Common Syndromes and Pathologies Massage Can Help With

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Massage Therapy for Headaches

Almost everyone has suffered the pain of a headache. Headaches can  last for a few hours up to several days, and sometimes involve  symptoms such as sensitivity to light and nausea. They can seriously impact daily life when they occur frequently or for an extended period of time. Massage is one natural alternative to allopathic medicine that can help relieve headaches while avoiding the side effects that often accompany prescription and over-the-counter headache medications.

Massage Therapy Can Relieve Headaches

Since many tension headaches and migraine headaches are accompanied by neck pain, headache sufferers find that manual therapies such as massage offer relief from headache pain and related symptoms. Because massage therapy relaxes tense muscles, relieves muscle spasms, improves blood flow and aids relaxation, it can be helpful for relieving the pain of both tension and vascular headaches.

Types of Headaches: Muscle Tension and Vascular Headaches

The most common types of headaches are muscle tension and vascular headaches. Muscle tension headaches produce dull, constant pain on both sides of the head and may also involve an aching neck or sensitive scalp. They generally start slowly and can last from hours to days.

Muscle tension headaches are sometimes called muscle contraction headaches because it is the tightening of the muscles of the head, face and neck that causes the pain. This is why tension headache sufferers often describe their pain as a “vice-like grip” at their temples or as tightening bands around the forehead or along the base of the skull.

Vascular headaches are the ones many people describe as “pounding” or “throbbing.” They occur when the blood vessels that supply the brain and the muscles in the head swell and constrict. Vascular headache pain intensifies with physical activity and typically lasts from 4 to 72 hours. It may be associated with other symptoms such as vision problems, extreme sensitivity to light, and nausea. Migraines, cluster headaches and headaches that result from high blood pressure are all examples of vascular headaches.

How Does Massage Therapy Relieve Headaches?

Massage therapy helps to relieve both types of headaches by easing muscle tension, relieving muscle spasms, releasing shortened muscles and relaxing tension held in the muscles of the head, shoulders, and neck. When muscle tension eases, there is less pressure on the nerves and blood vessels that supply them. Oxygen-rich blood circulation improves, which also relieves pain. Massage therapy not only helps the muscles of the body to relax but also effectively reduces the anxiety and mental stress that can cause or exacerbate headaches. Regular, ongoing massage therapy can also help to prevent headaches by helping to reduce overall stress and the muscle tension that can trigger headache pain and by helping to maintain emotional balance.

What Is Massage Therapy?

Massage therapy is a form of bodywork. It is “touch,” or manual, therapy in which various parts of the body are rubbed, pressed, kneaded, stroked and tapped. Massage has a demonstrated ability to help relieve physical and emotional tension and stress and to improve circulation throughout the body.

Different Types of Massage for Different Types of Headaches

Because headaches often result from or involve pain referred from problems associated with the bones and muscles in the neck, shoulder, and back, massage focusing on the cervical spine (the vertebrae in the neck behind the skull) can help to relieve headache pain. Shiatsu massage, a Japanese technique in which pressure is applied with the fingers, thumbs and palm to acupuncture points, also may help to reduce headache pain. Another therapeutic touch technique that seems to help headache sufferers is known as the Trager Approach. It uses massage to stretch muscles and joints and promote relaxation.

Some tension headaches may be relieved by a specific form of massage therapy called trigger point therapy (TrP). Trigger point therapy is the application of pressure to specific points such as along the trapezius muscles (the muscles extending from the base of the skull to mid-back located along the spine) and sternocleidomastoid muscles (muscles on either side of the neck). This pressure interrupts the nerve signals that not only cause the headache pain but also create the trigger point. This therapy aims to relieve pain and to re-educate the muscles so they assume healthy positions and postures that do not generate pain.

What Causes Headaches?

In general, it is difficult to pinpoint the precise cause of an infrequently occurring muscle tension or vascular headache, but sometimes the anatomy of the headache—how it starts, where the pain is felt, and how long it lasts—provides valuable clues about its source.

It was once believed that there were only two simple origins of headaches. Vascular headaches, such as migraines, occurred when blood vessels that supplied the brain and muscles of the head and neck dilated or were constricted. Tension headaches were thought to result from the tensing and contracting of muscles of the head, face, and neck in response to physical stress, such as injury or emotional distress.

Today, it is understood that there are complex chemical changes in the brain associated with headache pain. Tension headaches are associated with neurochemicals in the brain —varying levels of serotonin, endorphins and other chemicals that serve as neurotransmitters (substances that nerves use to send messages to one another) helping nerves to communicate.

