In the last 60 years, pain research and pain science education have come a long way.
It was once thought that pain started with pain receptors located in the muscles of the body. When the pain receptor was irritated, a signal would be sent to the brain to tell us to withdraw or that there was damage that needs care.
This idea is no longer accepted as a definition of pain.
Pain Science Education
The definition of pain, according to the International Association for the Study of Pain, is: “An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.”
So, what do we currently know about pain science?
- Pain does not mean there is tissue damage
- Pain is an output of the brain and nervous system
- There are no “pain receptors”
- Pain is a warning system to let us know when there is tissue damage
- Pain is individual and can be worse or less depending on social and psychological factors
This is some of what has been learned in the last several decades. But what does all this mean for massage therapists? Why should we care?
Massage training programs in the U.S. don’t teach up-to-date concepts of pain science. It is normal for general education to be a little behind in current science. This is why it is important for us to continue our education even after we graduate.
As massage therapists, we see a lot of people in pain. More and more people are turning to massage as a safe treatment option. With massage, our clients are able to manage and find relief from chronic pain.
There is no reason to change what we are currently doing with our clients. Pain science isn’t a technique or a modality; it’s more about a paradigm shift in the reasoning behind our work. As massage therapists, we tend to view pain science as something that is beyond our scope. We also seem to think it means that we have to toss everything we have learned. But nothing could be further from the truth.
For example, pain science shows that when someone is in pain and they experience additional stress, such as the loss of a pet, their pain worsens. So, stress can increase the brain’s perception of pain.
It’s this loop that goes ‘round and ‘round.
Pain Science and Massage
Massage can reduce stress, and thereby help the client feel less pain. With less pain, the client may be more willing to try a new exercise program; or she may find the ability to do more activities around the house.
In my work, I’ve found the best reason to stay informed about pain science is for my clients. Many times, our clients will ask us why they experience pain. All their X-ray, MRI and other tests are negative. They are usually a bit fearful and undergoing additional stress because they experience pain, and so believe something must be wrong with them.
Or they want to know how they can hurt less; how can they sit for long drives in the car or vacuum the house without pain.
If we stay informed, we can provide some answers to those questions.
There is still a great deal about pain we don’t know, but we can definitely work with what we do know. We might learn how pain creates more stress—and pain—for the nervous system and rethink some of the techniques we use.
Movement has been shown to help reduce pain, so we can recommend ways our client can move more, where doing so is within our scope of practice.
A Huge Movement
There is a huge movement right now, on a national level, to change pain treatment in the U.S. We are already seeing this shift, as mainstream medicine recognizes that opioids are not useful for the treatment of chronic pain.
The National Pain Strategy was recently created by six federal agencies and medical, scientific and patient communities led by The Interagency Pain Research Coordinating Committee within the National Institutes of Health.
This strategy outlines how the U.S. medical system needs to change how it treats pain. The National Pain Strategy is one of the first major efforts based on current pain science. We can participate in this movement, but only if we stay up-to-date on modern concepts of pain science.
Rajam Roose practiced massage for 16 years and is currently on sabbatical. She has an entrepreneurial spirit and is owner of Grow Your Massage Business. Roose is also the founder of the San Diego Pain Summit LLC, which offers National Certification Board for Therapeutic Massage & Bodywork-approved home study courses. She has collected a series of papers and blogs for massage therapists, available at no charge. Roose wrote “Understand Research: Be a Better Massage Therapist” in the June 2016 print edition of MASSAGE Magazine.