Massage & Back Pain

Could massage help my aching back?

Scientists have recently done studies suggesting that it could. A recent study in the Archives of Internal Medicine showed that massage substantially relieved lower back pain over the long term for people who suffered moderately severe chronic pain. After an hour of massage once a week for 10 weeks, participants in the study found their pain levels had dropped dramatically -- by nearly 50 percent. With the reduction of pain, participants also improved their ability to carry out daily tasks by about 50 percent.

How does massage help relieve back pain?

There are many theories as to how massage works. The use of therapeutic massage dates back thousands of years to ancient cultures in China, India, and Japan when practitioners used forms of massage to promote well-being.

However, it's only recently that Western scientists have done research suggesting that massage can ease lower back pain. According to one study, massage induces mental and physical relaxation and increases the level of pain you can tolerate by releasing endorphins, the body's natural painkillers.

Before getting massage therapy, ask your doctor if there's any reason you should not have a massage.

As with any bodywork, don't be reluctant to tell your therapist if he is exerting too much or too little pressure, if the pressure feels too painful, or if there are any areas he should avoid.

Also, discuss any conditions you have with your massage therapist, who can recommend the best types of massage for you.

Upper and Mid Back Pain

Pain in the upper or mid back can come from trigger points in the muscles of the back itself, or it can come from muscles in other places. Here are a few examples: Trigger points in the scalene muscles of the front and side of your neck can generate a constant irritating ache between your shoulder blades in your upper back. A trigger point in the serratus anterior muscle under your arm can cause a persistent middle backache at the lower tip of your shoulder blade.

Trigger points in the upper part of your rectus abdominis (stomach) muscle can be responsible for a band of pain across your mid back. No kind of therapy applied to the back itself will relieve these kinds of pain.

Spinal Problems

Even when back pain is due to genuine problems in your spine, trigger points may still be causing a major part of your pain.

Doctors Janet Travell and David Simons, the foremost authorities on Myofascial pain, believe that trigger points may actually be the root cause of many genuine spinal problems, such as a prolapsed or herniated disc, because of the muscle tension they maintain. Trigger points keep muscles shortened and tight. This can be the ultimate source of disk compression and spinal nerve impingement.

Misdiagnosis of Back Pain

X-ray evidence of arthritis or compressed disks is often used to justify surgery for back pain, although, as Doctors Travell and Simons point out, it's not uncommon to find such abnormalities in people who never suffer back pain. In other words, you may indeed have spinal arthritis or a compressed disk, or apparent symptoms of lumbar or cervical spinal stenosis, but trigger points in overworked muscles can still be the actual cause of the problem.

Failed Back Syndrome

Pain from Myofascial trigger points that remains after surgery can be greatly mystifying and frustrating to both doctor and patient. It’s disturbing to think that trigger points may have been the only thing needing treatment in the first place.

Hidden Risks in Physical Therapy

Physical therapy for back pain in the form of exercise and stretching can irritate trigger points and make them worse, as thousands of patients can attest. Exercising in an attempt to strengthen the abdominal muscles can be especially risky when unsuspected abdominal trigger points are the hidden source of your back pain. Exercise and stretching are valuable and effective forms of therapy but can actually worsen back problems for many people unless their trigger points are first deactivated.

Natural Backache Remedy

Trigger points should be at the top of the list during any examination for back pain. When healthcare practitioners have had adequate training and experience, trigger points are easy to locate and treat. In fact, there are ways to treat them yourself.

Self-applied trigger point massage is an appropriate and unusually effective remedy for back pain, because it goes to the source of the problem. It's only a matter of knowing where to look for the right trigger points and knowing the right techniques to use. Deactivation of trigger points stops the pain and allows the muscles to lengthen naturally, thereby relieving strain on the spine.

Back problems are often misdiagnosed. Your pain may have nothing to do with your spine. There is a good chance it may be nothing more serious than referred pain from Myofascial trigger points (tiny contraction knots) in your back muscles, or even in muscles some distance away.

Pain in your low back, for example, can be referred from trigger points in a number of muscles, such as the gluteus medius in your buttocks
and self-treatment of lower back pain with massage of the gluteus medius and maximus muscles using a tennis ball or lacrosse ball against a wall.

Common Causes of Back Pain

• Trauma: Injury to the lower back from a physical source e.g. sports injury, slipping on a wet surface, motor vehicle accident, a repetitive strain injury, twisting or turning, or lifting a heavy object.
• Repetitive Strain Injury: Results from activities requiring excessive muscle force at a high rate of repetition, or from maintaining fixed, awkward positions for long periods.
• Poor Posture: Excessive bend is the most common cause of low back pain. Some common causes are pregnancy, slouching and wearing high-heeled shoes.
• Tension: The muscles in the lower back may be tight from stress. This tightness reduces flexibility and makes individuals more susceptible to low back injury and pain.

Signs and Symptoms

There are three types of low back pain:

• Acute low back pain appears suddenly and sufferers experience intense pain and muscle spasms.
• Chronic low back pain strikes frequently and lasts for three months or longer.
• Recurrent low back pain hits the same area periodically and pain generally stems from an injury, poor posture or muscle tone.

