Massage treatment for back pain

Throughout history different forms of massage treatment have been used in all medical cultures to alleviate a wide range of symptoms. This article focuses on the most common form, classic muscular (Swedish) massage, as a symptomatic treatment for back pain. It will define the therapeutic modality, review the evidence for or against effectiveness and safety, and discuss possible mechanisms of action as well as the problems of conducting research in this area.

Swedish massage is a touch therapy that uses a range of techniques to manipulate the soft tissues of the body: effleurage (slow rhythmic stroking), kneading (circular compression), petrissage (forceful skin rolling), friction (penetrating pressure from the fingertips with circular or transverse movement), tapotement (percussive movements), vibration (trembling movement of both hands). In most English speaking countries, massage is seen as an alternative or complementary treatment, whereas on the European continent it is considered a conventional treatment.

Massage: A relaxing method to relieve stress and pain

soothing massage can help you unwind, but that's not all. Explore the health benefits and risks of massage therapy, plus what to expect.

By Mayo Clinic staff

You might think of a massage only as a luxury in exotic spas and upscale health clubs. But did you know that massage therapy, when combined with traditional medical treatments, is used to reduce stress and pain and promote healing in people with certain health conditions?

What is massage therapy?

During a massage, a therapist manipulates your body's soft tissues — your muscles, skin and tendons — using his or her fingertips, hands and fists. Massage can be performed by several types of health care professionals, such as a physical therapist, occupational therapist or massage therapist. Several versions of massage exist, and they're performed in a variety of settings.

A massage may make you feel relaxed, but it isn't likely to cure everything that ails you. And, if performed incorrectly, it could hurt you. Learning about massage before you try one can help ensure that the experience is safe and enjoyable.

Why it's done

Massage can relieve tension in your muscles, and most people use it for relaxation, relief of stress and anxiety, or to reduce muscle soreness. Massage can also cause your body to release natural painkillers, and it may boost your immune system.

While more research is needed to confirm the benefits of massage, some studies have found it helpful for:

• Anxiety. Massage reduced anxiety in depressed children and anorexic women. It also reduced anxiety and withdrawal symptoms in adults trying to quit smoking.
• Pain. Pain was decreased in people with fibromyalgia, migraines and recent surgery. Back pain also might be relieved by massage. However, back pain study results have been contradictory, and more research is required.
• Labor pain. Massage during labor appears to lessen stress and anxiety, relax muscles and reduce pain.
• Infant growth. Massage encouraged weight gain in premature babies and reduced the number of days they stayed in the hospital.
• Children with diabetes. Children who were massaged every day by their parents were more likely to stick to their medication and diet regimens, which helped reduce their blood glucose levels.
• Sports-related soreness. Some athletes receive massages after exercise, especially to the muscles they use most in their sport or activity. A massage might help increase blood flow to your muscles and may reduce muscle soreness after you exercise.
• Alcohol withdrawal. Massage during withdrawal from alcohol has shown benefits when combined with traditional medical treatment by increasing feelings of support, safety and engagement in the therapy.
• Immune system. People with HIV who participated in massage studies showed an increased number of natural killer cells, which are thought to defend the body from viral and cancer cells.
• Cancer treatment. People with cancer who received regularly scheduled massage therapy during treatment reported less anxiety, pain and fatigue.
• Self-esteem. Because massage involves direct contact with another person through touch, it can make you feel cared for. That special attention can improve self-image in people with physical disabilities and terminal illnesses. And using touch to convey caring can help children with severe physical disabilities.

Risks of massage

Massage is generally safe as long as it's done by a trained therapist. But massage isn't for everyone. And for some people it can even be dangerous. Discuss massage with your doctor before making an appointment if you have:

• Burns or open wounds on the area to be massaged
• Had a recent heart attack
• Cancer — you'll want to avoid direct pressure on the tumor area
• Deep vein thrombosis
• Unhealed fractures
• Rheumatoid arthritis in the area to be massaged
• Severe osteoporosis

In addition, talk to your doctor before getting a massage if you're pregnant.

Massage done properly rarely leads to severe injuries. Ask your massage therapist about his or her training and qualifications — some states require licensing. And if any part of your massage doesn't feel right or is painful, speak up right away. Most serious problems come from too much pressure during massage. In rare circumstances, massage can cause:

• Internal bleeding
• Nerve damage
• Temporary paralysis

Talk to your doctor and your massage therapist if you have any concerns about your risk of injury. Asking questions can help you feel more at ease.

What you can expect during a massage

No matter what kind of massage you choose, you should feel calm and relaxed during and after your massage. When you go for a massage, you can expect to:

• Answer a few questions. Your massage therapist will ask what you want from your massage. Are you looking for help with a pulled muscle? Massage therapists will also want to know about any medical conditions you may have, so they can decide if massage is safe for you or how to make it safer.
• Disrobe. You'll be asked to remove your clothes, or at least most of them. Your massage therapist should give you privacy while you take your clothes off and provide a robe or a towel to cover yourself. A good massage therapist will protect your modesty and keep you covered as much as possible throughout the massage. If taking your clothes off doesn't sound relaxing or if you're pressed for time, try a chair massage. These massages are conducted while you sit in a special chair that slopes forward so the therapist can massage your back. You keep your clothes on for this massage — it's often done in the open, rather than in a private room.
• Be asked to lie down. Most massages will require you to lie on a padded table. Pillows or bolsters might be used to position you during the massage. This allows you to relax completely during the massage. Music usually plays softly while you're massaged.
• Have oils and lotions used on your skin. Some massage therapists use oils or lotions to reduce friction while massaging your body. If you're allergic to any ingredients commonly found in body oils and lotions, tell your massage therapist. He or she might have products without that ingredient. You may opt not to use oils and lotions.
• Never feel significant pain. Pain that's more significant than momentary discomfort could indicate that something is wrong. If a massage therapist is pushing too hard, tell him or her to lighten the pressure. Your massage therapist should receive feedback from you to determine how best to massage you. Occasionally you may have a sensitive spot in a muscle that feels like a knot. It's likely to be uncomfortable while your massage therapist works it out. But if it becomes painful, speak up.
• Spend about an hour. Most table massages take about an hour, though some can be up to 90 minutes long. It's your preference.