These chemical changes observed in headache sufferers may cause, or be caused by, muscle tension. It is possible that tensed muscles in the neck and scalp may trigger a headache in someone with altered neurochemical levels or, on the other hand, the neck and scalp muscles may be tensing in response to these neurochemical changes. The rise and fall of these chemicals are thought to not only activate pain pathways to the brain but also interfere with the brain's own capacity to suppress the pain. Massage therapy can effectively ease the muscle tension that causes headaches. 

 

 
 

Massage Therapy for Neck Pain

Neck pain is one of the most common reasons patients seek medical treatment. In fact, the lifetime prevalence of a significant neck pain episode ranges from 40 to 70 percent. But you don't have to let your neck pain become a constant problem: regular massage treatments can help you manage pain, especially if you are suffering from neck pain long after a neck injury has occurred.

Neck pain often occurs with back pain, and the symptoms are similar. Symptoms of neck pain may include spasm, stiffness, muscle discomfort, limitation of movement and headaches. Neck pain can occur suddenly (acute) or be constant (chronic); an acute injury can lead to chronic pain and loss of range of motion, if left untreated. Massage is a noninvasive alternative to prescription medication commonly used for treating neck pain. Massage is a manual therapy that uses hands-on manipulation of the muscles and other soft tissues to relieve muscle tension and reduce stress. Although massage affects the whole body, it is especially therapeutic for the musculoskeletal, circulatory, lymphatic and nervous systems.

How Can Massage Help Neck Pain?

A combination of techniques, performed by an experienced massage therapist, will provide pain relief and help your recovery. Several types of massage that have been shown to provide neck pain relief including Swedish Massage, Deep Tissue Massage, Trigger Point Therapy, and Shiatsu.

Swedish Massage

Swedish massage is the term used to describe a variety of therapeutic massage techniques that help release tension with applied pressure to the surface muscles. This type of massage may be helpful in reducing emotional stress and tension that may add to your neck pain.

Deep Tissue Massage

Deep tissue massage may be performed with Swedish massage to release tension from the deeper muscles and connective tissues in the neck and upper back. With deep tissue massage, the applied pressure is harder, more intense, and focused on releasing adhesions (“knots”) or scar tissue that may be causing your neck pain.

Trigger Point Therapy

Trigger point therapy uses steady pressure to release neck muscle spasms and promote blood flow to the area to aid healing. Specific points or knots in muscles are located and released that often are the source of referred pain from the shoulder and back to your neck.

Shiatsu

Shiatsu is a form of Japanese massage in which the practitioner uses his or her body weight to gradually press acupressure points. By palpating, or feeling, the network of vessels through which your energy flows (meridians), the Shiatsu practitioner will be able to feel and simultaneously adjust the flow of energy ("Ki") in your body.

Recovery From Neck Pain

The length of recovery from neck pain depends on the severity of your injury as well as your age, health, and history of prior neck injury. Several massage treatment sessions may be needed before you achieve relief. Your massage therapist can recommend the frequency of massage sessions to best treat your condition.

A massage therapist can teach you how to massage your own neck to reduce muscle stiffness and increase range of motion. The effects of massage tend to be longer-lasting when massage is performed multiple times each day. Do not perform deep muscle massage in areas that are painful, swollen or inflamed as this could lead to injury.

What Causes Neck Pain?

It is a common misconception that neck pain is related to abnormal cervical spine curvature. However, the most common causes of neck pain are sprain (injury to the ligaments of the spine) and strain (injury to the spinal muscles). Neck sprain may occur after a neck injury that causes forcible stretching or tearing of the soft tissues of the neck, such as a contact sports injury or whiplash from a motor vehicle accident. Neck strain may also occur as the result of postural or repetitive stress (overuse), often related to sleep position or poor standing and sitting posture. Ongoing pain related to neck sprains and strains occurs as a result of soft tissue inflammation and swelling.

Other causes of neck pain include pinched nerves or a variety of structural or degenerative spinal disorders such as a herniated disc and cervical spondylosis (osteoarthritis). Neck pain may also be associated with dental disorders or rotator cuff injuries (muscles of the shoulder).

If you have chronic neck pain, your doctor should perform a thorough medical examination to rule out serious structural or physiological spinal disorders. X-rays and MRIs can help your doctor identify the source of your pain and plan the best course of treatment. It is important to seek immediate medical attention if your neck pain is severe or if fever, dizziness, weakness or any unusual symptoms occur along with neck pain.

How to Prevent Neck Pain

The tips below can help you avoid neck pain and accelerate healing of your condition.

Maintain good posture.

