Massage Therapy for Carpal Tunnel Syndrome (CTS)

Studies have shown that Carpal Tunnel Syndrome (CTS) symptoms are lessened following massage therapy. In general, massage is believed to support healing, boost energy, reduce recovery time after an injury, ease pain, and enhance relaxation, mood, and well-being. When used for Carpal Tunnel Syndrome, massage may lead to a significant reduction in pain and symptoms, as well as improved grip strength. Massage therapy can help relieve pain from muscles in the arm or shoulder that may mimic Carpal Tunnel Syndrome.

How Can Massage Help Carpal Tunnel Syndrome (CTS)?

Massage therapy eases the symptoms of Carpal Tunnel Syndrome and increases grip strength, according to a recent study. The massage routine consisted of stroking with moderate pressure from the fingertips to the elbow. Improvements lasted for at least four weeks after treatment.

A simple, self-performed “wrist-wringing” technique may also help to ease congestion in the wrist and encourage fluid movement in the joints. To use the technique, a person clasps one wrist with the other hand and massages it in a circular movement. Avoid movements that are painful and exercise the hands and arms gently to stretch them.

Professional massage therapy techniques, such as Neuromuscular Therapy (NMT) and Myofascial Release (MFR), can ease pressure on the nerve from inflamed tendons within the carpal tunnel and excessive fluid in the wrist area.

Studies have shown that both general massage and Carpal Tunnel Syndrome-targeted massage treatment programs reduced Carpal Tunnel Syndrome. Gains in grip strength, however, were only noted with the Carpal Tunnel Syndrome-targeted massage.

Special Considerations When Using Massage for Carpal Tunnel Syndrome (CTS)

There are several important factors to note when considering massage for Carpal Tunnel Syndrome. Direct manipulation of the damaged nerve is highly detrimental and can easily cause other problems. Direct pressure on the carpal tunnel region should be applied rarely and always with great caution.

In addition to specific techniques that focus on the wrist flexors or the carpal-tunnel region, it is important to address all the regions of the upper extremity and the neck when treating Carpal Tunnel Syndrome. The median nerve may be compressed in a number of other locations, which could further irritate the nerve at the carpal tunnel.

In general, massage is considered relatively safe. Pain or other rare negative side effects are usually only caused by an extremely vigorous massage techniques.

What is Carpal Tunnel Syndrome (CTS)?

Carpal Tunnel Syndrome, also called Repetitive Strain Injury or Repetitive Stress Injury (RSI), is a condition caused by an obstructed nerve in the wrist, resulting in pain and numbness in the index and middle fingers and weakness of the thumb. The carpal tunnel receives its name from the eight bones in the wrist, called carpals. These bones form a tunnel through which the median nerve extends toward the hand. Tasks requiring highly repetitive and forceful movements of the wrist can cause swelling around the tendons, resulting in a pinched nerve and producing symptoms of Carpal Tunnel Syndrome.

Signs and Symptoms of Carpal Tunnel Syndrome (CTS) Include:

• Nighttime painful tingling in one or both hands, often disturbing sleep
• Daytime tingling in the hands, followed by a decreased ability to squeeze things
• Pain shooting from the hand up the arm as far as the shoulder
• A feeling of uselessness in the fingers
• A sense that fingers are swollen, even though little or no swelling is outwardly apparent
• Tingling and burning in the thumb and first three fingers
• Inability to perform simple manual tasks, such as picking up small objects
• Loss of strength in the thenar muscle at the base of the thumb near the palm

Who is at Risk for Carpal Tunnel Syndrome (CTS)?

People at risk for Carpal Tunnel Syndrome include those who work at the computer all day, cashiers, carpenters, gardeners, and mechanics. Carpal Tunnel Syndrome is associated with health conditions such as Lyme disease, pregnancy and menopause. People with back, neck or shoulder problems, such as a slipped disc, broken collar bone or neck injury, are more likely to develop Carpal Tunnel Syndrome. Conditions including thyroid problems, diabetes, obesity, and rheumatoid arthritis can increase the risk of Carpal Tunnel Syndrome. Although Carpal Tunnel Syndrome can develop at any age, it most commonly occurs in people between the ages of 40 and 60. Women are more likely than men to develop Carpal Tunnel Syndrome. Use of caffeine, tobacco, alcohol, and artificial sweeteners are also contributing risk factors.

More than half of all pregnant women develop symptoms of Carpal Tunnel Syndrome. Fortunately, the condition generally improves after childbirth.

Should Anyone Avoid Massage?

People with rheumatoid arthritis or skin lesions, such as eczema, should not receive massage therapy during flare-ups. Those with cancer should check with their doctors before considering massage because a treatment can further damage tissue already subjected to chemotherapy or radiation treatments. Experts also advise that people with osteoporosis, high fever, few blood platelets or white blood cells, or mental impairment, or those recovering from surgery, should avoid massage.

Women should be cautious when receiving full body massages during pregnancy. Pregnant women should consult a therapist specifically trained to perform massages on pregnant women.

Tell your massage therapist about any medications you are taking, as massage may influence the absorption or activity of both oral and topical medications.

