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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}

 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
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.
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

 “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

 “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

because piriformis is tight and “pinches”
the sciatic nerve.
 Some stretches include:
 Piriformis Stretch – Modified Ardha
 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
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
 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 (long-
 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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