Tuesday, May 21, 2013

BODY-WORK: The Anatomy’s ’ Labor of Love Manual therapies you might find helpful for chronic pain.

by Celeste Cooper, RN

Chronic pain wears us down regardless of the source. There are many painful disorders recognized in May, and I have discussed ways to advocate and raise awareness, now it is time to say something about what we can do to help our body not only function better, but feel better too.

Self-Responsibility, “…One thing that seems to have been forgotten to a surprising degree is the lifelong plasticity of most of our bodies’ tissues, and the manner in which our whole style of living molds this plasticity in innumerable ways that could never be anticipated by the coding of our DNA.
~ Deane Juhan, author of Job’s Body: A Handbook for Bodywork
The myofascia covers all muscles, and it is part of the largest organ structure of the body, connective tissue. Is it any wonder so many chronic pain conditions share myofascial dysfunction?

The continuum of connective tissue for the most part is not made up from living cells, instead it is made up of fluids and fiber. Because of this, we need to help it along either manually or by stretching, keeping the life fluids going in and the waste fluids going out.

Massage therapy

Somewhere along the line, we forgot about the value of touch. As one of our major senses, touch has more than one job. It provides information to the brain regarding impending danger, and it provides feelings of comfort and caring. Massage therapy provides helpful feedback to the body and the brain, promotes relaxation, and relieves stress and physical pain and mobilizes stagnant fluid in the lymph system which is dependent on physical movement and manual stimulation.

The type of massage therapy depends upon your personal tolerance. Until your brain learns to like it, it is prudent to start with soft touch. As you progress, you should eventually be able tolerate bodywork that helps with deep muscle and joint function.

Massage therapy versus bodywork

Massage is a manipulation of the body using hands on touch therapy by stroking, kneading, and rubbing soft tissue. Massage is sometimes accompanied by aroma therapy, hot rocks, and other modalities to help you
achieve a full body experience.

Bodywork on the other hand, is a distinct therapy and requires advanced training. Bodywork targets specific areas of the anatomy that are holding back the body as a whole. It is a systematic therapy with specific goals for improving function and feelings of well-being. For instance, a good bodyworker knows how to break down restrictive tissue, such as adhesions and scars, and treat knotted up and tense muscles, thereby restoring the normal flow of blood and lymph. When you see a bodyworker, it is prudent to start with the problem that bothers you the most, pain, swelling, muscle weakness, etc.

The goal of both massages therapy and bodywork is to restore balance to the mind-body connection.

Myofascial trigger point massage/bodywork

Myofascial pain syndrome (MPS) has been associated with spinal disease, arthritis, sport injury, post surgical restrictions, migraine, chronic pelvic pain (including vulvodynia and bladder disorders), teeth grinding, TMJ, fibromyalgia, chronic fatigue syndrome, restless leg syndrome, TMJ, bowel dysfunction, sexual dysfunction and impotence, and the list goes on from there.

If you know you have co-existing myofascial pain syndrome which is identified as myofascial trigger points lasting more than three months,  specific bodywork is indicated. Read more here

Myofascial trigger points (MTrPs) are called “neurological imitators.” This explains why physicians who do not understand MPS are perplexed by what they think are unexplained tingling, numbness, or sensations of needles and pins, or other associated sensation abnormalities their patients often experience.

Myofascial trigger point pressure therapy by someone trained in the work of Travell and Simons, here,  is helpful in this instance.  You can also learn to do self treatment using tools such as tennis balls, Theracane, or Knobbers, Yoga ball, swim noodles, and a good book on self treatment, such as Clair Davies, The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief, forward by Dr. David Simons. (May you both RIP gentle souls).

Basically, any organ or body system can be affected by myofascial trigger points (MTrPs), they can also obstruct blood circulation, nerve transmission, and lymphatic flow. Learn more about MTrPs here


Bodywork and massage therapy comes in many shapes and sizes. The good news is that the current level of thinking among medical practitioners is that it works!

The next hurdle to overcome is getting insurance to cover it as a helpful medical tool. I want you to know that people are fighting for the integration of these types of therapies and more.  Raising awareness, such as what we do at the Pain Action Alliance to Implement a National Strategy, here, will help in these endeavors.

The goal of and bodywork is to keep all body parts in motion with the least amount of stress. Learn more about different types of bodywork, such as, Alexander technique, craniosacral therapy, shiatsu, myofascial release, reflexology, Rolfing, Rosen method, myofascial trigger point therapy, self treatment for myofascial trigger points, spray and stretch, acupressure, Trager work, Vodder manual lymphatic massage/drainage, and how to find the right, qualified therapist here.

You can also find helpful tips on massage and finding the right therapist in the Fall Devotions of the Broken Body, Wounded Spirit: Balancing the See-Saw of Chronic Pain, here.

*As with everything medical, there are some risks for certain people. These include, fear of touch, bleeding disorders or take blood-thinning medication, burns, open or healing wounds, blood clots in the veins, fractures, severe osteoporosis (brittle bone disease), or other severe bleeding disorders. If you are in doubt, be sure to check with your physician.  

All answers and blogs are based on the author's opinions and writing and are not meant to replace medical advice.  For more information about the author see http://TheseThree.com

Check pub med for citations

As with any new therapy, discuss any risks for your particular condition with your physician first.

Answers are based on the writings/books of the author and are not meant to replace medical advice.


Unknown said...

There are benefits of the massage therapy at the same time some ill effects as well .The person suffering with DVT or deep vein thrombosis, osteoporosis, bleeding disorder, cancer and recent fracture should not get massage therapy. It is also harmful to get a massage therapy when one is pregnant, has fragile skin, heart problem and others.

Massage Therapy West Kelowna

Ryan Rusty

Muscle Pain said...

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Leyo said...

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Unknown said...

Thank you for your post. I so agree human touch is a vital healing tool. Many insurance companies do not pay for massages. And in some areas a well trained therapist is rare. At one time I did save and treat my body to a massage but at this time due to osteoporosis and other back structure problems, not advised for me. I enjoyed your book Integrative Therapies

The Pained Ink Slayer said...

Thank you David. The role of the physical therapist can make or break a patient's perspective of the myofascia. When FM patients do not have a positive experience from physical therapy, I suspect it is because the PT does not understand the prevalence of myofascial pain syndrome, or have specific training, the same is true for physicians. The key in patient satisfaction, participation, and outcome is that close attention is paid to the centralization of pain from FM and the peripheral involvement of myofascial trigger points. When patients don't improve, we have to ask why that might be. I am thrilled that physical therapists are beginning to take a proactive role and specialized training, because when they don't have a clear understanding, they should not be caring for these patients, and when they do, patients will revere them as miracle workers.

Thank you for taking the time to read this blog. I am sorry it has taken me so long to get back to you. Our fourth and final book in the Broken Body Series will be released soon.

The Pained Ink Slayer said...

Thank you JoAnn. I appreciated your input and I can tell you that at PAINSproject.org we are working to improve massage and other integrative therapies as part of pain management, which means working with insurance companies to help them understand that these therapies will have a better patient outcome, cost less than some invasive treatments they now pay for, and save them money over the long run.

Thank you for reading the BIG book. I hope you will leave a review on Amazon, because we value the opinion of our readers. In healing and hope, Celeste

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