Massage Therapy for Stress

It’s no wonder we often feel “stressed out” in this complex world. With rising gas prices, a competitive job market, and increasing pressures from work and family—all complicated by limited time to take a break and unwind—it can be hard to find a balance.

Among the many ways to successfully manage stress, massage therapy is a great way to relieve tension. The benefits of massage therapy are numerous, ranging from promoting relaxation to loosening tight muscles and increasing blood flow.

How Can Massage Therapy Help Manage Stress?

Just taking a break from your hurried routine by to see a massage therapist can help you reduce stress, and once you arrive at the massage appointment, you’ll obtain even greater benefits. Massage can help you manage stress by relieving anxiety and tension, promoting relaxation, increasing your energy, improving sleep, reducing muscle soreness, and decreasing pain.

Therapeutic massage, such as Swedish massage, is the massage technique most often performed to relieve stress. Swedish massage techniques involve gentle kneading pressure and long strokes applied to the surface to relieve tension in the muscles and connective tissues. Therapeutic massage often involves aromatherapy in the form of massage oil or candles, and the pleasant fragrance can also contribute to stress relief during your massage therapy session.

A combination of massage techniques can also be helpful in managing stress. Other massage techniques that can help relieve stress include deep-tissue massage to release tension from the deeper muscles and connective tissues, trigger point therapy to release muscle spasms from specific areas, and shiatsu to improve the flow of energy (“Qi” or “Ki”) in the body by applying firm pressure to specific acupressure points.

What is Stress?

Stress is your body’s natural response to the demands of life. Stress helps you face challenges and “stay on top of your game.” Stress can be the result of environmental, physical or emotional factors. Although stress is a natural, and necessary, part of everyday life, prolonged or chronic stress can lead to damaging health effects, including psychological and emotional disorders, as well as the development of diseases such as cardiovascular disease.

What is Massage?

Massage is a manual therapy that uses hands-on manipulation of the muscles and other soft tissues to relieve muscle tension and reduce stress. Although massage affects the whole body, it is especially therapeutic for the musculoskeletal, circulatory, lymphatic, and nervous systems.

Helpful Tips for Managing Stress

While massage can help reduce stress and tension, it is only one of several useful tools to help manage your health, and it shouldn’t take the place of standard medical treatment recommended by your doctor.

Here are other ways you can manage your stress:

• Practice relaxation techniques: In addition to massage, deep breathing, meditation, guided imagery, yoga, Qi Gong, Tai Chi, and a variety of other relaxation techniques can help reduce stress and tension by producing a calming effect on the body and mind.

• Make positive cognitive and behavioral changes: Review your attitudes and beliefs, adjust your expectations, set realistic goals, and mentally rehearse before potentially difficult confrontations to help manage your stress. In addition, share your expectations assertively with others and communicate openly about your feelings.

• Don’t rely on unhealthy coping habits: Smoking, excessive drinking, and overeating are not the answers for managing stress. These are unhealthy coping habits that can actually escalate the negative effects of stress.

• Exercise regularly: Among numerous other health benefits, regular exercise can help you relieve stress.

• Get organized: Stress can often be the result of disorganization. Set goals, make lists, and purge unnecessary clutter to help you get back on track.

• Seek an experienced certified massage therapist for treatment: A certified massage therapist can make recommendations for the type of massage techniques that are right for you.

Massage Therapy for Frozen Shoulder

If you’ve been having trouble lifting your arm over your head because your shoulder is too stiff or painful, you may have a condition called adhesive capsulitis, commonly known as “frozen shoulder.”

Frozen shoulder is a general term used to describe a restricted range of motion or stiffness in the shoulder. Adhesive capsulitis is a specific condition characterized by a gradual onset of stiffness and pain in one shoulder caused by inflammation and tightening of the joint capsule (ligaments that attach the shoulder bones). Often, the terms frozen shoulder and adhesive capsulitis are used interchangeably.

Regular massage treatments can help manage shoulder pain and loosen stiff shoulder muscles. The standard treatment for frozen shoulder also includes regular physical therapy, home exercises, heat therapy, nonsteroidal anti-inflammatory medications (NSAIDs) and steroid injections. Prompt treatment aids recovery, although it may take from 12 to 18 months to nearly or fully restore range of motion. Conservative treatments are generally successful in treating frozen shoulder, although in some cases surgery may be needed to release the contracted joint capsule in the shoulder.

How Can Massage Therapy Help with Frozen Shoulder?

Massage therapy is a helpful treatment for frozen shoulder because it increases blood flow to the injured area and helps to reduce scar tissue. Regular massage treatments are needed to reduce muscle stiffness, and you may not start to feel relief until after several massage treatments.

A combination of techniques, performed by an experienced massage therapist, will provide shoulder pain relief and help your recovery during the “thawing,” or recovery stage of the condition. Deep-tissue massage is a common technique used to treat frozen shoulder. With this technique, the therapist applies steady pressure to the muscles to release adhesions or scar tissue that may be contributing to shoulder pain. A Japanese form of deep-tissue massage, called shiatsu, involves deep pressure on specific areas of the body, called acupressure points, to adjust energy flow (“Ki” in Japanese) through the body, thereby reducing pain. Deep-tissue massage techniques should be avoided during times of acute shoulder pain, inflammation, or swelling.

