage, and many other forms of alternative treatment, can pose risks to leukemia patients that might not exist for other cancer patients – the heightened risk of infection and bleeding means treatments like acupuncture and deep massage are incredibly dangerous and must be avoided.

     The researchers recruited 60 adults with leukemia for their study. 30 of these participants were randomly assigned to a massage group, and the other 30 participants were randomly assigned to a control group. The massage group would receive a slow-stroke back massage (SSBM) immediately after undergoing chemotherapy for a total time of 10 minutes. These 10-minute massages would happen three times a week over the course of four weeks. The control group received routine care after chemotherapy. The SSBM was as follows:

  • Vaseline was applied to the skin with the participant in a seated position.
  • Small circular strokes with thumbs on the neck (20 strokes in 30 seconds)
  • Surface strokes from the base of the skull to the sacral region using the palm of one hand and repeating the action on the other side of the spine using the palm of the other hand, while the first hand would move toward the base of the skull (60 strokes in 120 seconds)
  • Hand strokes along the shoulder blades using the thumb (20 strokes in 30 seconds)
  • Hand strokes using the thumb on either side of the spine from shoulder to waist (10 strokes in 30 seconds)
  • Sweeping strokes from the neck to the sacrum area using the palms of both hands (40 strokes in 90 seconds)
  • This routine was repeated, then the massage concluded.

 

     The researchers measured the intensity of the symptom cluster (pain, fatigue, and sleep disorder), as well as quality of sleep.

     At the conclusion of the study, the researchers discovered that SSBM significantly decreased the intensity of the symptom cluster and significantly increased the quality of sleep. This discovery seems to align with results from the only other study of massage and leukemia, in that massage provides significant relief for leukemia patients. The other study found significant relief after a 7-week intervention, whereas this study found significant results after a 4-week intervention. While both studies did discover that massage is a suitable, complementary therapy, it should be noted that the effects are short-term. Miladinia, Baraz, Shariati, and Malehi found that the effects of the massage had faded a week after the study had ended, with participants reporting that their symptoms began worsening.

     Regardless of its short-term effects, SSBM seems to provide a safe, noninvasive, and nondrug treatment that can improve the quality of life and level of comfort for patients with leukemia.

 

References:

Miladinia, M., Baraz, S., Shariati, A., & Malehi, A. S. (2017). Effects of Slow-Stroke Back Massage on Symptom Cluster in Adult Patients With Acute Leukemia. Cancer Nursing, 40(1), 31-38. doi:10.1097/ncc.0000000000000353

Taylor, A. G., Snyder, A. E., & Bourguignon, C. M. (2009). 123. Effects of massage on AML treatment-related symptoms and health-related QoL. Brain, Behavior, and Immunity, 23. doi:10.1016/j.bbi.2009.06.128

 

 

positional release for achilles tendon

Plantar Foot Massage to Treat Type 2 Diabetes Mobility and Balance Symptoms

An unfortunate reality for many people affected by type 2 diabetes is foot and leg circulatory problems. Decreased circulation means weakened sensitivity and poor healing. While symptoms vary widely between each individual, some of those affected have severe diabetic neuropathy that impacts mobility and balance. This can culminate into constant tripping/falling and decreased quality of life.

Researchers Yümin, Şimşek, Sertel, Ankarali, and Yumin (2017) investigated the effects of foot plantar massage as treatment for these balance, mobility, and reach issues.

The study consisted of 38 adults who were diagnosed with type 2 diabetes. The participants would partake in three assessments, receive a ten-minute massage, then retake assessments. The assessments went in this order:

Timed-Up and Go Test: This test is used to measure mobility. In this test, a participant is timed as he or she starts from a seated position, walks 3 meters, and returns to the seated position. The higher the score, the better the mobility and the lower the score, the poorer the mobility.

One-Leg Standing Test: This test is used to measure a person’s balance. The participant is timed while standing on one foot with no assistance. The longer a person is able to stand on one foot means the better his or her balance. For this study, the researchers had the participants run the test on each leg three times, then the mean value was recorded.

Functional Reach Test: This test is used to measure reach. The participant would stretch an arm as far as possible with measurements taken from base recordings. The reach value is then deducted from the base value.

