Massage & Arthritis

Dealing with pain can be the hardest part of having arthritis or a related condition, but you can learn to manage it and its impact on your life. The first step is knowing which type of arthritis or condition you have, because that will help determine your treatment. Before learning different management techniques, however, it's important to understand some concepts about pain.

The Purpose of Pain

Pain is your body's alarm system that tells you something is wrong. When your body is injured, nerves in the affected area release chemical signals. Other nerves send these signals to your brain, where they are recognized as pain. Pain often tells you that you need to act. For example, if you touch a hot stove, pain signals from your brain make you pull your hand away. This type of pain helps protect you. Long-lasting pain, like the kind that accompanies arthritis or Fibromyalgia, is different. While it tells you that something is wrong, it often isn't as easy to relieve. Managing this type of pain is essential to enhance your quality of life and sense of well-being.

Causes of Pain

Arthritis pain is caused by several factors, such as: Inflammation, the process that causes the redness and swelling in your joints; Damage to joint tissues, which results from the disease process or from stress, injury or pressure on the joints; Fatigue that results from the disease process, which can make your pain seem worse and harder to handle; Depression or stress, which results from limited movement or no longer doing activities you enjoy. You can get caught in a cycle of pain, limited/lost abilities, stress and depression that makes managing pain and arthritis seem more difficult.

How the Body Controls Pain

Pain signals travel through a system of nerves in your brain and spinal cord. At times, your body tries to stop these signals by creating chemicals that help block pain signals. These chemicals, called endorphins, are morphine-like painkilling substances that decrease the pain sensation.

Different factors cause the body to produce endorphins. One example is your own thoughts and emotions. For example, a father who is driving his children is hurt in a car accident. He is so worried about his children that he doesn't feel the pain of his own broken arm. The concern for his children has caused the natural release of endorphins, which block the pain signal and prevent him from noticing the pain.

The body also produces endorphins in response to external factors, such as medicine. Codeine is one example of a powerful pain-blocking medication. Other external pain control methods, such as heat and cold treatments, can stimulate the body to either release endorphins or block pain signals in other ways.

Through exercise, you can improve your overall health and fitness, as well as your arthritis symptoms. Exercise can:

• keep joints moving;
• strengthen muscles around joints;
• keep bones strong and healthy;
• help you to do daily activities more easily;
• improve your overall health and fitness, including increasing your energy;
• improving your sleep;
• controlling your weight;
• strengthening your heart;
• improving your self-esteem and sense of well-being.

Regular exercise also can help you effectively manage pain. A physical therapist, occupational therapist, exercise physiologist or doctor can recommend an exercise program for you.

Your program should include range-of-motion (the normal amount your joints can be moved in a certain direction) exercises to keep your joints flexible. It also should include endurance exercise, such as water exercise, walking or riding a stationary bicycle. Endurance exercises help keep your heart, lungs, bones and muscles strong. They help your body work more efficiently and give you more stamina so that you can work longer without tiring as quickly.

Some experts think alternative exercise, such as yoga and tai chi, can be beneficial for people with arthritis. These forms of exercise can improve flexibility, increase muscle strength and help you relax.

Heat and Cold Treatments

Using heat and cold treatment can reduce the pain and stiffness of arthritis. Cold packs numb the sore area and reduce inflammation and swelling. They are especially good for joint pain caused by a flare. Heat relaxes your muscles and stimulates blood circulation. You can use dry heat, such as heating pads or heat lamps, or moist heat, such as warm baths or heated wash cloths.

Before using either treatment, be sure your skin is dry and free from cuts and sores. If you have visible skin damage, don't use cold or heat, especially paraffin wax baths. Use a towel to protect your skin from injury when you are treating an area where the bone is close to the skin's surface.

After using heat or cold, carefully dry the area and check for purplish-red skin or hives, which may indicate the treatment was too strong. Also check the area for any swelling or discoloration. Gently move your joint to reduce stiffness. Allow your skin to return to normal temperature and Color before using heat or cold again.

It is normal for your skin to appear pink after using a cold or hot pack. However, if an area appears dark red or spotty red and white, there may be some skin damage. Blisters may indicate the pack was too cold or hot.

Massage and Arthritis

How can working with muscles and fascia (connective tissue) help your joints?

• Massage decreases muscle tension, taking stress off of your joints and making movement easier.
• When you are in pain, your muscles tense, which causes more pain, which interferes with your sleep, which makes you hurt more, which makes you more tense, which limits your movement, and so on and so on...
• Massage helps you to break this cycle of chronic pain. Studies have shown that massage therapy reduces pain and anxiety.
• You may already know that exercise can be very beneficial in slowing the processes of arthritis and keeping symptoms in check.
• By relieving muscle tension and restoring balance, massage therapy makes exercise more comfortable.

I have worked with many people who have arthritis. In my experience, combining massage with exercise and other self-care techniques is a very effective strategy to reduce pain and restore movement to stiff joints.

More, than 2,000 years ago, the ancient Greek physician Hippocrates wrote that doctors should be experienced in "rubbing that can bind a joint that is loose and loosen a joint that is too hard." Today, massage is still a popular way to manage arthritis pain. Proponents claim that massage therapy, done correctly, can help improve joint movement, relax tense muscles, and stimulate the flow of blood and nutrients to the skin and underlying tissues. What's more, it just feels good, and the relaxation it brings can help break the cycle of pain and stress that often goes along with arthritis.

Much-Kneaded Advice

A typical massage therapy session lasts about 30 to 60 minutes. To see real improvement, though, you may need four to six sessions about a week apart. The cost runs $30 to $55 but insurance sometimes covers the treatment if you have private health cover and the extras' in that cover.

• The first session usually begins with the massage therapist asking questions about your current physical condition, medical history, and goals for the treatment.
• Next, you'll be asked to remove some your clothing and lie on a padded table. A sheet or towel is provided, and the therapist should uncover only the part of your body being massaged.
• This not only protects your modesty, but also helps you stay warm.
  Often, the therapist will use oil or lotion, so if you know you have skin allergies, be sure to mention them up front.
• During the massage, don't hesitate to speak up if anything feels inappropriate or causes pain. While massage therapy may provide short-term pain relief, massage therapy that is too rough may aggravate arthritis pain and symptoms.

Therapeutic massage does not treat, heal, prescribe or cure anything. It is complementary healthcare, not a substitute for a Medical Doctor.

Some conditions are “red flags” that prohibit massage, including phlebitis, some cancer, infectious disease, and some skin and certain cardiac conditions.

Your therapist should take a health history, but it is always best to consult your physician if you have any concerns. “Don’t wait until you feel like a train wreck before you come to see me.” I, like many therapists, offer a discount for those who come regularly; it makes the work more effective for you and easier on both of us (minimum of 6 sessions for discount).