PAIN: Not Just French Bread

This first of a 3-part blog series on pain management is written from the perspective of Jennifer Hyland, Registered Massage Therapist and Pat Stanziano, Sport Physiotherapist at Leaps and Bounds: Performance Rehabilitation.  It offers some insight into what pain is,  and introduces the role massage therapy can play in the reduction of your pain.

Pain is a distressing sensory and emotional experience associated with actual, or perceived tissue damage.  There are many factors that influence the pain you feel; most, if not all, of which you can control.  That’s great, because it means there are several treatment options that can help.

Pain is a warning signal that our brain and the rest of our nervous system produces to protect our body.  This can be a useful response because it can help avoid injury; for example, pulling your hand away when you touch a hot stove.   However, our brain can also be overprotective, and it can send out warning signals (i.e. pain) in response to other factors that you may have been experiencing at the same time you were feeling pain. For example, if you sprained your ankle in a cold room, the feeling of cold can remind your nervous system of the ankle injury, causing you to feel pain when you’re cold.  What factors can your body associate with the experience of pain?  They can range from just about anything – thoughts, emotions, people, places, and everything in between.  This response is called maladaptive pain, or pain that is out of proportion to actual tissue damage, or perceived long after the tissue has healed.  Persistent maladaptive pain can lead to chronic pain syndrome, if not addressed.

So what can be done?  Our understanding of the current research helps us retrain the pain system that results in the reduction of pain itself.  The most important thing to realize is your thoughts about pain can actually change how you feel it and respond to it.

Massage Therapy and the Gate Control Theory of Pain:

Massage therapy has been shown in research, to provide some pain relief in both acute and chronic settings.  For those with new injuries who are experiencing acute pain, massage therapy sends tactile information along the same nervous system pathways that relay pain information to the brain.  Because the brain ranks the tactile information as being more important, it closes the gate on the pain information and, theoretically, less pain is felt.  This is known as the Gate Control Theory of Pain, and has the potential to reduce the use of painkillers and improve emotional well-being, relaxation, and sleep.

Massage Therapy and Neuromodulation of Pain:

In cases of chronic pain, it has been shown that the autonomic nervous system (the part of you that control’s the fight-or-flight response) is in a state of dysfunction.  Two of its parts: (1) the sympathetic nervous system (SNS) is excited, and (2.) the parasympathetic nervous system (PNS) is depressed, resulting in an increased state of stress that primes the body to protect itself by fighting or fleeing.  In chronic pain patients, more stress equals more pain.  The tactile stimulation of massage therapy triggers reflexive chemical reactions at the spinal cord which suppress the actions of the SNS, while stimulating the PNS, promoting a state of relaxation.  More relaxation equals less pain.  In studies of patients with chronic pain – including but not limited to those with MS, fibromyalgia, and chronic fatigue syndrome – following a massage treatment plan can result in reduction of pain levels up to 20%.

At Leaps and Bounds, if you are dealing with acute or chronic pain, you will be assured a thorough assessment of your condition, an individualized treatment plan, an honest prognosis, and plenty of coaching and education that will help you with self-management.  Speaking of which, here are a couple of resources to help get you started:

Recovery Strategies: Your Pain Guidebook  

It’s Time to Rethink Persistent Pain

Stay tuned for Part 2 of our series on PAIN, when Dr. Patti Farrell, Chiropractor, discusses the role that contemporary medical acupuncture can play in the reduction of your pain.

References:

Adams R, White B, & Beckett C:  The effects of massage therapy on pain management in the acute care setting.  International Journal of Therapeutic Massage Bodywork. 2010 Mar 17;3(1):4-11.

Backus D, Manella C, Bender A, Sweatman M: Impact of Massage Therapy on Fatigue, Pain, and Spasticity in People with Multiple Sclerosis: a Pilot Study.  International Journal of Therapeutic Massage Bodywork.  2016 Dec; 9(4): 4–13.

Munk N, Kruger T, Zanjani F.  Massage therapy usage and reported health in older adults experiencing persistent pain.  Journal of Alternative and Complementary Medicine. 2011 Jul;17(7):609-16.