For the massage, the researchers used a combination of Swedish and deep-friction massage, including kneading and stroking. The participants were in supine positions as the massage was applied to the left and right foot dorsum; medial, lateral regions of the foot; the toes; and the plantar region.

Researchers discovered that after receiving a ten-minute foot plantar massage, participants’ balance, reach, and mobility were significantly increased. Researchers argue that this is most likely because the soles of the feet are thought to be important to attain postural control and balance.

There are limitations to this study, however. The study only used one group for a single treatment – it is unknown if the effects last over time. The use of a control group would also provide better accuracy with the results of this study.

Regardless, significant gains were made with participants with type 2 diabetes in terms of balance, mobility, and reach. It appears that foot massage may provide a positive treatment that can be incorporated into rehabilitation programs.

References

Yümin, E. T., Şimşek, T. T., Sertel, M., Ankaralı, H., & Yumin, M. (2017). The effect of foot plantar massage on balance and functional reach in patients with type II diabetes. Physiotherapy Theory and Practice, 33(2), 115-123. doi:10.1080/09593985.2016.1271849

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The Overactive Trapezius and Massage: a Study

Sore shoulders and neck are no uncommon enemy – many individuals suffer from pains and aches in their upper body with localization in the neck and shoulders, or the mid and upper trapezius. The trapezius muscle, a muscle that extends from the lower thoracic vertebrae to the occipital bone and scapula, is prone to increased activity which translates to tension. When this muscle is subject to prolonged postural contractions, it can overload, making it susceptible to injuries including muscle trauma/pain and fatigue.

It comes as no wonder that many people complain of neck and shoulder pain; working conditions commonly include being seated in front of a desk with the neck strained forwards. Even at home, many find it comforting to stay seated for extended periods of time rather than standing or walking about. The pains can vary from mild to severe, even debilitating for some. New research looked at massage to alleviate the muscle activity and tension.

The study

Domingo et al. (2017) gathered 17 young adults for their study. The study lasted for 24 hours with two 30-minute interventions –  in one intervention, participants received a massage and the other consisted of quiet sitting. The researchers started the intervention by taking surface electromyography measurements (EMG), followed by massage or quiet sitting. After 5 minutes had passed, measurements were taken again and this procedure followed along until the 30 minutes were up.

The massage consisted of interlaced effleurage, petrissage, and friction at moderate pressure. The massage was performed on the upper shoulders and neck bilaterally, with the researchers spending equal time on each side.

The results

The researchers found there was a small decrease in the trapezius muscle activity during the quiet sitting intervention; however, this decrease was very small (1.0%) and proved insignificant. Trapezius muscle activity significantly decreased by 19.3% when a massage was given. These results showed even after only five minutes of massage had been provided.

These results implicate massage as a useful and simple tool to help ease the aches in the neck and shoulders, as well as minimize the chance of muscle trauma occurring by calming the muscle activity. For those who work daily in an office seated at a desk, asking a partner or roommate for a five-minute massage may help improve the effects of prolonged sitting.

While this research certainly sheds light on short massage combatting the pains of daily life, the researchers argue further studies are needed to investigate whether these results can provide long-term benefits towards bodily function and improved quality of life. Another area of study could delve into the benefits of calming an overactive trapezius muscle with a weekly or monthly massage. For those who are unable to receive a quick massage after a day of work, would a weekly or monthly massage suffice to alleviate the aches in the shoulders and neck until the next week or month?

Massage is well-known among the general population as a source of relief from muscle fatigue and trauma; this new research shows that by massaging a muscle that is prone to being overactive, massage can not only relieve pain but also prevent further injury, something of increasing importance in working life.

