A growing number of Americans understand that massage therapy is effective for reducing or managing pain.
Through learning more about massage for pain relief, we can be more effective at meeting clients’ expectations.
Pain science is teaching us new ways the body and brain process pain signals.
Here are four areas related to pain and massage for pain relief that massage therapists need to understand.
1. Social Variables
Our experience of pain—how much, what type, and including whether we feel pain at all—is determined by how the brain processes a combination of biological, psychological and social variables.
The International Association for the Study of Pain defines pain as “An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.”
Although pain often has a detectable physical cause, sometimes it doesn’t.
There is a subjective quality to pain. If someone says they have pain, but no one can find anything medically wrong with them, we should still accept that they are feeling pain.
Psychological and social variables alone can cause (or prevent) excruciating pain. There are well-documented cases of this happening.
2. There is no “Pain Center” in the Brain.
Nociceptors and nociception are not “pain receptors” and “pain signals.”
We have many kinds of sensory receptors in our skin and other tissues that connect to neurons that transmit information about what they detect.
Nociceptors detect noxious stimuli, or stuff that indicates possible tissue damage. This includes excessive heat or cold, and chemicals released when cells die.
Nociceptors act like fire alarms, detecting potential danger and warning the spinal cord and brain. This process is called nociception.
Non-nociceptive (non-threatening) sensory input passes through nerves and the spinal cord to reach the brain more quickly than the threatening signals do. This helps the brain understand the context in which the nociception is occurring while interpreting it.
Nociception can trigger reflex responses at the spinal cord even if we don’t feel pain.
Pain science also tells us that in the brain, there is no “pain center” to receive “pain signals.” Nearly all sensory input is routed through the thalamus, which connects to many portions of the brain for processing and interpretation.
3. Pain is a Protective Response to Perceived Danger
Brains interpret sensory input with a wide range of other factors, including prior similar experiences, emotional states, cultural backgrounds and other contextual information.
When brains perceive danger, people may experience pain. Sometimes brains perceive danger when there is none, causing people to experience pain even though nothing is wrong.
4. When the Nervous System Feels Safe, Pain May be Reduced
Pain may be reduced by increasing the brain’s perception of safety.
Massage therapists can help reduce pain through helping a client’s nervous system feel safe.
Some ways to do this include:
- Establishing rapport through listening and adjusting to their style of communication.
- Providing a comfortable, pleasant and clean environment.
- Respecting a client’s priorities, concerns and boundaries.
- Making the client physically comfortable via positioning, cushioning and temperature.
- Using methods that do not trigger guarding, bracing or jump responses.
- Modifying techniques to avoid causing discomfort. These modifications include reducing pressure and slowing down.
- Staying focused on the client’s experience in communication while avoiding negative language. (“How does this area feel to you now?” versus “You’re so tight!”)
Massage for Pain Relief: Be More Effective
Massage therapists are in a great position to help people reduce their pain and enjoy better quality of life, even when pain is present.
Studying pain science is like studying anatomy and physiology—it helps us understand how to adapt our work to be more effective.
About the Author
Jason Erickson, BCTMB, CPT, BBA, teaches and hosts continuing education classes. He is a Board Certified massage therapist and certified personal trainer. Erickson co-owns and sees massage patients at Eagan Massage Center and trains clients at Burn Personal Training. To receive his free PDF copy of the Pain Science Learning List with clickable links contact him at firstname.lastname@example.org. Erickson wrote “Understanding the Lived Experiences of People in Pain is Your Foundation for Success” for the July 2018 issue of MASSAGE Magazine.