Other massage techniques for frozen shoulder include trigger point therapy, in which steady pressure is applied to targeted points within muscles to relieve muscle spasms, and Swedish massage, which involves gentle kneading and long strokes applied to surface muscle tissues to reduce stress and tension.

Heat therapy, applied immediately before or after massage, is also very beneficial in treating frozen shoulder.

What is Massage Therapy?

Massage is a manual therapy that uses hands-on manipulation of the muscles and other soft tissues to relieve muscle tension and reduce stress. Although massage treats the whole body, it is especially therapeutic for the musculoskeletal, circulatory, lymphatic, and nervous systems.

What Causes Frozen Shoulder?

Frozen shoulder most commonly affects people from 40 to 60 years old and typically affects one shoulder, but can also develop in both shoulders. Frozen shoulder can occur after a fall or motor vehicle accident or may be related to an underlying condition, such as arthritis, a shoulder injury, rotator cuff tendonitis, or resulting from shoulder surgery. The use of a sling, splint, or cast may cause joint stiffness and contribute to frozen shoulder due to limited use and immobility. Diabetes increases the risk of developing frozen shoulder. Often there is no known underlying cause for frozen shoulder.

A gradual onset of pain is the initial symptom of frozen shoulder (phase one or the “freezing” stage), which leads the person into developing stiffness due to lack of movement (second phase of the condition or the “frozen” stage). Although pain decreases gradually in the second phase, stiffness remains. The “thawing,” or third phase of the condition, occurs when shoulder function and range of motion gradually improve and the pain subsides.

If you develop shoulder pain that limits range of motion for an extended period of time, your doctor should perform a thorough medical examination. X-rays and MRIs can help your doctor rule out arthritis or other underlying conditions and plan the best course of treatment. Arthroscopy (also called arthroscopic surgery), a type of minimally invasive procedure in which a contrast material is injected into the joint space, also may be used to allow the physician to examine the extent of scarring or inflammation.

It is important to seek immediate medical attention if your shoulder pain is severe or if fever, dizziness, weakness, or any unusual symptoms occur along with shoulder pain.

Helpful Tips for Shoulder Pain

• Perform the stretching and strengthening exercises recommended by your doctor or physical therapist: If you are experiencing shoulder pain, don’t stop moving your shoulder completely; continue to perform gentle exercises to maintain your mobility, as advised. Resting the injured area for prolonged periods may increase muscle stiffness and reduce range of motion.

• Warm up properly before any activity, and don’t neglect your “good” shoulder —exercising both shoulders is equally important: A physical therapist can recommend specific stretching and strengthening exercises to loosen the shoulder joint, decrease your pain, and help speed your recovery.

• Seek treatment from an experienced therapist: A specially trained physical therapist or a certified massage therapist who has experience treating frozen shoulder and other shoulder conditions should provide treatment so you can achieve maximum benefits.

Trigger Point Massage Therapy

The more stressed out and overworked you become, the more knots can be found in the muscles of your body. Sometimes, focal points of tenderness can be found, but in other cases, it seems that the pain covers a larger area of your body. Relaxing massage on the uncomfortable area may not be able to help the pain go away. One possible way to manage this constant pain is Trigger Point Massage Therapy.

What is Trigger Point Therapy Massage?

Trigger Point Massage Therapy, also known as Myofascial Trigger Point Therapy, is a form of physical manipulation used to relieve muscle skeletal pain caused by muscle spasm. Trigger points, the focal source of the muscle contraction, received their name from the twitch response that arises when they are pressed: a distinct, sharp, radiating pain. By discovering and dissolving these trigger points, you can release muscles from a dysfunctional state and relieve your pain.

Trigger Point Therapy was created by Janet G. Travell, MD, an innovative doctor who served as personal physician to Presidents John F. Kennedy and Lyndon Baines Johnson. With the help of David Simons, M.D., a U.S. Air Force flight surgeon, Travell wrote the text: "Myofascial Pain and Dysfunction: The Trigger Point Manual.”

What is a Trigger Point?

Trigger points are areas in muscle tissue that have developed tender spots in taut bands of muscle. Often, we refer to trigger points as “knots” in our muscles. Trigger points are muscle cells that are locked in a contracted state, which can restrict range of motion, create muscle weakness, and create pain. Trigger Points develop due to poor posture or some other form of repetitive stress on the muscle. When these particular cells within a muscle are in spasm, there is limited blood flow through the area, leading to a build up of metabolic waste and a lack of fresh oxygen and nutrients. To release these trigger points, we need to “reset” these cells and allow the proper exchange of blood through the area.

Trigger points commonly occur either in the belly of muscles where the main nerves innervate or at the attachments of muscles. There are two main types of trigger points: active trigger points and latent trigger points. Active trigger points are in a state of constantly producing pain. Latent trigger points posses the same stiffness, restricted motion, and twitch response of active trigger points, but do not cause any pain. However, latent trigger points can easily be reactivated by strain or overuse of a muscle, leading to pain and discomfort.