References

Domingo, A. R., Diek, M., Goble, K. M., Maluf, K. S., Goble, D. J., & Baweja, H. S. (2017). Short-duration therapeutic massage reduces postural upper trapezius muscle activity. NeuroReport, 28(2), 108-110. doi:10.1097/wnr.0000000000000718

shoulder-internal-rotation

Massage Therapy as Additional Treatment for Multiple Sclerosis (MS)

Over two million people worldwide have multiple sclerosis (MS), an incurable disease that affects the central nervous system. The severity of symptoms vary for each affected person; however, the disease has the capability of becoming disabling, with some patients unable to walk unassisted. When the symptoms do occur, many MS patients have difficulty carrying out daily tasks and functions, which can affect their perceived quality of life. Some of the most common symptoms of MS include fatigue, pain, and spasticity. Spasticity is an abnormal increase in muscle tone and stiffness, which may cause difficulties with speech and movement, as well as pain.

Patients of MS must undergo treatments when symptoms occur, such as physical therapy and/or medications. An issue with MS treatments is the cost associated with these treatments, as well as side effects stemming from medications. Thus, it comes as no surprise that almost a third of MS patients use massage therapy in conjunction with their standard treatments to alleviate symptoms. Backus, Manella, Bender, and Sweatman (2016) recognized this trend and its lack of supporting empirical evidence, and thus decided to test massage therapy’s efficacy with a pilot study.

This pilot study used a total of 24 participants with a nonrandomized, pre-post design. The study lasted for a total of six weeks, with participants receiving a massage every week. The researchers measured for: fatigue, pain, spasticity, and perceived health and quality of life. These measures were taken at the beginning and end of the six weeks.

The massage provided included a combination of effleurage, petrissage, friction, and static compression strokes. A more detailed table of the massage, taken directly from the article, is provided below. The massage lasted between 30 minutes to an hour.

Massage therapy proved beneficial in most of the researchers measures. Fatigue and pain decreased significantly after the six week massage program. Fatigue scores decreased 4.08 points, from 12.0 to 7.92. Pain also decreased 4.54 points, from 18.46 to 13.92. While there was a small improvement of spasticity, the increase was not significant. The researchers explain that a massage more focused on affected muscles might prove more significant. They also note that taking measurements immediately after the massage may provide different results.

After the six week massage treatment, participants also indicated that their perceived mental health and quality of life had improved. Mental health scores saw an increase of 13.29 points, while quality of life saw an increase of 11.13 points. The quality of life measurement can include areas such as perceived general health, physical functioning, and social functioning.

This study does provide a foundation of solid, empirical evidence detailing benefits of massage for patients of MS. The researchers note that treatments for MS can be quite costly, especially since these costs can accumulate into large sums over the span of a lifetime. Also, many treatments do not provide patients with adequate relief from symptoms. Medications may help treat symptoms further, but many of these medications come with unwanted side-effects. An example may be the use of opioids for the treatment of pain – many of these medications can become addicting, especially when used long-term for chronic pain. Taking these into consideration, massage as a supplemental therapy seems entirely reasonable.

While the study is only the first stepping stone of many, it seems that massage therapy truly provides safe and effective relief, both physically and mentally, to those with MS.

 

References

Backus, D., Manella, C., Bender, M. A., & Sweatman, P. M. (2016). Impact of Massage Therapy on Fatigue, Pain, and Spasticity in People with Multiple Sclerosis: a Pilot Study. International Journal of Therapeutic Massage & Bodywork: Research, Education, & Practice, 9(4), 4. doi:10.3822/ijtmb.v9i4.327

massage-hands-on-body

Seven Benefits of Massage

Finding time to yourself is becoming increasingly difficult in a chaotic, non-stop world of juggling family, work, childcare, and finances. It is important to alleviate this stress and maximise the quality of ‘down time’ we have.

Massage, good for the body, mind and soul…

With experts quoting up to ninety percent of disease having links to stress, it is important to minimise this wherever possible. Massage has therapeutic benefits as well as a targeted treatment in the form of physiotherapy massage to alleviate pain and assist with rehabilitation from injury.  Massage really can be key to a better body and mind state.

So, how can massage help me?

