The Opioid Epidemic and Low Back Pain

The opioid epidemic topic is highly related to low back pain since opioids are mostly prescribed for this condition. For this reason, the largest medical society in the world known as American College of Physicians (ACP) has had a change of vision when it comes to treating low back pain.² After performing trials and studies, the ACP now recommends heat therapy, massage, acupuncture and spinal manipulation as non-drug options in their most recent guideline (2017) to treat low back pain. The next recourse in case no relief was provided by the previous therapies would be ibuprofen or muscle relaxants. Considering the high risk of addiction and overdosing, the prescription of opioids is the last recommendation on the guide to treat low back pain.
There are a few recommendations on behalf the American Chiropractic Association to help prevent low back pain:³

• Keep an active lifestyle
• Keep a healthy weight
• Perform proper warm ups before exercising
• Avoid high heels (use shoes that support you!)
• Do your best at keeping good posture (sitting or standing)
• Be careful when lifting heavy objects (lift with your legs, not with your back)
• Stop smoking. It affects your circulation!

Studies of massage and chronic low back pain

Massage could provide significant relief to people with chronic low back pain.⁴ A study performed by William G. Elder, PhD, Family and Community Medicine at the University of Kentucky and Niki Munk, PhD, LMT, School of Health and Rehabilitation Sciences at Indiana University-Purdue University Indianapolis showed that massage helped more than 50% of the participants with “clinically meaningful improvement.” People who participated in the study received 10 massage sessions during a 12 week period. By the end of their sessions, 54.1% reported vast improvement in their chronic back pain and then at 24 weeks 75% of those benefited from massage still maintained the benefits of the massage therapy sessions. Dr Munk emphasizes that massage should be considered as maintenance therapy and people should not expect a quick fix on the first session – especially if suffering with chronic low back pain for 10 to 15 years. It is not realistic to expect results that quick so be patient with your body and your healing process!

Massage therapy helps with pain relief and getting back to your normal life quicker than the usual medical care when it comes to chronic low back pain. ⁵ This statement is backed by the University of Vermont in Burlington, the Oregon Health and Science University in Portland and Group Health Research Institute at the University of Washington in Seattle. They researched results of structural massage, relaxation massage and the by-the-book medical treatment for chronic low back pain. Participants received 1 hour massage therapy a week during 10 weeks and their results were reported at the end of the treatment as well as 6 months and 1 year after. At 10 weeks or right after the end of the massage sessions, people in the massage groups showed significant improvements in their symptoms and disabilities compared to the regular medical treatment group. They showed a more active lifestyle, less time in bed and less use of medication than people in the by-the-book medical treatment. The massage groups retained some of the benefits of the massage and at 1 year all the groups reported about equal improvements. But remember, the massage groups were benefited quicker, without drugs! So that means no side effects or risks from medications or injections.

Massage therapy could help people with chronic low back pain, even if they are already using strong pain medications. This study was done with a 63 year old former construction worker who suffered with scoliosis, spinal stenosis, degenerative disc disease and osteoarthritis. The man’s goal was to decrease the pain medication he was taking. His prescription was Percocet at 7.5mg, 4 times a day and he indicated it made him feel lethargic and disoriented. During this study, this male received 4 massages in a 20 day period. By the end of his massage therapy treatments he improved on 9 out of 10 measurements on his reports of pain and activities. The most improved were his ability to walk and the intensity of the pain he was going through. He was also able to decrease his medication (down to 1 or 2 a day max) and he used his bike (after the 3rd massage session) for the first time in years! This man’s Oswestry Disability Index Score was 60% at the beginning of the study and 38% at the end of his 4th massage session. That is a 22% reduction from severe disability category to moderate disability category. The initial plan was to complete 6 massage sessions but since the male reported zero pain after the 4th massage therapy session, it was agreed to end this study after the 4th session.

Treating Your Low Back Pain with Massage Therapy

Debilitating and limiting low back pain can be a thing of the past but truth be told, there is no therapy that can help you unless you try it. As a therapist, I’ve personally worked on numerous people with low back pain that have had great results. The most memorable clients with low back pain are people who shared how grateful they felt after their 4th or 5th massage therapy session to treat their condition because it really worked for them! Sometimes all your body needs is a Muscle Therapy Tx (treatment) so book your appointment with us or with your local therapist.