Trigger points are primarily diagnosed through their characteristic twitch response, which creates a sensation of referred pain to areas called pain reference zones. Within these pain reference zones, satellite trigger points can develop due the increased stress on these muscles. The pain reference zones were fully mapped out by Dr. Janet Travell’s work and follow consistent patterns. An understanding of these zones is necessary to treat the pain effectively, as treating only “local” satellite trigger points will not permanently resolve the pain.

To relieve a trigger point, the practitioner will determine its exact location through palpation of the muscle, and then apply direct continuous pressure to the trigger point for approximately 10 seconds. While the pressing upon the trigger point can be rather uncomfortable, the relief provided by the subsequent relaxation of the muscle will be significant. It is common to perform this technique on a trigger point several times during a treatment session, as well as treating other trigger points that may work in conjunction to create the pain pattern you are experiencing.

Benefits of Trigger Point Therapy Massage

• Trigger Point Therapy Massage can help relieve your muscular pain and stiffness: By balancing the muscles of your body, we can increase your muscle strength and range of motion, leading to an improvement in your posture.
• Prevent latent trigger points from becoming active trigger points: Studies show that almost everyone has some trigger points that have developed in their muscles. Even if you are not experiencing pain, treating these trigger points can help your muscular functioning.
• Clear trigger points to increase your muscular functioning: Trigger points prevent muscles from contracting correctly, making them seem weak. By clearing our trigger points, we can return the full ability to our muscle to provide strength, balance, and faster recovery from exercise.
• Improve the health of your muscular system: Healthy muscles are soft and relaxed allowing proper flow of blood and nutrients. When you develop trigger points in your muscles, they become tight and tender to pressure.

Massage Therapy for Neck Pain

Neck pain is one of the most common reasons patients seek medical treatment. In fact, the lifetime prevalence of a significant neck pain episode ranges from 40 to 70 percent. But you don't have to let your neck pain become a constant problem: regular massage treatments can help you manage pain, especially if you are suffering from neck pain long after a neck injury has occurred.

Neck pain often occurs with back pain, and the symptoms are similar. Symptoms of neck pain may include spasm, stiffness, muscle discomfort, limitation of movement and headaches. Neck pain can occur suddenly (acute) or be constant (chronic); an acute injury can lead to chronic pain and loss of range of motion, if left untreated. Massage is a noninvasive alternative to prescription medication commonly used for treating neck pain. Massage is a manual therapy that uses hands-on manipulation of the muscles and other soft tissues to relieve muscle tension and reduce stress. Although massage affects the whole body, it is especially therapeutic for the musculoskeletal, circulatory, lymphatic and nervous systems.

How Can Massage Help Neck Pain?

A combination of techniques, performed by an experienced massage therapist, will provide pain relief and help your recovery. Several types of massage that have been shown to provide neck pain relief including Swedish Massage, Deep Tissue Massage, Trigger Point Therapy, and Shiatsu.

Swedish Massage

Swedish massage is the term used to describe a variety of therapeutic massage techniques that help release tension with applied pressure to the surface muscles. This type of massage may be helpful in reducing emotional stress and tension that may add to your neck pain.

Deep Tissue Massage

Deep tissue massage may be performed with Swedish massage to release tension from the deeper muscles and connective tissues in the neck and upper back. With deep tissue massage, the applied pressure is harder, more intense, and focused on releasing adhesions (“knots”) or scar tissue that may be causing your neck pain.

Trigger Point Therapy

Trigger point therapy uses steady pressure to release neck muscle spasms and promote blood flow to the area to aid healing. Specific points or knots in muscles are located and released that often are the source of referred pain from the shoulder and back to your neck.

Shiatsu

Shiatsu is a form of Japanese massage in which the practitioner uses his or her body weight to gradually press acupressure points. By palpating, or feeling, the network of vessels through which your energy flows (meridians), the Shiatsu practitioner will be able to feel and simultaneously adjust the flow of energy ("Ki") in your body.

Recovery From Neck Pain

The length of recovery from neck pain depends on the severity of your injury as well as your age, health, and history of prior neck injury. Several massage treatment sessions may be needed before you achieve relief. Your massage therapist can recommend the frequency of massage sessions to best treat your condition.

A massage therapist can teach you how to massage your own neck to reduce muscle stiffness and increase range of motion. The effects of massage tend to be longer-lasting when massage is performed multiple times each day. Do not perform deep muscle massage in areas that are painful, swollen or inflamed as this could lead to injury.

What Causes Neck Pain?

It is a common misconception that neck pain is related to abnormal cervical spine curvature. However, the most common causes of neck pain are sprain (injury to the ligaments of the spine) and strain (injury to the spinal muscles). Neck sprain may occur after a neck injury that causes forcible stretching or tearing of the soft tissues of the neck, such as a contact sports injury or whiplash from a motor vehicle accident. Neck strain may also occur as the result of postural or repetitive stress (overuse), often related to sleep position or poor standing and sitting posture. Ongoing pain related to neck sprains and strains occurs as a result of soft tissue inflammation and swelling.

