I'm a nerd. Last winter when we vacationed on a beach, I read a book on pain management. I had recently attended a lecture on it and wanted to better understand how I could help my patients manage their pain through massage.

He issued a call to massage therapists to enter the healthcare world as part of the solution to pain management. With the looming opiod epidemic, the medical world is looking for alternatives.

He said that we need to evaluate how we think about pain. Maybe we can not eliminate pain, but we need to manage it. Rather than measuring pain on a numerical scale, we need to measure how pain affects four areas of life: activity, sleep, mood, and stress. The pain may remain the same, however if the patient can function in these four areas, there is success and pain is managed.

He explained that as an anesthesiologist he could drop someone to zero pain, however they would be on the floor drooling and unable to do anything. That is unacceptable for daily life. There is a difference between someone who has a pain level 7 and is unable to function and someone with a pain level 7 who can sleep and function within their pain. They are managing their pain. 

Massage therapy can be part of managing the pain. We can complement what their doctor is prescribing. Massage can easily be combined with other pain management methods, including drugs. Drugs have their place, but we need to find ways to minimize them.

​Pain is a major public health concern, significantly affecting the quality of life of approximately 100 million Americans.

The Samueli Institute, commissioned by the Massage Therapy Foundation with support from AMTA, conducted a systematic review and meta-analysis of published science on massage and pain. This systematic review and meta-analysis is the first to rigorously assess the quality of massage therapy research and evidence for its efficacy and effectiveness in treating pain, function-related and health-related quality of life outcomes for people with various types of surgical pain and anxiety. 

Here is a link to the review:
Massage Therapy and Pain Management

I was particularly interested in his explanations on using movement and energy (i.e. vibrations like gentle touch, sound, and light) on and in the body to affect the brain. I am more and more convinced that movement is necessary to maintain optimal health. I am not convinced that we need specialized training or to do heavy exercise, but we DO need to keep moving. We've heard it before, but movement, even as simple as walking, will not only benefit the body, but also the brain.  

I am intrigued by fascia, or connective tissue. I use myofascial release in many massages and find that it helps to break adhesion, thus decreasing pain and increasing range of motion. Today I read an article in The Scientist by Dr Helene M. Langevin where she explains her research with connective tissue. I'll highlight some of what she wrote below, but you can read the entire article if you want more information.

The study of connective tissue is shedding light on pain 
and providing new explanations for alternative medicine.

Helene M. Langevin is a visiting professor of medicine and Director of the Osher Center for Integrative Medicine at Brigham and Women’s Hospital, Harvard Medical School, and a professor of neurological sciences at the University of Vermont.

Connective tissue is one of the most integral components of the human machine. Indeed, one could draw a line between any two points of the body via a path of connective tissue. This network is so extensive and ubiquitous that if we were to lose every organ, muscle, bone, nerve, and blood vessel in our bodies, we would still maintain the same shape: our “connective-tissue body.”

Everyone has scars, and some of those scars form adhesion in the body, causing pain or restricted range of motion. As I have worked on scars during massages (using Myofascial Release), I have been amazed at the results. 

For example, one client had restricted range of motion in his knees because of ACL surgeries nearly 30 years ago. After the first massage on his knees, specifically working with the scar tissue, he reported increase in his range of motion and less pain. He received several subsequent massages and noticed even more improvement. 

Another client had a latissimus dorsi flap breast reconstruction surgery. The large scars on her back restricted the range of motion in her shoulders and caused lower back pain. After receiving several massages which targeted her scar tissue, she regained much of her range of motion in her shoulder joints and reported decreased pain in her back - enough that she slept much better and could begin exercising again. In a future blog post, I will present the case study I did on this client.

Recently I've been intrigued by the fascia in our body and how keeping it pliable affects our health. Our bodies are made to move. Massage, especially myofascial release and Thai massage, helps restore movement. In the video below Gil Hedley explains what fascia is.