May you always have a healthy body and a heart filled with gratitude!

<sup>References
1,2, 3. https://www.acatoday.org/Patients/Health-Wellness-Information/Back-Pain-Facts-and-Statistics [accessed 2/14/29]
4. https://www.spineuniverse.com/treatments/alternative/massage/massage-real-deal-option-chronic-low-back-pain [accessed 2/14/19]
5. https://www.spineuniverse.com/treatments/alternative/massage/massage-real-deal-option-chronic-low-back-pain [accessed 2/14/19]</sup>

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It is the most common chronic disease in kids and the top reason why they miss school. It accounts for approximately 13.8 million lost school days for children and it affects 6.1 million kids under 18 years of age.¹ This condition makes it difficult for air to move in and out of the lungs . It can turn deadly if not treated correctly and tends to be more dangerous as people get older.² Some asthma triggers include:

• Air pollution
• cigarette smoke
• colds
• exercise
• infections
• change in air temperature
• stress
• allergies

Asthma is a serious health problem in the United States. To have a better perspective at the amount of kids being affected, take in consideration that 1 in 12 children had asthma in 2016.³

Study of effects of massage on kids with asthma

A hospital in Egypt conducted a study of effects of massage on children with asthma. The pediatric allergy and chest unit of the New Children’s Hospital of Cairo University performed the study with sixty kids and divided them in two groups: the massage therapy group and the control group. The control group continued with the usual treatment for five weeks while the massage therapy group received a massage of twenty minutes every day for the same five weeks.

The kids with asthma belonging to the massage therapy group showed significant improvement in pulmonary function compared to the group that did not get massaged.⁴ That is great news for kids suffering with this excruciating condition and for their parents too! Getting massaged daily improves the diameter of airways and helps control asthma.⁵

If you have a friend or family member with asthma and now that you have this valuable information, please don’t keep it to yourself! Share this with as many people you know. Massage therapy can be life changing to someone with this respiratory health condition. Please contact a massage therapist who is licensed or a certified professional. They will be happy to assist with a treatment plan for you and/or your kids who suffer with asthma.

For readers in the Los Angeles area in California, don’t hesitate to contact us to book an appointment. We come to your home or office and we’ll be happy to assist you.

^1,2. https://www.lung.org/lung-health-and-diseases/lung-disease-lookup/asthma/learn-about-asthma/asthma-children-facts-sheet.html
^3. https://www.epa.gov/sites/production/files/2018-05/documents/asthma_fact_sheet_0.pdf
^4. https://www.liebertpub.com/doi/full/10.1089/acm.2010.0758
^5. https://www.ncbi.nlm.nih.gov/pubmed/9602199/

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COLD THERAPY FOR PAIN MANAGEMENT

Also known as cryotherapy, cold therapy can help you deal with the pain of a recent injury within the acute phase (1-7 days).¹ It can also help you with any conditions that cause inflammation such as a swollen, arthritic joint. The standard recommendation for an acute injury is RICE – Rest, Ice, Compression and Elevation. This guideline was created by Dr. Mirkin in the late 70’s through his bestseller Sports Medicine Book.² Most emergency rooms, doctors, physical therapists and professionals in the medical sector still go by this recommendation.

I had to check if Dr. Mirkin had changed his opinion on RICE since his book was published a while ago and I did find and update! He starts his statement by explaining the healing process of an injury and how ice can delay such process but at the same time he goes to mention that ice has been shown to be a great option for pain management. Dr. Mirkin’s recommendation now is that for pain management, a soft tissue injury can be iced for 10 minutes followed by a 20 minute rest.³ This can be done once or twice. According to him, Ice should not be applied more than six hours after the injury occurred. He also stresses the importance of stopping exercise right after the injury and resuming once the injury has healed and the activity does not cause any pain.

