massage therapy for chronic pain
Definition of chronic pain:  Chronic pain is not a symptom, but a disease state.
 Pain which lasts beyond the ordinary

duration of time that an insult or injury to the body needs to heal.  4 – 6 weeks, although others have chosen three months as the dividing line between acute and chronic pain {Bonica, JJ. The
management of pain. In: Lea and Febiger, 2nd ed, Philadelphia 1990}

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Headache Low back pain Cancer pain Myofascial pain (trigger points) Arthritis pain Herpes Zoster ( post-herpetic neuralgia) Includes, but not limited to, neuropathies that affect nerves throughout the body.

Ref: {Clinical Anesthesia, Paul G. Barrash, 4th edition}

Pain of such chronic and intense proportions that it overwhelms all other symptoms & becomes the main problem

 Inability to work.  Appetite falls off  Physical activity of any kind is

exhausting and aggravates pain.  People become victims of a vicious circle total preoccupation with pain leads to irritability and depression.

Effects Cont’d
 Less sleep at night

more irritability, depression, and pain.  “Terrible triad" of suffering, sleeplessness, and sadness.  drug-dependency  Submission to repeated surgery/resorting to questionable practitioners who promise quick & permanent "cures”.

The Pathology
 Tight muscles reduce circulation

waste products accumulate soreness and fatigue. Waste products also irritate nerves, causing the pain to spread.  Muscles stay tightened over time body compensates by developing restricted patterns of movement.  Fatigue, frustration, lack of energy, mental and emotional stress can develop from post-traumatic chronic pain and physical restriction.

Study: Levoska S., MD, Archives of Physical Medicine and Rehabilitation
(Vol. 74, April 1993)

 Deep heat & massage improve blood  

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circulation and metabolism reducing pain. Poor blood circulation in a muscle decreases pH & reduces muscle contraction, as well as muscle strength. When M.T’s release contracted muscles, they help restore capacity for normal movement. Anxiety & stress lessen as clients increase their activity level & achieve more control in their daily functioning. People sleep better after a massage aids physical & emotional health and helps restore mental equilibrium. As clients begin to feel better with massage, they often discover renewed energy and motivation for physical activity.

REFLEXOLOGY in Chronic Pain
 Reflexology, or zone therapy, is the

practice of massaging, squeezing, or pushing on parts of the feet, or sometimes the hands and ears, with the goal of encouraging a beneficial effect on other parts of the body, or to improve general health.

 There is no clinical or scientific

evidence that reflexology has any

 Sciatica is pain radiating from the

buttocks down the leg due to pressure on the sciatic nerve.

 Causes:

4. Root Pressure: entrapment of the root involving spinal nerves from L4-S3 either by a herniated vertebral disk or arthritic narrowing of the spinal canal itself. Or more commonly cause 5. The Piriform Muscle: tension in this gluteal muscle can compress the sciatic nerve causing pain.

Reflexology for Sciatica

This nerve is of particular interest to Reflexologists because it is the very nerve conducting all the touch and pain sensations from the feet

YOGA Therapy for Sciatica
 Yoga therapy can be an alternative (or

complementary) treatment to Massage Therapy.

 “We need to strengthen lines of Myofascial

that are ‘locked long’ and stretch lines that are ‘locked short’. If we attempt to stretch tight muscles without strengthening the opposing muscles, the stretch will be relatively temporary and ineffective, and the imbalance that led to the problem will largely remain.”

 “Yoga is an effective form of structural

therapy because it focuses not just on

“Yoga poses work from head to toe

recognizing the ‘weave’ of energies that run through the entire body. An injury at any one place in this ‘fabric’ affects the integrity of the whole, and also shows a weakness in the whole”
Doug Keller “Yoga as Therapy”

Yoga for Sciatica
 Sciatica can be a problem for individuals

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because piriformis is tight and “pinches” the sciatic nerve. Some stretches include: Piriformis Stretch – Modified Ardha Matseyendrasana Eka pada rajakapotasana (pigeon pose) These poses can be offered as treatment or home care as a part of a Massage Therapy treatment plan.

Pregnancy & Chronic Pain What a Doula can do for you
 Experiencing chronic pain while pregnant is

almost unavoidable, however coping and healing chronic pain is obtainable with the help of a doula.

 What is a Doula?

A doula provides physical and emotional assistance and encouragement during child birth and in the early post partum phase. The doula contributes as an extra pair of hands for the doctor/midwife and father during the labour. An experienced doula can greatly improve a pregnancy and labour by offering consistent information

Pain experienced during pregnancy

 “25-56% of those that are pregnant will

suffer from back or pelvic pain while they are pregnant. 3% of these will get severely disabled from it, and a clear third of the pregnant women will have pain so severe that it will affect their work, their sleep, and their daily lives.”

Other pains associated with pregnancy
 Depression  Immobility leading to DVT (Deep vein

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thrombosis), which are leg blood clots that lead to strokes and heart attacks. Post partum carpel tunnel syndrome Nerve entrapment Thoracic pain Degenerating fibroid

The benefits of a doula:
 During the pregnancy: Provides safe, drug free

relief of aches and pains, reduces swelling, teaches skills for dealing with and preparing for the labour, increases circulation, eases pressure on the sciatic nerve, improves sleeping and emotional tension.  During the Labour: Greatly reduces the need for a Cesarean section, the need for pain medications or epidurals, the need for forceps and vacuum extraction, and shortens the length of the labour!  Postpartum: Alleviates muscle pain from postural shifts, fuller breast, and weight of carried infant. Restores muscle tone to abdomen, and stimulates the uterus to return to its pre-pregnant size.  Infant Massage: Promotes bonding with parent and infant, stimulates circulation, and eases colic, gas, and digestive discomfort. Improves sleeping patterns, and stimulates brain development.

The Power of Touch
Often touted are the psychological benefits of massage therapy

The Power of Touch
 Stress chemicals (the fight or flight

response), can be harmful to the body over long periods of time.  Physical touch and massage techniques involving slow, soothing strokes to one's back or neck can slow a busy, overworked mind and settle or centre a person. 

 The communication of such caring touch

is also recognized by health professionals as an adjunct to pain relief, whether physical or emotional If a person's physical or emotional health is challenged, massage therapy can produce benefits whether the situation is acute (immediate) or chronic (longstanding).    Many people also use regular massage therapy as a form of body maintenance, receiving massage faithfully for the continuance of good health.
Canadian Massage Therapist Alliance, 2004


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