Why Rubbing Eases Pain ; The Study of Neurons and Serotonin is Explaining How Massage Works

By ABIGAIL LEICHMAN, STAFF WRITER

Orthopedists, chiropractors and physical therapists all had tried their hand at relieving Pam Zeldin’s chronic back pain.

Although cortisone shots, adjustments and exercises helped somewhat, Zeldin said she found the greatest respite in acupuncture and therapeutic massage.

“The combination of the two has been phenomenal,” said Zeldin, 46, of Teaneck.

Massage, best known for easing tension and stress, has found a new niche.

“Higher numbers of consumers [are] turning to massage therapy for pain relief than we’ve ever seen before,” said Mary Beth Braun, president of the American Massage Therapy Association.

More than half of the 18- to 34-year-olds surveyed last year by the organization had got a massage to relieve pain. Most said it was recommended by their doctor or other health-care provider.

Medical professionals’ enthusiasm has grown, given that new clinical studies show massage can reduce pain from surgery, cancer and back problems.

Perhaps that shouldn’t come as a surprise. After all, when we stub a toe or bump an elbow, we instinctively rub the spot to make it feel better. Today, scientists understand why that works.

“When receptors under the skin are stimulated with moderate pressure, there’s a cascade of physiological and biochemical events,” said Tiffany Field, director of the Touch Research Institute at the University of Miami School of Medicine.

One of those events is the rubbing-makes-it-better phenomenon, known in scientific lingo as Gate Theory. It has to do with how nerve fibers, or neurons, communicate with the brain.

“Neurons responding to pressure are longer and more insulated than pain neurons,” Field said, “so the pressure message gets to the brain faster than the pain message. Once that happens, the brain ‘closes the gate,’ and the pain message can’t get through.”

Massage also boosts levels of serotonin, the body’s natural pain- relief substance, and induces deeper sleep. Well-rested bodies emit fewer pain-triggering chemicals, Field explained.

Zeldin was already getting relief from Ramsey acupuncturist Mark Smiley when she noticed a flier in a health-food store posted by Navah Mozeson of Therapeutic Massage for Women in Teaneck. With Smiley’s approval, Zeldin made an appointment.

“If I work with a massage therapist and tell them the muscles that are tight and the areas I think are ‘off,’ we can work to complement what I do,” said Smiley.

Untangling muscles

Smiley treats Zeldin’s painful “trigger points,” or knotted muscles, with acupuncture needles. Mozeson uses her hands and smooth heated stones to keep the muscles untangled.

“Massage enhances and maintains chiropractic adjustments, and it helps with chronic back or neck pain, hand pain and posture issues,” said Mozeson, who received her training and certification from the Healing Hands Institute in Westwood.

“But I’m not a diagnostician, so I always make sure clients get a proper diagnosis and an OK from their physician or alternative practitioner before they come here.”

New Jersey is one of 33 states that regulate massage therapists. However, practitioners don’t all specialize in the same methods.

Usually health spas offer the classic Swedish massage, a relaxing treatment that increases blood flow and relieves tension.

For pain relief, other methods may be needed.

Edward Shekhtman, a massage therapist at Beaura Spa at the Parker Center for Plastic Surgery in Paramus, uses deep-tissue massage to ease the kind of aches people get from consistently sleeping or sitting in the wrong position.

A method called lymphatic Danish massage reduces swelling and pain and improves circulation. “Many patients need this after surgery,” Shekhtman said.

Increasingly, therapeutic massage is available at hospital- affiliated spas as well, such as Beyond at Hackensack University Medical Center.

Its medical director, Dr. Louis Teichholz, said massage is one of various useful techniques in pain management, but it’s not a cure- all.

“If the pain is muscular, [massage] techniques, similar to physical therapy, can improve the condition by relaxing the muscle,” he said. For non-muscular problems, he said, “massage doesn’t cure pain. It somehow changes the brain’s perception of pain … by relaxing the nervous system.”

Teichholz said it’s important to determine the cause of the pain before trying massage. “You don’t want to treat a problem like a tumor locally,” he said.

“If you have a tumor or joint pain, massage can actually aggravate it,” said Osamu Kamiyama, a massage therapist and energy healer at the Japanese-American Wellness Center in Ho-Ho-Kus.

Combinations can help

Kamiyama said he believes massage is more helpful for de- stressing and enhancing circulation than for pain relief, but he used both massage and energy healing to cure client May Nakagawa’s tendinitis last year. “It was like a miracle,” said the Allendale woman.

In the growing field of non-narcotic pain relief, some practitioners favor approaches like cold laser treatment over massage. “This new modality gives more permanent and lasting effect for pain relief,” said Dumont chiropractor David Levine of the laser method.

However, many prefer the “all of the above” approach that helped Zeldin and Nakagawa.

“Mind-body techniques like massage, hypnotherapy and other complementary techniques all work to relax the nervous system, and that can block pain impulses,” explained Teichholz.

Dwight Vega, director of Alternative Two Healing Arts Center in Lyndhurst, said clients often try massage together with cold laser, reiki (Japanese energy balancing), touch healing even crystals.

“It all works, depending on the client and what they’re open to,” said Vega. “A combination can be amazingly helpful.”

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By the numbers

* 47 million Americans received a massage within the past 12 months, representing an increase of 2 million people from last year.

* 17 percent of men surveyed had had a massage in the past 12 months, up from 14 percent last year.

* 40 percent of women surveyed had had a massage in the past two years.

* 32 percent of adult Americans who received a massage in the past five years did so for medical purposes, such as for muscle soreness and spasm, injury recovery and rehabilitation, and pain relief.

* 46 percent of all respondents have had a massage at some time to relieve pain, and more than half of 18- to 34-year-olds have had a massage to relieve pain.

* 50 percent of surveyed cancer patients reported a reduction in symptoms of pain, fatigue, stress, nausea and depression following massage therapy.

* 82 percent of hospitals offering complementary and alternative- medicine therapies include massage therapy among their health-care offerings. Of those hospitals, 70 percent utilize massage therapy for pain management and pain relief.

* 74 percent of HMO plans cover massage/relaxation therapy in some way.

Source: American Massage Therapy Association’s 2005 Consumer Survey

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Common massage types

* Deep tissue releases the chronic patterns of tension in the body through slow strokes and deep finger pressure on the contracted areas.

* Myofascial release uses long, stretching strokes to rebalance the body by releasing tension in the fascia (connective tissues).

* Chair massage, intended to relax and improve circulation, is administered while the client is clothed and seated in a specially designed chair.

* Reflexology is based on a system of points in the hands and feet thought to correspond, or “reflex,” to all areas of the body.

* Rosen Method utilizes gentle touch and verbal communication to help release suppressed emotions and muscular tension.

* Shiatsu and acupressure are Eastern systems of finger pressure to treat points along acupuncture “meridians” (channels of energy flow).

* Sports massage focuses on muscle systems relevant to a particular sport.

* Swedish massage is a system of long strokes, kneading and friction techniques on the superficial layers of the muscles, combined with active and passive movements of the joints.

* Trigger point therapy applies concentrated finger pressure to “trigger points” (painful muscle areas) to break cycles of spasm and pain.

Want to know what to expect during a massage or find a qualified therapist in North Jersey? Go to amtamassage.org and click on “Find a Massage Therapist,” or call 888-843-2682.

American Massage Therapy Association

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E-mail: leichman@northjersey.com

(c) 2006 Record, The; Bergen County, N.J.. Provided by ProQuest Information and Learning. All rights Reserved.