My favorite cold therapy tools are ice packs because they are mess-free. I wrap them in a thin towel and apply them to the affected area. After I’m done using them, they just need to be washed in soapy water after each use. Just put them back in the freezer so they’re ready to use anytime. These are the ice packs I get from *Amazon. As we can see, cold therapy is very helpful to relieve pain, just don’t over do it. If you can’t feel the area where you are applying cold therapy or your skin is becoming red, it’s time to take a break. Wait until your skin returns back to normal and reapply if needed.

HOT THERAPY FOR PAIN MANAGEMENT

Heat therapy is widely used for situations where there’s no inflammation or injury present. It is very soothing for muscle pain, stiff joints, trigger points (or knots), muscle spasms, etc.⁴ Remember, hot therapy should be avoided whenever there is an infection or recently injured tissue.

Heat on the body becomes very therapeutic. Think about a warm bath or a massage: they both generate heat in the body. The warm bath is very relaxing and can positively change how you are feeling. It’s no different with a massage where the friction and hopefully warm hands of the massage therapist, generate heat on your skin. When heat penetrates our skin, it’s working on our nervous system to relieve pain. Quick heat therapy options can be an electric pad, a microwavable gel pack, a cherry seed pack or an infrared massager.

Just like with cold therapy, there are precautions to take. Do not overheat whatever tool you are using. Always quickly test if hot therapy’s temperature tool is not too hot to be applied on your skin. If you have an electric tool, follow the safety instructions.
People have a favorite kind of therapy between hot or cold but always remember to follow your doctor recommendations and notice how your body responds to it.

* It will not cost you more to buy from my link and I will earn a small amount if you use it. As an Amazon Associate I earn from qualifying purchases.

¹.Physiopedia. Soft Tissue Healing.
   https://www.physio-pedia.com/Soft_Tissue_Healing
^2,3. Dr. Mirkin. Why Ice Delays Recovery.
   http://www.drmirkin.com
⁴. PainScience.com. Heat for Pain.
   https://www.painscience.com/articles/heating.php

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The top 10 reasons to get a massage. When people hear the word “massage” they often think about getting “pampered”.  A massage therapy session can be more than just pampering if you get it from a professional massage therapist. A professional massage therapist is someone who has the knowledge and training behind them to perform a massage. Professional titles may vary from state to state within the US but they are most of the time either LMTs (Licensed Massage Therapist) or CMTs (Certified Massage Therapist).  There are so many online resources, studies and research about the benefits of getting a massage.  In case you don’t have enough reasons to get a regular massage, here are 10 of them.

Reason 10
Boost Immune System

Recent studies have found that massage therapy can help women with breast cancer improve their immune system function¹. It can also alleviate symptoms for children who suffer from asthma.  People from all ages can benefit from this reason to get a massage!

Reason 9
Lower Blood Pressure

A clinical trial study was performed with fifty pre-hypertensive women. Half of the group received a Swedish massage three times a week for about ten to fifteen minutes. The study found that women in this group presented a lower blood pressure reading even after 72 hours after getting the massage². If I were you, I’d be reaching for my phone to schedule my next massage session.

Reason 8
Recover Faster from Workouts

A healthy, active person can also benefit from getting a massage with a faster recovery after a workout.  The Journal Science Translational Medicine published a study where 11 young men received a massage in one leg after exercising to exhaustion.   They took tissue samples from their legs before the massage, after the massage and 2.5 hours later after the massage. The study found massage boosted mitochondria (the powerhouse in a cell) production³. Massage can help you get relief on those overused and tired muscles after a workout so give it a try.

Reason 7
Alleviate Low Back Pain

Almost two thirds of Americans suffer from low back pain and they don’t get any treatment to alleviate it.  The reason is they just don’t seek it. That data comes from a survey done by the American Physical Therapy Association on 2,600 people ages 18 and older⁴. All that sitting at a desk, carrying heavy items or a little extra body weight can take a toll on our bodies in the form of low back pain. There might be other specific reasons for everyone but you don’t have to live in pain.  Try a getting a massage to alleviate low back pain. Endorphins are amino acids used by our body as natural painkillers and we release endorphins when we get a massage⁵. Talk to your massage therapist about your specific symptoms. Your massage therapist will talk to you about your progress in every session. Please remember to be patient with your body. You could feel better right after the first massage therapy session or it could take a few.