Other causes of neck pain include pinched nerves or a variety of structural or degenerative spinal disorders such as a herniated disc and cervical spondylosis (osteoarthritis). Neck pain may also be associated with dental disorders or rotator cuff injuries (muscles of the shoulder).

If you have chronic neck pain, your doctor should perform a thorough medical examination to rule out serious structural or physiological spinal disorders. X-rays and MRIs can help your doctor identify the source of your pain and plan the best course of treatment. It is important to seek immediate medical attention if your neck pain is severe or if fever, dizziness, weakness or any unusual symptoms occur along with neck pain.

How to Prevent Neck Pain

The tips below can help you avoid neck pain and accelerate healing of your condition.

Maintain good posture.

Try to always maintain a natural aligned spinal position when sitting, standing and walking. Consider a lumbar support cushion for your car seat or desk chair. If your job requires repetitive tasks such as holding a telephone between your shoulder and ear, or if you are frequently in the same position while you work, such as sitting at the computer, take breaks and stretch your neck muscles. Also, make sure your neck is properly positioned during sleep: Avoid positions that abnormally flex your neck. Often, a worn pillow or mattress can lead to neck pain. Cervical pillows are available to provide proper neck support.

Exercise regularly and practice neck-strengthening exercises.

Regular exercise is helpful to improve posture. A physical therapist can recommend specific stretching and strengthening exercises to decrease your neck pain and prevent it from coming back. When performed correctly, yoga can be an excellent method to both stretch and strengthen your body.

Seek an experienced, certified massage therapist for treatment.

There are many types of massage that can help relieve neck pain, but it is important to seek treatment from a certified massage therapist who can assess your condition and recommend the massage techniques that are right for you.

Massage Therapy for TMJ Disorder

TMJ Disorder or Syndrome is a term often used to describe temporomandibular disorders (TMD), which occur as a result of problems with the jaw, jaw joint and surrounding facial muscles that control chewing and moving the jaw. The temporomandibular joint (TMJ) is the hinge joint that connects the lower jaw, or mandible, to the temporal bone of the skull. This bone is located immediately in front of the ear on each side of the head. When healthy, the joints are flexible, allowing the jaw to move smoothly up and down and side to side, also enabling one to talk, chew, and yawn. Muscles attached to and surrounding the jaw joint control the position and movement of the jaw. For the purposes of this article, the term TMD will be used to describe the disorder, and TMJ will be used to describe the actual joint.

People with temporomandibular joint disorder (TMD) experience severe pain and discomfort that can be temporary, or it may last for many years. More women than men experience TMD and this disorder is seen most commonly in people between the ages of 20 and 40.

Massage therapy is a time-honored modality, dating back thousands of years and practiced the world over. It has been proven to help alleviate a variety of medical conditions, including temporomandibular joint disorder (TMD).

What Causes Temporomandibular joint disorder (TMD)?

Asymmetry of the muscles of mastication (chewing), forward head posture, tightness of the back of the neck, and multiple myofascial trigger points can cause or are the result of temporomandibular joint disorder (TMD) problems. Injury to the jaw, temporomandibular joint (TMJ), or muscles of the head and neck – such as from a heavy blow or whiplash – can cause TMD. Also, grinding or clenching the teeth puts a lot of pressure on the TMJ. Additionally, the jaw is a ball and socket joint, and dislocation of the soft cushion or disk between the ball and socket can result in TMD. Those experiencing the wear and tear of osteoarthritis or the inflammation of rheumatoid arthritis in the TMJ can develop temporomandibular joint disorder (TMD). Finally, TMD can result from stress, which can cause a person to tighten facial and jaw muscles or clench the teeth.

What Are the Symptoms of Temporomandibular joint disorder (TMD)?

There are several indicators that one is experiencing temporomandibular joint disorder (TMD), including:

• Pain or tenderness in the face, jaw joint area, neck and shoulders, and in or around the ear when chewing, speaking, or opening the mouth wide
• Limited ability to open the mouth very wide
• Jaws that get "stuck" or "locked" in the open- or closed-mouth position
• Clicking, popping, or grating sounds in the jaw joint when opening or closing the mouth (which may or may not be accompanied by pain)
• A tired feeling in the face
• Difficulty chewing or a sudden uncomfortable bite – as if the upper and lower teeth are not fitting together properly
• Swelling on the side of the face

Other common symptoms include toothaches, headaches, neck pain, dizziness, as well as earaches and hearing problems.

What Happens at a Massage Therapy Session for Temporomandibular Joint Disorder (TMD)?

In treating temporomandibular joint disorder (TMD), the massage therapist should focus treatment on the reduction of tension in the masticatory (chewing) muscles, eliminating trigger points—the hyperirritable “knots” felt in the muscle that refer pain elsewhere—and releasing tension in the fascia around the jaw area. Fascia is the tough, densely woven connective tissue that surrounds every muscle, bone, nerve, blood vessel and organ of the body, much like shrink-wrap. When treating jaw pain, it is beneficial for a therapist to have experience in the following techniques:

• Swedish Massage – This is the most common and best-known massage modality. It has a number of benefits; a primary one being that of relaxation. Facilitating relaxation through a full-body Swedish massage can have a major impact in reducing jaw tension, as stress contributes greatly to TMJ disorders.