  1. Relaxation –  Massage therapy has been linked with reduction in the levels of cortisol, or the stress hormone, in the body. When the body is tense during times of stress and anxiety, it produces more of this hormone, leading to sleepless nights, decreased appetite, or increased cravings for the ‘wrong’ type of food, which can cause digestive issues. Massage therapy increases blood flow around the body, helping to relieve tension and thus lowering the level of cortisol and inducing relaxation, reducing stress levels in the body, improving mood, and improving mental state.
  2. Reducing blood pressure – Regular massage has been shown to reduce systolic (the upper number) and diastolic (lower number) levels. There is a link between using massage almost as prevention in the form of relaxation, and as a non-medical treatment in the use of stabilizing blood pressure.  The more tension and anxiety there is in your life, the more pressure you are putting on your vital organs, and high blood pressure can trigger heart attacks and strokes. Regular massage can help control circulation, reduce the stress hormone, and, therefore, help to reduce these risks. Similarly, people with low blood pressure can benefit from improved circulation and reduce their risks.
  3. Improved posture – Many of us spend the day hunched over a desk or computer,  or sit contorted in the driving positon for the daily commute. If you work in a repetitive work environment or in a job that requires lots of sitting, standing and lifting can put a lot of pressure on lower limbs but also on your back. Most postural stress occurs in the shoulders and neck, yet sometimes we accept a level of pain in our lives and live with it, which can cause further injury and damage to our posture as we carry our bodies incorrectly to cope with the discomfort. Massage can help align the back into the correct position, relaxing the muscles allowing the body to move into a non-painful position. This can also allow the body to have greater flexibility in the joints. Massage has been linked to assisting the treatment of chronic complaints such as those with arthritis or chronic back pain as examples.
  4. Improved circulation –  Massage therapy can increase the rich blood supply around the body to stiff, damaged and tense muscles. The improved blood flow can promote recovery of muscles and healing.  The actual action of massage can improve lymph circulation, thus improving the body’s drainage system and encouraging the removal of waste from the body’s organs, improving bodily function.
  5. Strengthen the immune system – The more stressed an individual is, the more fatigued he or she will be, and as well as interrupting sleep patterns and the digestive systems, this can impact upon the body’s immune system, making a person more vulnerable to infection. Massage has been proven to boost the body’s cytotoxic capacity, the body’s ‘defence cells,’ meaning the body can have an increased capacity to fight disease. Regular massage can help maintain the immune system and keep the system resilient.
  6. Pain management – Massage therapy has been shown to increase blood flow and the feeling of relaxation, which can help to release endorphins promoting a sense of wellbeing that can help with pain management. Massage has been proven to release opioids, the body’s natural pain killer, helping alleviate the pain as well as the mind over matter coping strategy. Whilst it is not the only solution, it can be a combination approach to pain management.
  7. Tissue regeneration – Massage pumps oxygen and nutrients around the body which gets to the vital organs, promoting regeneration.  Oxygen stimulates the healing function in the body. The skin is the body’s largest organ, and increased oxygen can help promote skin cell renewal and reduce scar tissue and stretch marks and improve skin appearance.

 

Over a prolonged period, regular massages can have an excellent impact on lowering stress levels and improving sleep patterns, therefore improving mood and emotions. Massage can ease discomfort and can help your skin glow with health. Incorporate bodywork into your health and wellbeing plans and book in for a massage to relieve the pressure!

 

 

This post was offered by Jon Reyes from Clearwells, Jon is an expert writer in the health and fitness niche and has been writing and studying topics like this one for over 10 years.

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Postpartum Anxiety and Massage

Many mothers can attest that motherhood is no easy feat. Perhaps more daunting are the first few days after the birth of your first child. While most may imagine these days as filled with joy and excitement, the reality is that many first-time mothers experience anxiety, from mild to severe, as well as exhaustion and fatigue. Researchers Jahdi, Mehrabadi, Mortazavi, and Haghani (2016) warn that postpartum anxiety may be a stepping stone to postpartum depression (which may lead to long-term consequences for mother and child), and decided to test whether massage was an effective treatment for anxiety in primiparous women.
 