Reason 6
Enhanced Sleep Quality

Chances are you know how important your sleep is. Our energy is renewed and our body regenerates during our sleep. That is how we keep ourselves healthy (and young looking!). Getting naps during the day has become a goal for many people who want to enjoy the benefits. Unfortunately, for many as 164 million Americans this has become a difficult task since they have trouble sleeping at least once a week⁶. Many turn to apps, drugs or supplements to be able to sleep. But guess what? Massage therapy can enhance sleep quality and many people even fall asleep during a massage⁷. The latter will depend on the level of trust you have with your massage therapist.

Reason 5
Increased Energy

Greater energy obtained through massage therapy is directly related to different reasons on this list.  We have covered increased immune function, enhanced sleep function and will cover reduced stress in the top 3 reasons to get a massage (so keep reading). The result of those three benefits of massage combined is increased energy. Don’t underestimate the power of touch.

Reason 4
Increased Circulation

The majority of modern occupations involve a lot of sitting. We are sitting when we drive, eat, work, etc. Different case studies have shown how detrimental sitting can be to our health: poor circulation, varicose veins and swollen limbs are just a few examples. But I have good news for you. Researchers from the University of Illinois conducted a study that proves that had two groups. One group exercised and received massage; the other group only received a massage. The interesting outcome is they noticed that both groups received the same improvement on their circulation levels. As one of the researchers said, “…massage is really changing physiology in a positive way”⁸. That does not mean you should skip your workout though. That means people with limited mobility can get a massage and get the same benefits as if they just exercised when it comes to their circulatory system.

Reason 3
Lessen Depression and Anxiety

Depending on the type of communication and level of trust you develop with your massage therapist, you might want to share you are coping with depression, anxiety or any other stress related disorder.  You can also choose to keep it to yourself. Massage therapy affects the body’s biochemistry to relieve depression and anxiety⁹. Massage also increases production of the neurotransmitters that help reduce depression (dopamine and serotonin)¹⁰. That’s the beauty of massage: your body starts healing itself.

Reason 2
Stress Relief

There is an epidemic that is getting people sick by the day.  It is often referred as “America’s #1 health problem”.  Data shows that 75-90% of doctor visits are caused by stress related ailments¹¹. There are different ways to manage stress and massage therapy is a very effective one.  Research conducted by University of Miami School of Medicine reviewed studies measuring cortisol (stress hormone) before and after getting a massage. They concluded that massage therapy lowered cortisol by 53 percent. Being that stress is the underlying reason of so many ailments, cutting it down to more than half is always a good option.

Reason 1
Massage Therapy Has Cumulative Benefits

Brush aside the old idea that massage is for pampering. As we can see in our “10 reasons to get a regular massage”, it can also be therapeutic.  You may have perfect health (and props to you!) so by getting a massage you are taking a preventative approach.  Once you start getting a regular massage, you’ll see the improvements in your body, posture mental health and just an overall sense of wellbeing. Those are considered cumulative benefits of massage.  Just one more recommendation, talk to your massage therapist about how often you need a massage. This will involve your current health status, budget and availability. Book a massage today to improve your  health. You deserve it!

Sources:
1, 3 – http://www.wsj.com/articles/SB10001424052702304537904577277303049173934
2 – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3733180/
4 – http://www.apta.org/Media/Releases/Consumer/2012/4/4/
5, 7 – http://www.massagetherapy.com/learnmore/benefits.php
6 – http://www.consumerreports.org/sleep/why-americans-cant-sleep/
8 – https://news.uic.edu/massage-therapy-improves-circulation-alleviates-muscle-soreness
9,10 – https://www.amtamassage.org/findamassage/health_conditions.html?src=navdropdown#5
11 – Job Stress: America’s Leading Adult Health Problem, by Paul J. Rosch, M.D., F.A.C.P., in USA Magazine, May 1991.

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