Try to always maintain a natural aligned spinal position when sitting, standing and walking. Consider a lumbar support cushion for your car seat or desk chair. If your job requires repetitive tasks such as holding a telephone between your shoulder and ear, or if you are frequently in the same position while you work, such as sitting at the computer, take breaks and stretch your neck muscles. Also, make sure your neck is properly positioned during sleep: Avoid positions that abnormally flex your neck. Often, a worn pillow or mattress can lead to neck pain. Cervical pillows are available to provide proper neck support.

Exercise regularly and practice neck-strengthening exercises.

Regular exercise is helpful to improve posture. A physical therapist can recommend specific stretching and strengthening exercises to decrease your neck pain and prevent it from coming back. When performed correctly, yoga can be an excellent method to both stretch and strengthen your body.

Seek an experienced, certified massage therapist for treatment.

There are many types of massage that can help relieve neck pain, but it is important to seek treatment from a certified massage therapist who can assess your condition and recommend the massage techniques that are right for you.

 
 
 

Massage Therapy for Frozen Shoulder

If you’ve been having trouble lifting your arm over your head because your shoulder is too stiff or painful, you may have a condition called adhesive capsulitis, commonly known as “frozen shoulder.”

Frozen shoulder is a general term used to describe a restricted range of motion or stiffness in the shoulder. Adhesive capsulitis is a specific condition characterized by a gradual onset of stiffness and pain in one shoulder caused by inflammation and tightening of the joint capsule (ligaments that attach the shoulder bones). Often, the terms frozen shoulder and adhesive capsulitis are used interchangeably.

Regular massage treatments can help manage shoulder pain and loosen stiff shoulder muscles. The standard treatment for frozen shoulder also includes regular physical therapy, home exercises, heat therapy, nonsteroidal anti-inflammatory medications (NSAIDs) and steroid injections. Prompt treatment aids recovery, although it may take from 12 to 18 months to nearly or fully restore range of motion. Conservative treatments are generally successful in treating frozen shoulder, although in some cases surgery may be needed to release the contracted joint capsule in the shoulder.

How Can Massage Therapy Help with Frozen Shoulder?

Massage therapy is a helpful treatment for frozen shoulder because it increases blood flow to the injured area and helps to reduce scar tissue. Regular massage treatments are needed to reduce muscle stiffness, and you may not start to feel relief until after several massage treatments.

A combination of techniques, performed by an experienced massage therapist, will provide shoulder pain relief and help your recovery during the “thawing,” or recovery stage of the condition. Deep-tissue massage is a common technique used to treat frozen shoulder. With this technique, the therapist applies steady pressure to the muscles to release adhesions or scar tissue that may be contributing to shoulder pain. A Japanese form of deep-tissue massage, called shiatsu, involves deep pressure on specific areas of the body, called acupressure points, to adjust energy flow (“Ki” in Japanese) through the body, thereby reducing pain. Deep-tissue massage techniques should be avoided during times of acute shoulder pain, inflammation, or swelling.

Other massage techniques for frozen shoulder include trigger point therapy, in which steady pressure is applied to targeted points within muscles to relieve muscle spasms, and Swedish massage, which involves gentle kneading and long strokes applied to surface muscle tissues to reduce stress and tension.

Heat therapy, applied immediately before or after massage, is also very beneficial in treating frozen shoulder.

What is Massage Therapy?

Massage is a manual therapy that uses hands-on manipulation of the muscles and other soft tissues to relieve muscle tension and reduce stress. Although massage treats the whole body, it is especially therapeutic for the musculoskeletal, circulatory, lymphatic, and nervous systems.

What Causes Frozen Shoulder?

Frozen shoulder most commonly affects people from 40 to 60 years old and typically affects one shoulder, but can also develop in both shoulders. Frozen shoulder can occur after a fall or motor vehicle accident or may be related to an underlying condition, such as arthritis, a shoulder injury, rotator cuff tendonitis, or resulting from shoulder surgery. The use of a sling, splint, or cast may cause joint stiffness and contribute to frozen shoulder due to limited use and immobility. Diabetes increases the risk of developing frozen shoulder. Often there is no known underlying cause for frozen shoulder.

A gradual onset of pain is the initial symptom of frozen shoulder (phase one or the “freezing” stage), which leads the person into developing stiffness due to lack of movement (second phase of the condition or the “frozen” stage). Although pain decreases gradually in the second phase, stiffness remains. The “thawing,” or third phase of the condition, occurs when shoulder function and range of motion gradually improve and the pain subsides.

