Manipulation, or massage therapy, is thousands of years old. References to massage have been found in literature from ancient China, Rome, Greece, India, and Egypt. As a treatment, it is used in conventional medicine as well as in complementary and alternative medicine. The basic goal of the massage therapist is to increase the flow of blood and oxygen to a specific area of the body, relax and warm the soft tissues, and decrease pain by pressing, rubbing, and moving soft muscles and other tissues, primarily using the hands and fingers. The feet and forearms also are commonly used. There are more than eighty different types of massage therapy, including:
- Swedish massage, in which the therapist uses kneading, friction, and long strokes on the muscles and joints to increase relaxation and flexibility.
- Deep-tissue massage, in which the therapist uses strokes and pressure on muscular parts of the body, focusing on the muscles deep under the skin.
- Pressure-point massage, in which the therapist applies more focused pressure on myofascial (“myo” refers to muscle and “fascial” refers to connective tissue) trigger points, that is, the junctions between the muscles and fascia, and uncomfortable “points” that form in the body.
People use massage for any number of reasons and health-related purposes including for general wellness, for rehabilitation, to increase relaxation, to decrease stress, to help alleviate feelings of depression or anxiety, or to relieve pain. There is no doubt that a soothing massage can ease the pain of a long day and soothe achy joints and muscles. There is growing evidence that manipulation therapy can help with chronic pain in some people. Painful conditions that have been treated with massage include cancer, back pain, fibromyalgia, neuralgia, Parkinson’s disease, whiplash, and arthritis. A variety of reasons are cited for why massage is an effective treatment for pain. Some believe that rubbing and stroking may override and block painful signals from reaching the brain—the gate control theory again. Massage clogs the pathways (closes the gate) to the brain so that pain is unable to trigger a sensation. A number of practitioners believe that massage lessens many of the factors that contribute to the sense of pain, including stress, muscle tension, and spasm, and pain itself is then eased. They say that since pain and tension decrease blood circulation and massage increases it, manipulation has a negating effect on painful areas. Massage helps stimulate the limbic system to create more endorphins, the brain’s natural opiate painkillers. Research with animals has shown that massage can speed the flow of oxytocin, a hormone that relaxes muscles and causes feelings of contentment and calmness. Many massage techniques can be temporarily painful, as the weight of the therapist’s body puts pressure on muscles, joints, and tendons to “release” them, resulting in reduction of pain. This is another example of long-term gains from short-term increase in discomfort. This blog post is an excerpt from A Day Without Pain (Revised) by Mel Pohl, MD, FASAM; Published by Central Recovery Press (CRP).