• Neuromuscular Therapy – This therapy involves the therapist applying pressure to trigger points in the jaw muscles to help relieve tension and return muscles to a relaxed state.

• Cranial-Sacral Therapy – This modality focuses on gently working with the spine, the skull and its cranial sutures, diaphragms, and fascia to ease the restrictions of nerve passages, to optimize movement of cranial sacral fluid through the spinal cord, and to restore misaligned bones to their proper position. It has been proven to provide great relief for temporomandibular joint disorder (TMD).

• Post-Isometric Relaxation – With this technique, the therapist can restore the decreased range of motion that is usually found with TMD disorders through a systematic process of stretching and providing resistance.

• Acupressure – Using this Traditional Chinese Medicine technique, the therapist massages the meridians, or energy channels, that surround the jaw in order to increase circulation and provide relief for temporomandibular joint disorder (TMD).

What is Massage?

Massage is the manual or mechanical manipulation of the muscles and other soft tissue of the body. The term massage therapy covers a group of practices and techniques. In fact, there are over eighty types of massage therapy. In all of them, therapists press, rub, and otherwise manipulate the muscles and other soft tissues of the body, often varying pressure and movement. Usually the intent is to relax the soft tissues, increase delivery of blood and oxygen to the massaged areas, warm them, and decrease pain.

Is Massage Therapy Safe?

Massage therapy is a proven modality that has existed for thousands of years. It appears to have few serious risks if appropriate cautions are followed. A very small number of serious injuries have been reported, and they appear to have occurred mostly because cautions were not followed or massage treatment was given by a person who was not properly trained. Side effects of massage include temporary pain or discomfort, swelling, or bruising, when working deeply within the muscle tissue.

Massage Therapy for Arthritis

Although massage therapy cannot cure or stop the progression of arthritis, it can ease the symptoms associated with inflammation and help improve your quality of life. While the cartilage damage of arthritis cannot be reversed, massage is helpful in reducing muscle spasms and decreasing compression associated with the arthritic joint disorder.

How Can Massage Therapy Help Ease Arthritis?

Massage therapy involves working soft body tissues with the hands or with an instrument. When practiced correctly, massage therapy can help improve joint movement, relax tense muscles and stimulate the flow of both blood and nutrients to the skin and tissue underneath. Patients report it feels good and breaks the cycle of stress that often comes with chronic illnesses, such as arthritis.

The benefits of massage include:

• Increased circulation
• Increased flexibility and mobility
• Decreased pain and inflammation
• Relief of muscle aches and stiffness
• An overall sense of relaxation and wellness

A variety of massage styles can help decrease arthritis pain. Swedish massage therapy is the most relaxing and is used to stimulate blood flow to the skin and relax the muscles. Deep-tissue massage therapy can decrease pain and improve movement in specific muscles and joints. Reflexology involves applying deep pressure to points on the feet that correspond to specific areas of the body. During an acute flare-up of arthritis, reflexology is often recommended because painful joints are not touched directly, and pain and symptoms can be relieved from this distal treatment.

Can Massage Therapy Help Arthritis?

Recent studies have found that massage therapy seems to be helpful in the treatment of osteoarthritis (OA) of the knee, and also effective for chronic hand arthritis.
During a four-week study, patients with chronic hand arthritis who received regular massage therapy experienced less anxiety and pain, along with improved mood and greater grip strength. Overall, the massage therapy group showed greater improvement than did the standard treatment group on all measures.

What Happens During a Massage Therapy Session?

A massage therapy session can last from 15 - 90 minutes and can include a schedule of follow-up visits, depending on the severity of your situation. At your first massage therapy session, the practitioner should ask you about any symptoms you may have (like painful joints) and will also ask questions about your medical history. The practitioner will also discuss your expectations regarding massage therapy.

Swedish Massage Therapy is the most common type of massage therapy in the United States. Swedish massage therapists use long smooth strokes, kneading, and circular movements on superficial layers of muscle using massage lotion or oil. This type of massage can be very gentle and relaxing, which may ease arthritis pain.

Massage should be avoided when joints are especially tender or inflamed, since a treatment can actually worsen the symptoms at such times. Your massage therapist should be informed of your condition and use gentle techniques.

What is Arthritis?

Healthy cartilage on the joints between bones allows the bones to glide smoothly within the joints and helps to cushion the stress of physical movement. In a person with arthritis, bones may not glide as smoothly and joints may be painfully inflamed. Symptoms of arthritis can include pain, stiffness, redness, swelling, heat, and limited range of movement.