If you develop shoulder pain that limits range of motion for an extended period of time, your doctor should perform a thorough medical examination. X-rays and MRIs can help your doctor rule out arthritis or other underlying conditions and plan the best course of treatment. Arthroscopy (also called arthroscopic surgery), a type of minimally invasive procedure in which a contrast material is injected into the joint space, also may be used to allow the physician to examine the extent of scarring or inflammation.

It is important to seek immediate medical attention if your shoulder pain is severe or if fever, dizziness, weakness, or any unusual symptoms occur along with shoulder pain.

Helpful Tips for Shoulder Pain

  • Perform the stretching and strengthening exercises recommended by your doctor or physical therapist: If you are experiencing shoulder pain, don’t stop moving your shoulder completely; continue to perform gentle exercises to maintain your mobility, as advised. Resting the injured area for prolonged periods may increase muscle stiffness and reduce range of motion.
  • Warm up properly before any activity, and don’t neglect your “good” shoulder —exercising both shoulders is equally important: A physical therapist can recommend specific stretching and strengthening exercises to loosen the shoulder joint, decrease your pain, and help speed your recovery.
  • Seek treatment from an experienced therapist: A specially trained physical therapist or a certified massage therapist who has experience treating frozen shoulder and other shoulder conditions should provide treatment so you can achieve maximum benefits.
 

  

Massage for Tendinitis

Tendinitis (also spelled tendonitis) is the painful inflammation of a tendon (fibrous tissue that connects muscle to bone) that often occurs as the result of a repetitive strain or a muscular overuse injury. Massage is a type of manual therapy that can help relieve the pain associated with tendinitis and improve overall function by manipulating the affected area to reduce excessive tension in the connective tissue and muscles, and promote healing.

How Can Massage Help Relieve Tendinitis?

Treatments for tendinitis are intended to heal the injured tendon. Restricted activity, rest, anti-inflammatory medications, elevation, compression, and splinting are the first lines of treatment for tendinitis. Massage for tendinitis may help relieve excessive tension and help prevent the buildup of scar tissue via hands-on manipulation of the affected area. Icing may be done before and after massage to provide optimal relief.

Massage should not be given during the acute stage of a tendinitis injury (which is typically the first 48 hours after injury) and should not be performed when tissues are swollen or visibly inflamed.

Studies have suggested that deep transverse friction massage (also called Cyriax massage) is the type of massage that is most beneficial for treating tendinitis. With this technique, the fingers use short, abrupt, sweeping back-and-forth motions to move the skin but do not slide over it. The goal of transverse massage is to move across a ligament or tendon to mobilize it as much as possible. Transverse massage, when performed before active exercise, can help reduce the pain associated with tendinitis and restore mobility. Transverse massage is generally thought to be safe and effective for treatment of tendinitis, though larger studies are needed to conclusively determine the exact benefits of transverse friction massage for tendinitis.

The Active Release Technique is a patented soft tissue management treatment that reduces adhesions and scar tissue that may form as the result of tendinitis. This muscle manipulation massage technique is used to treat problems that occur with tendons, as well as muscles, ligaments, fascia, and nerves. This specific massage technique combines precisely directed tension by the practitioner with very specific active movements by the patient to release the contacted tissue. Treatments take about eight to 15 minutes for each area being treated and two to ten visits may be needed before full functionality is restored.

What is Tendinitis?

Tendinitis is the pain and tenderness that occur just outside of a joint as the result of inflammation or irritation of a tendon. Tendinitis commonly affects the shoulder (rotator cuff tendinitis), elbow (tennis elbow or golfer's elbow), wrist and thumb (de Quervain's disease), hip (iliotibial band tendinitis), knee (runner’s knee or peripatellar tendinitis), and lower calf or ankle (Achilles tendinitis). People with a chronic medical condition such as diabetes may have calcific tendinitis, a buildup of calcium deposits in the joint.

Acute (sudden onset) tendinitis may lead to chronic (long-term) tendinitis (called tendinosis or tendinopathy) if the person does not adequately rest the joint or if the person keeps using the joint while experiencing symptoms.

What Causes Tendinitis?

Repetitive strain injury (also called overuse injury) is the most common cause of tendinitis and may occur more commonly with certain occupations or sports (such as baseball, golf or tennis). It may also be associated with an inflammatory condition, such as rheumatoid arthritis, or may occur as the result of an acute injury, such as an excessive muscle stretch.

How Can Tendinitis be Prevented?

Stretching before and after an activity, cross-training, and avoiding activities that cause excessive stress on the tendons for long periods can help prevent or reduce the risk of tendinitis. Physical therapy that includes range-of-motion exercises as well as flexibility and strengthening exercises also may help reduce the risk of recurring tendinitis.