Treatment

First, consult your physician for a comprehensive diagnosis. Your RMT will then evaluate the diagnosis and suggest a treatment plan for your specific condition. Treatments include a combination of Massage Therapy, posture correction, relaxation techniques and therapeutic exercises.

Helpful Tips

When standing, place a box or stool under one foot.

When sleeping, lie on your back on a firm mattress with a pillow underneath your knees, or sleep on your side with a pillow between your legs. Sleeping on your stomach bends the spine and forces the neck into an awkward position.

When sitting, sit straight back in chairs with lumbar support. If there is no lumbar support, place a pillow in the small of the back to keep a natural curve. Place your feet on the floor with thighs horizontal. Try lowering or raising your chair and place a stool under your feet for additional support.

What is chronic pain?

Chronic (long-term) pain is pain that lasts 3 to 6 months or longer. Usually, pain is your body's way of reacting to an injury or illness. Pain warns your body that something is wrong. But with chronic pain, caregivers may have trouble finding an exact reason for your pain. This makes chronic pain difficult for both you and caregivers to understand.

There are also many types of chronic pain. Everyone reacts to chronic pain in different ways. What you think is painful may not be painful to someone else. But, always remember your pain is whatever you say it is!

What causes chronic pain?

Chronic pain can be caused by many things like an old injury or chronic illness. Chronic illnesses are ones that have no cure and may get worse over time, such as multiple sclerosis. Moving a body part over and over in the same way can also cause chronic pain. Often, chronic pain is caused by more than one problem. This makes it even harder to treat. And sometimes, there is no clear cause for chronic pain. At lest 75 to 80 million people in the United States are believed to suffer chronic pain.

Chronic pain often falls into two groups:

• The first group of people have ongoing tissue damage like what happens with cancer, arthritis, or chronic diseases. Even typing at a keyboard in a bad position over time can cause damage and chronic pain.
• The second group has no "new" tissue damage. This kind of chronic pain can happen from an old back injury that never goes away. Or, it may develop all of the sudden with no clear reason. With chronic pain, you may not want to move the painful part of your body at all. But, you may also have pain because you are not moving this body part.

What is your chronic pain like? Caregivers want you to talk to them about your chronic pain. The more you can tell them about it the better. This may help them understand what causes it and how to treat it.

Keep a pain diary Sometimes it may be easier to answer caregiver's questions by making a pain diary or book. A pain diary or journal will help you remember exactly what happened each day because it is all written down. A diary also helps track pain cycles. This will help you be more aware of when pain is bad and how to make it better. A diary answers caregiver's questions about your pain over time.

Why is chronic pain control important? Chronic pain may affect many areas of your life. It can affect your appetite (ability or desire to eat), how well you sleep, your energy and your ability to do things. It can also affect your mood (how you feel about things) and your relationships with others. Chronic pain is complex, and sometimes it is hard to find its' cause. You may feel at times that it is impossible to get rid of your pain. This can cause a cycle of suffering, sleeplessness and sadness. If caregivers can help you control your pain, you will suffer less and enjoy life more.

Care The best way to decrease chronic pain is to treat the cause of the pain. Almost all types of pain, including cancer pain, can be controlled.

Successful pain management for chronic pain is more than just taking medicines. It may also include exercise, relaxation therapies and behaviour changes. Remember that there is no quick fix for chronic pain.

Because chronic pain is complicated, it may be hard to get your pain to go away completely. But, it is possible to lower your pain level so you can live and be comfortable doing everyday things. Work with your caregiver to find the pain control treatments that are best for you.

Exercise for back pain

Healing through back pain exercise Active forms of back pain exercise (physical therapy) are typically necessary to rehabilitate the spine and help alleviate back pain. Importantly, a regular back pain exercise routine provides patients with the means to help avoid recurrences of low back pain, and helps reduce severity and duration of potential future episodes of low back pain.

The natural stimulus for the back to heal is active back pain exercises, done in a controlled, gradual, and progressive manner. Movement distributes nutrients into the disc space and soft tissues in the spine to keep the discs, muscles, ligaments and joints healthy. And the converse is true too—lack of exercise can worsen back pain by leading to stiffness, weakness, and de-conditioning.

Generally, a patient’s back pain exercise program should encompass a combination of stretching exercises (such as hamstring stretching), strengthening exercises (such as dynamic lumbar stabilization exercise, or other back exercise programs) and low impact aerobics (such as walking, bicycling, water therapy or swimming). Depending the patient’s specific diagnosis and level of pain, the back pain exercise and rehabilitation program will be very different, so it is important for patients to speak to a therapist who is trained to develop an individualized exercise program provide instruction on using the correct form and technique.

Stretching as part of a back pain exercise routine Almost everyone can benefit from stretching the soft tissues—the muscles, ligaments and tendons—in the back and around the spine. The spinal column and its contiguous muscles, ligaments and tendons are all designed to move, and limitations in this motion can accentuate back pain. Patients with chronic back pain may find it takes weeks or months of stretching to mobilize the spine and soft tissues, but will find that meaningful and sustained relief of low back pain typically follows the increase in motion.