How Chiropractic Massage can Help in Managing Joint Pain

Chronic low back pain is one of the most common reasons why most people see a healthcare provider. In fact clinical data suggest that the lifetime risk of developing at least one debilitating episode of low back pain is 80%. Likewise, lifetime risk of knee joint pain is 50%, ankle joint pain is 27% and so forth.

But the important questions are:

• How many times have you experienced joint pain in the past 6 months?

• What are some of the interventions you employed to manage the discomfort and pain?

• How effective were those protocols?

• And most importantly, how are you planning to resolve future episodes of joint pain?

There are several factors that may determine the frequency, severity and recurrence of joint pain. The three most common causes of recurrent and moderately severe joint pain in general population:

1. Osteoarthritis (extensive degenerative damage to the connective tissue elements as a result of wear and tear changes)

2. Rheumatoid arthritis – the autoimmune variety that reportedly affects more than 53.2 million US adults (1)

3. Joint pain due to trauma/ injury/ accident that may be trivial or chronic. In most cases, if you suffer from fracture/ dislocation of a primary joint, the chances of recurrent episodic joint pain are high even after primary repair.

In addition, joint pain can also be felt due to acute sprain, mal-alignment of connective tissue elements, malignancy and uncontrolled diabetes. Although, you can always opt for mean and extensive procedures like surgery, joint replacement, medications, intra-articular injections etc. but it is imperative to understand that:

• Most of these procedures/ interventions offer only minimal or temporary relief

• There are several holistic and functional therapies that are less hazardous and more effective in short term as well as long term.

According to a report published in Annals of Internal Medicine (2), most primary care providers prefer holistic and complementary therapies to manage chronic joint pain over pharmacological interventions. Based on the efficacy and cause of chronic pain, about 65% clinicians advise therapeutic massage therapy; about 55% suggest the use of therapeutic ultrasonography; and when the cause of joint pain is mal-alignment of spinal segments, about 22% recommended spinal manipulation for optimal relief.

What is massage therapy?

Use of manual or instrumental forces to stimulate the superficial (and/ or deep layers of tissues) to alleviate pain, swelling and discomfort is referred to as massage therapy and it is indeed one of the oldest methods of managing acute or chronic pain (both articular and non-articular).

Massage therapy is usually employed as an adjuvant to other holistic protocols to increase the efficacy while serving other functions in the body.

What are different types of massage therapies that may be utilized for the management of joint pain?

Chiropractors and holistic practitioners use different techniques and protocols of massage therapy to reduce swelling, alleviate pain and promote healing in the inflamed tissues around the joints. A few most notable varieties are:

Swedish massage:

This variety involves gentle circular movements and effective use of vibrations to induce muscle relaxation.  Swedish massage is perhaps one of the safest options for the management of chronic joint pain.

According to a study conducted by Furlan and associates (3), it was suggested that Swedish massage and other types of therapeutic massage are extremely beneficial if utilized for patients with the history of subacute (pain that may last for up to 4-12 weeks) as well as chronic joint pain (that extends for more than 12 weeks). Report also suggested that the effects of massage can be increased several folds if therapies are complemented with therapeutic exercises and patient education

Deep massage:

It involves slow but with more forceful strokes to generate energy deeper in the muscle layers. It is also helpful in promoting healing and recovery in certain injuries. Deep tissue massage has several other benefits; such as:

• Promoting blood circulation in the tissues to optimize the pace of healing and recovery. Normally inflamed tissues are tense and tender due to high concentration of chemical mediators that restrict movement and interfere with normal circulation. However, with deep tissue massage in the hands of an expert chiropractor, the chemical mediators are flushed out from the circulation to restore normal blood supply

• Once the blood flow is established, the chances of healing and recovery increase several folds.

• Deep tissue massage also helps in neutralizing and flushing out the toxins from the adipose tissue stores.

It is recommended to speak to your chiropractor about your expectations and primary indications. If your joints are overly painful (or acutely inflamed) you may want to try other massage therapies since deep tissue massage may increase joint pain at least temporarily.

Sports massage:

This variety is similar to Swedish massage but is usually performed on sport players, to prevent injuries and to optimize strength and wellness. Sports massage therapy improves healing, helps in rejuvenation of inflamed tissues and reduce discomfort.

In addition, sports massage can also be used to improve athletic endurance and physical strength in professional athletes.

Trigger point massage:

This massage technique mainly focuses on the stiff muscles to reduce the sensation of pain and discomfort in acute cases.

Research published in the peer reviewed Journal of Bodywork and Movement Therapies (4), authors suggested that trigger point massage helps in normalizing several parameters of discomfort associated with acute or chronic joint pain (such as increased heart rate, high levels of anxiety, rising tension in muscles, pain intensity, stiffness, limited range of motion etc.)

Other holistic remedies that may be used for the management of chronic joint pain are:

• Protect your inflamed joint from excess stress and strain by utilizing joint support by wraps or braces

• Ensure optimal rest and avoid excessive activity that may pose pressure or pull on the affected joint/ muscles.

• Apply ice or cold compresses on the joint surface several times per day for approx. 15 minutes

• Apply elastic wraps to support highly mobile joints.

• Elevate the joints in case of long periods of inactivity.

• Applying ice over painful joint provides instant relief by reducing swelling, inflammation and pain. Use heating pad for muscles spasm or wrap it several times a day for speedy resolution.

References:

1. http://www.rheumatology.org/Research/Prevalence_Statistics/

2. Chou, R., & Huffman, L. H. (2007). Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline. Annals of internal medicine, 147(7), 492-504.

3. Furlan, A. D., Imamura, M., Dryden, T., & Irvin, E. (2008). Massage for low-back pain. Cochrane Database Syst Rev, 4(4).

4. Buttagat, V., Eungpinichpong, W., Chatchawan, U., & Kharmwan, S. (2011). The immediate effects of traditional Thai massage on heart rate variability and stress-related parameters in patients with back pain associated with myofascial trigger points. Journal of bodywork and movement therapies, 15(1), 15-23.