Finding a Massage Therapist

It is important to seek treatment from an experienced, licensed massage therapist who can assess your condition and recommend the massage techniques that are right for you. Most states regulate the massage therapy profession in the form of a license, registration or certification.

A variety of massage styles incorporate elements of cross fiber and active release techniques to relieve tendinitis. Ask your massage practitioner about their experience with these advanced manipulations for treatment.

Some important questions to ask the massage therapist, as recommended by the American Massage Therapy Association, include:

  • Are you licensed to practice massage?
  • How long have you been practicing massage?
  • Do you have experience in performing deep transverse friction massage for tendinitis?
  • Are you nationally certified in therapeutic massage and bodywork?
  • Are you a member of the American Massage Therapy Association?
  • Where did you receive your massage therapy training?

 

     
 

Tennis elbow

Definition

Tennis elbow is an inflammation of several structures of the elbow. These include muscles, tendons, bursa, periosteum, and epicondyle (bony projections on the outside and inside of the elbow, where muscles of the forearm attach to the bone of the upper arm). This condition is also called epicondylitis, lateral epicondylitis, medial epicondylitis, or golfer's elbow, where pain is present at the inside epicondyle.

Description

The classic tennis elbow is caused by repeated forceful contractions of wrist muscles located on the outer forearm. The stress, created at a common muscle origin, causes microscopic tears leading to inflammation. This is a relatively small surface area located at the outer portion of the elbow (the lateral epicondyle). Medial tennis elbow, or medial epicondylitis, is caused by forceful repetitive contractions from muscles located on the inside of the forearm. All of the forearm muscles are involved in tennis serves, when combined motions of the elbow and wrist are employed. This overuse injury is common in adults between ages 20–40.

 

People at risk for tennis elbow are those in occupations that require strenuous or repetitive forearm movement. Such jobs include mechanics, assembly line work, house painting, or carpentry. Sport activities that require individuals to twist the hand, wrist, and forearm, such as tennis, throwing a ball, bowling, golfing, and skiing, can cause tennis elbow. Individuals in poor physical condition who are exposed to repetitive wrist and forearm movements for long periods of time may also be prone to tennis elbow.

Causes & symptoms

Tennis elbow pain originates from a partial tear of the tendon and the attached covering of the bone. It is caused by chronic stress on tissues attaching a group of forearm muscles known as extensor muscles to the elbow area. Individuals experiencing tennis elbow may complain of pain and tenderness over either of the two epicondyles. This pain increases with gripping or rotation of the wrist and forearm. If the condition becomes long-standing and chronic, a decrease in grip strength can develop.

Diagnosis

Diagnosis of tennis elbow includes the individual observation and recall of symptoms, a thorough medical history, and physical examination by a physician. Diagnostic testing is usually not necessary unless there may be evidence of nerve involvement from underlying causes. X rays are usually always negative because the condition is primarily soft tissue in nature, in contrast to a disorder of the bones. However, magnetic resonance imaging (MRI) has been shown to be helpful in diagnosing cases of early tennis elbow because it can detect evidence of swelling and tissue tears in the common extensor muscle group.

Treatment

Heat or ice is helpful in relieving tennis elbow pain. Once acute symptoms have subsided, heat treatments are used to increase blood circulation and promote healing. The physician may recommend physical therapy to apply diathermy or ultrasound to the inflamed site. These are two common modalities used to increase the thermal temperature of the tissues in order to address both pain and inflammation. Occasionally, a tennis elbow splint may be useful to help decrease stress on the elbow throughout daily activities. Routine exercises are very important to improve flexibility to all forearm muscles, and will aid in decreasing muscle and tendon tightness that has been creating excessive pull at the common attachment of the epicondyle.

Massage therapy also has been found to be beneficial if symptoms are mild. Massage techniques are based primarily on increasing circulation to promote efficient reduction of inflammation. Manipulation, acupuncture, and acupressure have been used as well. Contrast hydrotherapy (alternating hot and cold water or compresses, three minutes hot, 30 seconds cold, repeated three times, always ending with cold) applied to the elbow can help bring nutrient-rich blood to the joint and carry away waste products. Botanical medicine and homeopathy may also be effective therapies for tennis elbow. For example, cayenne (Capsicum frutescens) ointment or arnica, wintergreen, or rue oil applied topically may help to increase blood flow to the affected area and speed healing.

Allopathic treatment

The physician may also prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation and pain. Injections of cortisone or anesthetics are often used if physical therapy is ineffective. Cortisone reduces inflammation, and anesthetics temporarily relieve pain. Physicians are cautious regarding an excessive number of injections as they have been found to weaken the tendon's integrity. In addition, a significant number of patients experience a temporary increase in pain following corticosteroid injections.