There are more than 100 different forms of arthritis. Two of the most common conditions are osteoarthritis (OA) and rheumatoid arthritis (RA).
Osteoarthritis (OA), the most common type, is mainly seen in older adults. In OA, joints are damaged as cartilage, the material that surrounds joints, wears down, causing inflammation. The disease can become disabling. Osteoarthritis often affects the knees, making it hard to walk. Other commonly affected areas include the hips, fingers and spine. The wrists, elbows, shoulders, and ankles can also be involved when there is a prior injury or weakness from repetitive strain.

Rheumatoid arthritis (RA) is an autoimmune disease, in which the immune system attacks parts of the body, resulting in inflammation. The most commonly affected areas include the hands and feet, although RA can also affect the elbows, shoulders, neck, jaw, ankles, knees, and hips. As with Osteoarthritis, cartilage is broken down and worn away by Rheumatoid arthritis, causing bones to rub together. Patients with RA also have joint swelling, pain, and stiffness.

Are There any Risks Associated with Massage?

Massage is considered a generally safe procedure. Pain or other negative side effects are usually caused by overly vigorous massage techniques. Diabetics should check blood sugar levels after a massage session because it may be too low afterward.

Tell your therapist to stop if you feel any pain. Massage should not be performed on any joint that is currently swollen or painful.
Massage may influence absorption or activity of both oral and topical medications. Tell your massage therapist about any medications you are taking.

Possible side effects of massage therapy may include:

• Temporary pain or discomfort
• Bruising
• Swelling
• A sensitivity or allergy to massage oils

Massage for Tendinitis

Tendinitis (also spelled tendonitis) is the painful inflammation of a tendon (fibrous tissue that connects muscle to bone) that often occurs as the result of a repetitive strain or a muscular overuse injury. Massage is a type of manual therapy that can help relieve the pain associated with tendinitis and improve overall function by manipulating the affected area to reduce excessive tension in the connective tissue and muscles, and promote healing.

How Can Massage Help Relieve Tendinitis?

Treatments for tendinitis are intended to heal the injured tendon. Restricted activity, rest, anti-inflammatory medications, elevation, compression, and splinting are the first lines of treatment for tendinitis. Massage for tendinitis may help relieve excessive tension and help prevent the buildup of scar tissue via hands-on manipulation of the affected area. Icing may be done before and after massage to provide optimal relief.

Massage should not be given during the acute stage of a tendinitis injury (which is typically the first 48 hours after injury) and should not be performed when tissues are swollen or visibly inflamed.

Studies have suggested that deep transverse friction massage (also called Cyriax massage) is the type of massage that is most beneficial for treating tendinitis. With this technique, the fingers use short, abrupt, sweeping back-and-forth motions to move the skin but do not slide over it. The goal of transverse massage is to move across a ligament or tendon to mobilize it as much as possible. Transverse massage, when performed before active exercise, can help reduce the pain associated with tendinitis and restore mobility. Transverse massage is generally thought to be safe and effective for treatment of tendinitis, though larger studies are needed to conclusively determine the exact benefits of transverse friction massage for tendinitis.

The Active Release Technique is a patented soft tissue management treatment that reduces adhesions and scar tissue that may form as the result of tendinitis. This muscle manipulation massage technique is used to treat problems that occur with tendons, as well as muscles, ligaments, fascia, and nerves. This specific massage technique combines precisely directed tension by the practitioner with very specific active movements by the patient to release the contacted tissue. Treatments take about eight to 15 minutes for each area being treated and two to ten visits may be needed before full functionality is restored.

What is Tendinitis?

Tendinitis is the pain and tenderness that occur just outside of a joint as the result of inflammation or irritation of a tendon. Tendinitis commonly affects the shoulder (rotator cuff tendinitis), elbow (tennis elbow or golfer's elbow), wrist and thumb (de Quervain's disease), hip (iliotibial band tendinitis), knee (runner’s knee or peripatellar tendinitis), and lower calf or ankle (Achilles tendinitis). People with a chronic medical condition such as diabetes may have calcific tendinitis, a buildup of calcium deposits in the joint.

Acute (sudden onset) tendinitis may lead to chronic (long-term) tendinitis (called tendinosis or tendinopathy) if the person does not adequately rest the joint or if the person keeps using the joint while experiencing symptoms.

What Causes Tendinitis?

Repetitive strain injury (also called overuse injury) is the most common cause of tendinitis and may occur more commonly with certain occupations or sports (such as baseball, golf or tennis). It may also be associated with an inflammatory condition, such as rheumatoid arthritis, or may occur as the result of an acute injury, such as an excessive muscle stretch.

How Can Tendinitis be Prevented?

Stretching before and after an activity, cross-training, and avoiding activities that cause excessive stress on the tendons for long periods can help prevent or reduce the risk of tendinitis. Physical therapy that includes range-of-motion exercises as well as flexibility and strengthening exercises also may help reduce the risk of recurring tendinitis.

Osteopathy for Back Pain

Osteopathy treats back pain with a combination of conventional medical treatments and spinal manipulation. Osteopathic manipulation techniques (OMTs) are particularly well suited for treating common causes of back pain.

