Massage Therapy And Pain Relief

As a massage therapist, it is important when treating clients that we are aware when not to diagnose and can refer a client to another therapist if a problem is beyond the realms of our expertise. Many people come to a massage therapist in the hope that they may be able to "fix" their bad back or "get rid of" their migraines. As is often the case with complementary medicine, persistence with treatment over time along with appropriate lifestyle changes and finding ways of dealing with whatever might be exacerbating the problem is more likely to produce a successful result. This is opposed to a blind faith in the therapist to immediately cure the problem. I believe that it is when you take responsibility for your own health seriously that the really miraculous changes start to occur.

Massage is well known for reducing stress and promoting relaxation but it is commonly perceived by the British public as something slightly seedy or hopelessly self-indulgent. This perception is, however, being increasingly challenged and massage is being valued for its enormous physical, emotional and spiritual benefits. As massage therapists we cannot make sweeping claims, however, a growing body of research shows that massage therapy is extremely effective for relieving and managing chronic and acute pain. Recent clinical research in the States has shown that massage is more effective for chronic back pain than other complementary therapies. It is also effective in promoting relaxation and alleviating the perception of pain and anxiety in cancer and stroke patients.

The American Massage Therapy Association (AMTA) recently announced the results of three surveys that confirm more people are seeking massage therapy to relieve and manage their pain. According to a consumer survey conducted by the AMTA, 47 percent of those polled said they have tried massage for pain relief - 58 percent of which are between the ages of 18-24 and 35-44 years. Additionally, 91 percent of the adults polled said massage therapy is effective in reducing pain.

Pain is a complex phenomenon and is difficult to define as it can vary from a transient ache to a sensation that makes people scream. As any definition needs to take into account physiological, psychological and sociological factors, perhaps the simplest is McCaffery's (1988) 'Pain is what the experiencing person says it is, existing whenever he says it does.' Pain is a subjective, unique and complex experience and can be influenced by many factors, eg., age, sex, culture, personality, social class, and family influence, as well as anxiety, fatigue or depression.

Whilst there is evidence that sensation thresholds in humans are similar, pain perception threshold and particularly pain tolerance can be influenced by a number of factors. eg. If a person's attention is focused onto the pain it may be perceived as more intense, so distraction can relieve or diminish pain perception.

It is suggested that, transmission of pain impulses are via different types of nerve fibre.  This knowledge lead, in 1965, to Melzack and Wall outlining the Gate Control theory. The theory attempts to explain pain modulation. The theory has become quite refined and complex but, in essence, proposes the existence of a neural mechanism in the posterior horn of the spinal cord which acts like a gate, increasing or decreasing the flow of nerve impulses from the periphery to the central nervous system. The degree to which the gate increases or decreases pain transmission depends on activity in other fibres and on descending influences from the brain. 

The central nervous system modifies pain by releasing chemicals which bind with receptors throughout the nervous system and alter pain perception. These chemicals include the endogenous morphine like substances known as endorphins. So, it is likely that massage has an effect on pain perception in a number of ways.

Massage produces relaxation and diminishes arousal and this alone may achieve pain modulation. As exercise increases the amount of circulating endorphins, it is likely that massage would produce an increase in them too. Massage stimulates touch and pressure receptors which transmit impulses along fast conducting A fibres. Stimulation of these may help to 'close the gate'. Massage also improves the circulation and thus may help to remove the substances that sensitise nociceptors from the affected area. Finally, it may allow patients to focus on something other than the pain and thus act as a distraction.

My experience as a therapist so far has enabled me to witness the increased positive effects in my clients with the use of aromatherapy oils during massage. The pharmacological, physical and aromatic effects of essential oils can greatly relax and improve physical and emotional well being. In massage, essential oils are absorbed into the body and interact with the body’s chemistry. The neurotransmitters along the nerves are subtly altered by the presence of essential oils, which soothe and help to relax once absorbed into the skin.

When we breathe in, some essential oil molecules travel to the lungs to be absorbed into the blood. Other molecules go directly to the brain. This is the quickest route and the most effective way to heal weak or fragile emotions and states of mind, such as stress and depression. The nose not only warms and cleans the inhaled air, but it also enables us to identify substances by their smell. Tiny hairs in the human nose called cilia send information via receptor cells to the brain to identify the inhaled molecules. This information is received by the limbic are of the brain, which is the area associated with memory, emotions and instincts.  The brain then releases neourochemicals and these have either a sedative or a tonic effect depending on the aroma. This is why aromatherapy massage can have such a powerful effect on our moods.

A user of aromatherapy massage quickly realizes they have found a form of drugless therapy to assist in reaching their objective of freedom from pain or stress. Massage is one of the earliest remedial practices for restoration of proper and healthy body function. It is a natural and instinctive and combined with the powerful properties of essential oils, the most wonderful effects can be achieved.

References: Massage & Pain Relief (Anne Betts, Massage and Health Review, Spring 1999) "Massage Therapy Increasingly Sought for Pain Relief." AMTA press release. Oct. 15, 2003. www.amtamassage.org.

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Author: Clara Hutchinson
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