A newer method of treatment for tennis elbow is shock wave therapy, in which pulses of high-pressure sound are directed at the injured part of the tendon. The "shock" refers to the high pressure, which breaks down scar tissue and stimulates the regrowth of blood vessels in healthy tissue. Shock wave therapy sessions take about 20 minutes and have been reported to have a success rate of 80%. Shock wave therapy has very few side effects; one group of German physicians found that temporary reddening of the skin or small bruises were the most commonly reported side effects.

Botulinum toxin, or Botox, is also being tried as a treatment for tennis elbow as of late 2003. Although further research needs to be done, Botox appears to relieve pain in chronic tennis elbow by relaxing muscles that have gone into spasm from prolonged inflammation.

Surgery

If conservative methods of treatment fail, surgical release of the tendon at the epicondyle may be a necessary form of treatment. Although surgical intervention is relatively rare in the treatment of tennis elbow, it is completely succesful in about 70% of cases.

Expected results

Tennis elbow is usually curable; however, if symptoms become chronic, it is not uncommon for treatment to continue for three to six months.

Prevention

Until symptoms of pain and inflammation subside, activities requiring repetitive wrist and forearm motion should be avoided. Once pain decreases to the point that return to activity can begin, the playing of such sports as tennis for long periods should not occur until excellent condition returns. Many times, choosing a different size or type of tennis racquet or tool may help. Frequent rest periods are important despite what the wrist and forearm activity may be. Compliance to a stretching and strengthening program is very important in helping prevent recurring symptoms and exacerbation. In some cases, the patient may be advised to change his or her occupation to prevent further injury. 

 
 

Massage Therapy for Carpal Tunnel Syndrome (CTS)

Studies have shown that Carpal Tunnel Syndrome (CTS) symptoms are lessened following massage therapy. In general, massage is believed to support healing, boost energy, reduce recovery time after an injury, ease pain, and enhance relaxation, mood, and well-being. When used for Carpal Tunnel Syndrome, massage may lead to a significant reduction in pain and symptoms, as well as improved grip strength. Massage therapy can help relieve pain from muscles in the arm or shoulder that may mimic Carpal Tunnel Syndrome.

How Can Massage Help Carpal Tunnel Syndrome (CTS)?

Massage therapy eases the symptoms of Carpal Tunnel Syndrome and increases grip strength, according to a recent study. The massage routine consisted of stroking with moderate pressure from the fingertips to the elbow. Improvements lasted for at least four weeks after treatment.

A simple, self-performed “wrist-wringing” technique may also help to ease congestion in the wrist and encourage fluid movement in the joints. To use the technique, a person clasps one wrist with the other hand and massages it in a circular movement. Avoid movements that are painful and exercise the hands and arms gently to stretch them.

Professional massage therapy techniques, such as Neuromuscular Therapy (NMT) and Myofascial Release (MFR), can ease pressure on the nerve from inflamed tendons within the carpal tunnel and excessive fluid in the wrist area.

Studies have shown that both general massage and Carpal Tunnel Syndrome-targeted massage treatment programs reduced Carpal Tunnel Syndrome. Gains in grip strength, however, were only noted with the Carpal Tunnel Syndrome-targeted massage.

Special Considerations When Using Massage for Carpal Tunnel Syndrome (CTS)

There are several important factors to note when considering massage for Carpal Tunnel Syndrome. Direct manipulation of the damaged nerve is highly detrimental and can easily cause other problems. Direct pressure on the carpal tunnel region should be applied rarely and always with great caution.

In addition to specific techniques that focus on the wrist flexors or the carpal-tunnel region, it is important to address all the regions of the upper extremity and the neck when treating Carpal Tunnel Syndrome. The median nerve may be compressed in a number of other locations, which could further irritate the nerve at the carpal tunnel.

In general, massage is considered relatively safe. Pain or other rare negative side effects are usually only caused by an extremely vigorous massage techniques.

What is Carpal Tunnel Syndrome (CTS)?

Carpal Tunnel Syndrome, also called Repetitive Strain Injury or Repetitive Stress Injury (RSI), is a condition caused by an obstructed nerve in the wrist, resulting in pain and numbness in the index and middle fingers and weakness of the thumb. The carpal tunnel receives its name from the eight bones in the wrist, called carpals. These bones form a tunnel through which the median nerve extends toward the hand. Tasks requiring highly repetitive and forceful movements of the wrist can cause swelling around the tendons, resulting in a pinched nerve and producing symptoms of Carpal Tunnel Syndrome.

