Breakdown on Pain
A typical exchange with new clients in a medical massage therapy practice starts with the potential client explaining what drove them to seek medical massage therapy in the first place. More often than not, the answer comes around to pain. Sometimes, it's clients who have run out of other options with little to no relief of chronic pains. Other times, clients "slept wrong" or perhaps injured themselves exercising. Regardless of the specifics, pain is almost always the motivating force behind clients seeking medical massage therapy.
Pain Physiology - current knowledge
Pain science is an emerging and changing field. It requires knowledge of physiology, and neuroscience. Besides to research science, there's also data from experience from practitioners across specializations in health and wellness. According to the International Association for the Study of Pain, pain is an unpleasant sensory and emotional experience that may or may not be accompanied by the presence of tissue damage.
Here is where understanding pain gets slippery. While all pain is real, it doesn't always come from real tissue damage. Pain is the sensation created in the brain as it interprets incoming information. That isn't to say that experiencing pain is creating something false. The brain acts to receive data from both inside and outside the body. This is often referred to as sensory input. What the brain does with that sensory input is where this is complex.
Throughout our lives, the brain never stops learning. As we experience more, our brains learn to better how to interpret experiences based on the past. For example, a baby eats ice cream for the first time. That baby doesn't have a clue what "sweet" is or what "cold" is. Despite this lack if understanding the brain recognizes this as a desirable experience. It logs away the smell, the feel, the taste, perhaps the location or word "ice cream" for future reference. The brain knows what to expect with "ice cream."
Painful experiences, despite being the opposite of ice cream experiences are logged away and learned from similarly. With one exception. Our brains are hard-wired to learn from negative experiences more strongly than positive experiences. Throughout time pain has become the warning signal that something is wrong. In essence, avoiding pain or causes of pain is the brain's way of keeping us safe. Our brains like for us to stay safe. When pain is involved once, it becomes magnified in the future and for every recurrence thereafter, thus making what's called the central sensitization. In this sense, pain is truly worse with age.
This is what can make the job of professionals who work with pain and pain related symptoms complex. One aspect of their job is to decide whether it's a physiological cause for the pain someone is experiencing or if it's due to central sensitization. For the rest of this discussion we will assume that all pain we are discussing has a manageable, musculoskeletal aspect.
Two main types of pain. Chronic vs Acute.
All types of pain rooted in a physiological cause will fit into one of two categories. Chronic pain is commonly referred to as long term. It may have gradually grown in intensity but has manifested over time. Acute pain is attributed to a brief occurrence. Incidences resulting in acute pain can range from "I slept wrong" to "I was in a severe car accident." Determining the underlying cause, and whether the client is suffering from acute or chronic pain will help the therapist to design a proper treatment plan.
Understanding chronic pain and the role of medical massage as a treatment strategy.
Chronic or long term pain can come from a variety of underlying problems. It's possible to have started as an acute pain that was neglected until it didn't go away. An example would be the long term effects of a car accident. If someone suffers an injury due to accident, their body adapts as it heals. As part of that adaptation process, the person begins to develop new wear and tear on joints and tissues that were not designed to withstand that stress. This becomes a snowball of musculoskeletal pain. Depending on the severity of the injury and how long an individual has been living with the after effects, massage therapy can help to reduce chronic pain in this instance. Medical massage targeted to improve tissue functionis effective when combined with corrective exercise therapy. Finding the right team of professionals to help guide this process is key to how successful these therapies can be.
Disease processes will often lead to chronic pain as well. Some of the most notable include arthritis and fibromyalgia. Massage therapy will not heal either of these conditions. The increase in pain in both conditions can be partially explained by central sensitization. Massage therapy has shown to be effective in the management of both of these conditions by working to reverse the central sensitization. Two of the notable improvements massage therapy offers is reduced pain, and improved sleep. By improving these two key areas, individuals see an improvement in health as their body has opportunity to rest and heal. While management is different from healing it does improve quality of life for the individual suffering with chronic pain from any condition.
Understanding acute pain and the role of medical massage therapy as a treatment strategy.
Acute pain is immediate pain. While it can be severe and as debilitating as chronic pain it differs in the amount of time someone is suffering with it. Acute pain typically has a definitive moment where it started and often is tied to a specific event. For medical massage therapy to be beneficial for an individual with acute pain a thorough health history is imperative. In taking a thorough history of when the pain started, what activities the individual was participating in, and what makes pain better or worse, a skilled therapist can help decide what tissue may be the root cause of the individuals pain. Once the primary culprit is identified, the therapist can work with the individual to develop treatment strategies to ease the pain.
Pain Changes People
It's worth noting that pain is a serious problem that affects the quality of life for millions of people every day. Regardless of the physiology or neurosciencethat goes into understanding what causes pain or how the brain works, the most significant understanding is how pain affects people who live with it. Pain changes people. This is true for individuals suffering from chronic pain. The stress of the unending unpleasant sensory and emotional experience can often be overwhelming. No matter the extent of training the therapist has had, a sense of understanding, patience and empathy is necessary when working with individuals suffering from pain. These are attributes that professional massage therapists are gifted with.
If you have questions about chronic or acute pain conditions and if medical massage could be a treatment strategy please don't hesitate to reach out to The Body Mechanics.