The researchers found 100 mothers who had given birth a day before the study to include in their single-blind clinical trial. The mothers were randomly separated into two groups: a massage group and a control group. The massage group received a 20-minute seated massage. The procedure was as follows:
 

“The mother was seated on the edge of the bed. Then, the researcher grasped the top of the mother’s shoulders with both hands and placed the thumbs of each hand just below the base of the skull, making tiny circular movements on the upper neck. In the next stage, the researcher placed the palm of one hand at the base of the skull and made a long and smooth stroke all the way down the patient’s spine to her waist. The second hand followed the first at the base of the skull and stroked down the spine as the first hand returned to the base of the skull. Next, the researcher placed her hands on either side of the mother’s neck under the mother’s ears and stroked down and over the mother’s collarbones with her thumbs just over the shoulder blades and repeated the motion several times. Then, she placed the thumb of each of her hands beside the spine, beginning with the shoulders, and moved the thumbs down the spine to the waist and repeated this movement several times. Finally, she completed the procedure by placing her palms on each side of the mother’s neck and making continuous, long, sweeping strokes down the neck, across each shoulder, and down the back near the spine and repeated the entire process several times.”

 
The researchers then tested the mothers on their anxiety, using a STAI test. The mothers who had received a massage had significant decreases in their anxiety scores immediately after the massage, as well as into the next morning.  Since massage regulates the autonomic nervous system, can adjust neural activity (amygdale, frontal brain, control network), and stimulates afferent c fibers in the skin, it is not all too surprising that massage is effective in alleviating anxiety symptoms. An interesting topic of study may be stress levels for new fathers, and whether massage can help new fathers too.
 
As new mothers are acclimating to the new physical and emotional demands of motherhood, massage can help bring them moments of peace and calm.
 
 

Reference

Jahdi, F., Mehrabadi, M., Mortazavi, F., & Haghani, H. (2016). The Effect of Slow-Stroke Back Message on the Anxiety Levels of Iranian Women on the First Postpartum Day. Iranian Red Crescent Medical Journal, 18(8). doi:10.5812/ircmj.34270

 

This image shows how to stretch the quadriceps muscles on runners.

Massage Post-Workout: A Quick Update

    Massage after exercise, especially for athletes, is no new phenomenon. A Google search of “massage post exercise” brings up an ad from the retailer Kohl’s, selling at-home massagers as “exercise massagers.” Magazine articles entice readers with headlines about muscle recovery through massage; a Men’s Fitness article explains that just ten minutes of massage post-exercise can reduce sore muscles. But the science goes beyond this – Best and Crawford (2016) penned a short article, almost a meta-analysis, describing the advancements made in the world of sports regarding massage.
 
    The authors elaborate on what is an effective massage post-workout, as well as why massage may help athletes so much. The authors describe the ideal massage for muscle recovery as taking place almost immediately after exercise, and lasting for a short session (between 5-12 minutes).
 
    The authors note that massage may be an effective recovery tool considering it provides both physical and psychological benefits. Physical benefits include demargination of leucocytes, reduced muscle oedema, and a decrease in damaged muscle fibers. Psychological benefits can be an increase of relaxation and a decrease of stress biomarkers.
 
    However, the authors note that there is still much left to study. The authors mention that many of the studies do not have a standardized physical protocol that participants engage in during the exercise portion of studies. In animal studies studying massage on muscle recovery, many studies have begun using standard protocols when the animals are exercising. In addition, variables such as amount of pressure during massage, frequency of massage, and athlete’s experience may affect massage’s effectiveness. That is, an athlete who has regularly exercised daily for a decade may not have as much pain and soreness post-exercise, and thus may have less effective results, than a new athlete who’s only begun training.
 
    In addition, the benefit of the post-exercise massage seems to be most effective immediately following the intervention. Studies have shown that the best results occur about five to ten minutes following the massage, and begin to decline after only an hour has passed.
 
    More research is underway about post-exercise massage, such as molecular changes in skeletal muscle post-massage or ideal frequency in massage following workouts. The authors suggest future research also look into a combination of recovery strategies (i.e. cold water immersion, compression) with massage.
 
    While more research continues, the existing research seems to paint a clear picture for athletes – massage may not be the all-in-one solution, but it undoubtedly provides benefits for your sore muscles!

 

Reference

Best, T. M., & Crawford, S. K. (2016, September 18). Massage and postexercise recovery: The science is emerging. British Journal of Sports Medicine. doi:10.1136/bjsports-2016-096528

 

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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