Signs and Symptoms of Carpal Tunnel Syndrome (CTS) Include:

  • Nighttime painful tingling in one or both hands, often disturbing sleep
  • Daytime tingling in the hands, followed by a decreased ability to squeeze things
  • Pain shooting from the hand up the arm as far as the shoulder
  • A feeling of uselessness in the fingers
  • A sense that fingers are swollen, even though little or no swelling is outwardly apparent
  • Tingling and burning in the thumb and first three fingers
  • Inability to perform simple manual tasks, such as picking up small objects
  • Loss of strength in the thenar muscle at the base of the thumb near the palm

Who is at Risk for Carpal Tunnel Syndrome (CTS)?

People at risk for Carpal Tunnel Syndrome include those who work at the computer all day, cashiers, carpenters, gardeners, and mechanics. Carpal Tunnel Syndrome is associated with health conditions such as Lyme disease, pregnancy and menopause. People with back, neck or shoulder problems, such as a slipped disc, broken collar bone or neck injury, are more likely to develop Carpal Tunnel Syndrome. Conditions including thyroid problems, diabetes, obesity, and rheumatoid arthritis can increase the risk of Carpal Tunnel Syndrome. Although Carpal Tunnel Syndrome can develop at any age, it most commonly occurs in people between the ages of 40 and 60. Women are more likely than men to develop Carpal Tunnel Syndrome. Use of caffeine, tobacco, alcohol, and artificial sweeteners are also contributing risk factors.

More than half of all pregnant women develop symptoms of Carpal Tunnel Syndrome. Fortunately, the condition generally improves after childbirth.

Should Anyone Avoid Massage?

People with rheumatoid arthritis or skin lesions, such as eczema, should not receive massage therapy during flare-ups. Those with cancer should check with their doctors before considering massage because a treatment can further damage tissue already subjected to chemotherapy or radiation treatments. Experts also advise that people with osteoporosis, high fever, few blood platelets or white blood cells, or mental impairment, or those recovering from surgery, should avoid massage.

Women should be cautious when receiving full body massages during pregnancy. Pregnant women should consult a therapist specifically trained to perform massages on pregnant women.

Tell your massage therapist about any medications you are taking, as massage may influence the absorption or activity of both oral and topical medications.

 
 
 
 
 
 
 

Massage for Back Pain

Back pain is one of the most common complaints heard by doctors today. It is highly likely that you will experience some level of back pain during your life. Unfortunately, if the condition does not resolve quickly, you can end up with chronic back pain that can become difficult to treat. The good news is that regular massage treatments can help you manage your back pain and lead a healthier life.

What Causes Back Pain?

Back pain can appear anywhere along your spine, leading to the development of neck pain, mid-back pain, and lower back pain. The most common causes are muscle spasms, sprains or strains of tendons or ligaments, herniated discs, or a variety of degenerative disorders related to the spine.

It is always recommended to get a thorough medical examination if you have chronic back or neck pain to eliminate any serious structural or physiological issues with your spine. X-rays and MRIs of the relevant area can help determine the best treatments for you. If you suddenly experience any unusually symptoms with your back pain, it is best to seek medical attention immediately.

Try to avoid suppressing your back pain with over-the-counter pain killers. While these drugs may provide temporary relief of back pain, they do not help resolve your condition and may cause unwanted side-effect or develop into chemical dependency.

How Can Massage Help Back Pain?

Back pain can be a difficult condition to treat. Often, the cause is related to a postural or repetitive stress on the body. Fortunately, regular massage treatments can help identify which muscles are tight and begin to dissolve this tension to provide relief.

Depending on the severity of your back pain, it may be necessary to have several massage treatments before you have sustainable relief of your back pain. Consult with your massage therapist for the proper frequency of treatment best suited to your condition.

When treating back pain, it is advisable for you to use several methods of massage together to enhance your recovery. Often, an experienced massage therapist will have training in several styles of massage allowing them to use a variety of techniques to help your back pain.

Here are some well-know styles of massage that can be beneficial for back pain:

Swedish Massage:
Swedish massage can be an excellent way to start treatment for back pain. The relaxing oil-based massage can release of many of the surface muscles and decrease the emotional stress that may be contributing to your back pain condition.

Deep Tissue Massage:
Deep tissue massage is commonly used in conjunction with Swedish massage to work the deeper muscles of the back. Hard compression and cross fiber friction can be applied to your back muscles to break up any adhesions or scar tissue that may be causing your back pain.

Trigger Point Therapy:
Trigger point therapy can be used to release muscles in your back that are in spasm. By applying steady pressure on the knots in your muscles, you can “reset” the muscle and release the spasm. This will allow fresh blood and nutrients to flow through the area and promote healing. Trigger Point therapy is excellent at correcting postural imbalances of muscles, a common cause of back pain.