Osteopathic manipulation techniques (OMTs) for back pain are often used in combination with:

• Pain medications
• Muscle relaxants
• Spinal injections with steroids, morphine or other agents
• Electrical stimulation of the spinal cord
• Surgery to repair damaged muscle or tissue

What types of back pain are treated with Osteopathy?

At least 80 percent of people in the industrialized world suffer from occasional back pain and an estimated 50 million Americans endure chronic back pain. Back injuries account for 33 percent of all disability costs in the United States and acute low back pain is the most common cause of disability in people under age 45. Low back pain is also one of the most common reasons for visits to osteopathic physicians (Doctors of Osteopathy, DO).

Nearly half of all visits to primary-care physicians and specialists for low back pain involve spinal manipulation by osteopaths or chiropractors. In addition to treating acute low back pain, osteopathy can be effective for treating back pain resulting from strains, sprains, and other injuries, and conditions such as scoliosis—a sideways curvature of the spine.

How Does Osteopathy Treat Back Pain?

Using their hands, osteopaths examine the back and other parts of the body to identify sources of pain and restricted movement that may indicate injury or impaired function.

Osteopathy aims to relieve back pain by:

• Stretching the muscles and supporting ligaments of the back
• Relaxing muscle spasms
• Restoring normal mechanics to the vertebrae of the back
• Promoting free movement of the musculo-skeletal system
• Improving blood flow and drainage

An osteopath may also advise a patient on techniques for avoiding and relieving back pain, including:

• Proper posture
• Exercise and stretching
• Diet
• Stress management
• Proper lifting techniques
• Workplace ergonomics

What Osteopathic Manipulation Techniques (OMTs) Are Used For Back Pain?

Most back pain originates in the muscles, ligaments, or joints of the back. Direct osteopathic manipulation techniques (OMTs) move the tight or painful tissues toward the area of tightness or restricted movement. Indirect OMTs move the tissue away from the area of restricted movement. The tissue is held there until the muscle relaxes. Most OMTs for back pain take 2-6 minutes to perform.

A high-velocity low-amplitude (HVLA) thrust is the most common osteopathic manipulation for back pain. It is commonly performed to correct misalignment in the spine by decompressing the joints of the spinal vertebrae. After identifying the dysfunctional vertebrae, the osteopath locks the facet joints. These are the hinges that join the vertebrae together at the back of the spine and allow the spinal column to move. By locking them, the osteopath prevents any spinal movement other than that of the affected vertebrae. A quick, short, sharp thrust is directed at the involved vertebrae in the direction of the restricted movement. Indirect HVLA is delivered through the locked vertebral column. A direct or short-lever high-velocity low-amplitude (HVLA) thrust is delivered directly to the affected vertebrae.

Osteopathy treatment for back pain may include:

• Massage
• Gentle release techniques
• Soft tissue techniques that apply rhythmic stretching, deep pressure and traction to the muscles around the spine to promote elasticity and motion
• Myofascial release techniques that apply sustained pressure to tight muscles and connective tissue to eliminate pain and restore motion
• Muscle energy techniques that involve the patient in actively stretching and relaxing muscles against a counterforce applied by the osteopath
• Articulation or repetitive oscillatory movements to stretch connective tissue around a restricted joint and improve range-of-motion
• Rhythmic, passive joint mobilization--slow movements within or at the limit of the joint’s range-of-motion
• Joint manipulation - high-velocity thrusts to a joint, moving it beyond its restricted range-of-motion
• Counterstrain techniques for acute injuries, in which the patient is moved away from the restricted position toward one of greater comfort

Is Osteopathy Safe?

Serious complications from osteopathy for back pain are rare. Osteopathic manipulation techniques (OMTs) occasionally result in a temporary increase in pain or soreness that usually disappears within one day. Although direct techniques are usually more effective at eliminating pain than indirect manipulations, they do have a greater potential for complications.

Osteopathic manipulations should not be used on patients with:

• Broken or dislocated bones
• Damaged ligaments
• Bone or joint infection
• Spinal fusion
• Bone cancer
• Osteoporosis

Osteopathy is usually not recommended for patients who have undergone recent joint surgery or are taking blood-thinning medications such as aspirin or warfarin (Coumadin).

Is Osteopathy Effective For Back Pain?

Osteopathic manipulation techniques (OMTs) for back pain are believed to work by:

• Reducing bulging discs--the elastic structures between the vertebrae—and correcting the internal displacement of disc fragments
• Freeing adhesions around a prolapsed disk
• Inhibiting transmission of nerve impulses
• Relaxing tense muscles by sudden stretching

The clinical guidelines of the U.S. Agency for Healthcare Research and Quality indicate that spinal manipulation may be helpful for acute low back pain if used within the first month of symptoms. They recommend discontinuing the manipulation if symptoms and functioning do not improve after one month of treatment, although further treatment is not considered to be dangerous.

Three major studies of Osteopathic manipulation techniques (OMTs) for low back pain have reported some benefits and less use of medications and physical therapy. Other recent studies have found that OMTs are as effective as other medical treatments for relieving low back pain. However most studies on spinal manipulation have been performed by chiropractors or physical therapists and may not accurately reflect the results of manipulations performed by osteopaths.