A health care tool

For many conditions and injuries, massage may be a means to help you feel more relaxed and less anxious and to reduce pain. It's one of several useful tools for managing your health, but it doesn't take the place of standard medical treatment and exercise.

Addressing Headaches

Before we can intelligently discuss headaches, it is imperative that we understand what type of headache we are addressing. There are three types of headaches. First, there are tension headaches, which account for over fifty percent of all primary health care providers' visits. Second, there are sinus headaches, which are attributed to allergies and the flu. Third, and the most serious of all headaches, migraine headaches.

There are as many reasons to experience tension headaches as there are personalities and lifestyles. Whether the cause is emotional or physical the result is the same, throbbing temples and mental discomfort. We are certainly not at our creative best when our head hurts. Massage addresses tension headaches by relaxing the neck and shoulders. As we relax, we soften our muscles and headaches disappear. These are the easiest headaches for us to address.

Sinus headaches are best addressed by face massage. As the sinus cavities become relaxed, the fluids that are trapped in these spaces release and begin to flow, allowing us to drain and cleanse the sinuses. This is a slow process and usually takes a few massage sessions. There are simple techniques that any experienced massage professional can teach you to allow you to release these cavities yourself. Between massages, you will find relief with a few minutes of self-massage done on a regular basis.

Migraine headaches can be caused by either impingement of the nerves in the neck or by chemical imbalances. Massage can address the impinged nerve problem by releasing the Levator Scapula Muscles. It is often necessary to address either the left or right Levator muscle for several hours to achieve complete relief. Be sure to ask your massage professional if they have had experience eliminating migraine headaches. You will probably need to shop around a bit to find a massage professional who is willing to work just one muscle for two hours at a time.

Headaches cripple our ability to function optimally and are probably the most common form of what could be called discomfort. Now is a good time to allow a massage professional the opportunity to rid you of your headache discomfort naturally.

Addressing Pain

Pain is caused by lack of oxygen. Lack of oxygen can be caused by a myriad of possibilities. Some of the causes are a blow, a cut or a strain. One of the obvious causes of pain is the flu, as we go through this period of discomfort, we ache all over. As our body becomes hot with fever, our muscle fibers begin to stick together, inhibiting circulation, which causes lack of oxygen. When we recover from the flu it is necessary to address these muscle fibers or they will remain stuck together. Dehydration is the catalyst that accelerates the aging process.

When muscle fibers are stuck together, fluid is no longer able to pass between these fibers, causing lack of circulation. Lack of circulation causes lack of oxygen and in turn lack of oxygen causes pain. There is a secret to creating an environment within your body that makes pain less likely. This is a secret that you have probably had passed down to you by your grandparents and your parents too. This secret is to drink eight to ten 8 ounce glasses of water every day.

Our bodies are comprised of seventy percent water and when this level of liquid drops we enter a state of dehydration. Without water it is impossible to enjoy adequate circulation and we live in a constant state of pain. For those of you who have never experienced a professional massage, we would recommend that now is a good time for your first session. Drink lots of water, get lots of massage and live a pain free life.

Addressing Stress

Stress has a way of changing posture. As stress begins to tighten one's body, shoulders begin to roll forward, the chin lifts and the neck moves forward. This happens to all of us as the everyday pressures of life close in around us. In the world of psychology the term for this posture is armoring.

Think of a person sitting at a typing station. This person is not sitting erect, but leaning slightly forward. Her elbows are not hanging by her side but are just forward of her body. As her fingers dance across the keyboard she not only has to hold her forearms up, but has to hold her elbows forward. This puts a tremendous amount of pressure on the muscles of her upper back as well as her lower back.

There are two muscles that are punished the most by stress. We call these muscles the stress muscles. However, their medical name is Levator Scapula. These two muscles connect at the upper bones of the neck called the Cervical Vertebrae and connect to the shoulder blade, known as the Scapula. When we are stressed our shoulders lift putting pressure on our neck. This pressure creates headaches and neck and shoulder pain. The final result of this posturing is pressure on the Medial Nerve which eventually becomes Carpal Tunnel Syndrome.

This condition is easily addressed by massage and three or four visits usually alleviate this stress.How often should you get a massage? Probably once a week, if you have never had a massage before.

As the shoulders lift, the vertebrae of the spine are pulled close together, which puts pressure on the disk between the vertebrae. As the disk is crushed by this pressure it widens and puts pressure on the nerves that exit the Central Nervous System at these openings. As the nerves are impinged, everything in the body begins to shut down and we enjoy a lower level of energy. Life becomes harder.

From our point of view, stress is the fundamental cause of most illness. The Ancient Chinese said that disease was caused by congestion and wellness was the result of circulation. This was written six thousand years ago and it seems they were correct.

For those of you who have never experienced a professional massage, perhaps now is the time to give one a try. All you have to lose is stress and discomfort.