Helpful Tips for Back Pain

Always seek an experienced, certified massage therapist for treatment:
There are many techniques of massage that can help, but they can also aggravate a back pain condition. The massage therapist should never work directly on any area that is acutely swollen or inflamed.

Stretching and Exercise can help rehabilitate your back:
Back pain often occurs due to muscle imbalances or weakness in your body. By regularly stretching and performing core strengthening exercises, you can decrease your back pain and prevent it from coming back. Hamstring tightness is a common cause of back pain. Yoga can be an excellent method to both stretch and strengthen you body when performed correctly.

If your back pain is not preventing you from moving, keep active:
By immobilizing yourself when you feel back pain, you maybe preventing circulation of blood through you back that can assist your body’s self-healing mechanisms.

Maintain good posture and get a good quality mattress:
The way you stand and sit places significant strain on your back. This can lead to back and neck pain if you are not aligned properly. You should try to always maintain a natural spine position. Consider a lumbar support cushion for your car seat or desk chair. Also, make sure your mattress is providing proper support when you sleep; often, a worn out mattress can lead to back pain.

 
 
Scoliosis...
 
 
 Ankylosing Spondylitis...
 
 
 
 
 
 
  
 

Sciatica / Piriformis - Hip Pain

Definition
 

Sciatica refers to pain or discomfort associated with the sciatic nerve. This nerve runs from the lower part of the spinal cord down the back and side of the leg to the foot. Injury to or pressure on the sciatic nerve can cause the characteristic pain of sciatica: a sharp or burning pain or even numbness that radiates from the lower back or hip, possibly following the path of the sciatic nerve to the foot.

Description

The sciatic nerve is the largest and longest nerve in the body. About the thickness of a person's thumb, it spans from the lower back to the foot. The nerve originates in the lower part of the spinal cord, the so-called lumbar region. As the sciatic nerve branches off from the spinal cord, it passes between the bony vertebrae (the component bones of the spine) and runs through the pelvic girdle, or hip bones, and the buttock area. The nerve passes through the hip joint and continues down the back and side of the leg to the foot.

 
 
 Sciatica/Piriformis Syndrome... 
 
 
Sciatica is a fairly common disorder, approximately 40% of the population experiences it at some point in their lives. However, only about 1% have coexisting sensory or motor deficits. Sciatic pain has several root causes and treatment may hinge upon the underlying problem.

Of the identifiable causes of sciatic pain, lumbosacral radiculopathy and back strain are the most frequently suspected. The term lumbosacral refers to the lower part of the spine, and radiculopathy describes a problem with the spinal nerve roots that pass between the vertebrae and give rise to the sciatic nerve. This area between the vertebrae is cushioned with a disk of shock-absorbing tissue. If this disk shifts or is damaged through injury or disease, the spinal nerve root may be compressed by the shifted tissue or the vertebrae.

This compression of the nerve roots sends a pain signal to the brain. Although the actual injury is to the nerve roots, the pain may be perceived as coming from any point along the sciatic nerve.

The sciatic nerve can be compressed in other ways. Back strain may cause muscle spasms in the lower back, placing pressure on the sciatic nerve. In rare cases, infection, cancer, bone inflammation, or other diseases may cause the pressure. More likely, but often overlooked, is the piriformis syndrome. As the sciatic nerve passes through the hip joint, it shares the space with several muscles. One of these muscles, the piriformis muscle, is closely associated with the sciatic nerve. In some people, the nerve actually runs through the muscle. If this muscle is injured or has a spasm, it places pressure on the sciatic nerve—in effect, compressing it.

In many sciatica cases, the specific cause is never identified. About half of affected individuals recover from an episode within a month. Some cases can linger a few weeks longer and may require aggressive treatment. In other cases, the pain may return or potentially become chronic.

Causes & symptoms

Persons with sciatica may experience some lower back pain, but the most common symptom is pain that radiates through one buttock and down the back of the adjoining leg. The most identified cause of the pain is compression or pressure on the sciatic nerve. The extent of the pain varies among individuals. Some people describe pain that centers in the area of the hip, and others perceive discomfort all the way to the foot. The quality of the pain also varies; it may be described as tingling, burning, prickly, aching, or stabbing.

Onset of sciatica can be sudden, but it can also develop gradually. The pain may be intermittent or continuous. Certain activities, such as bending, coughing, sneezing, or sitting, may make the pain worse.

Chronic pain may arise from more than just compression on the nerve. According to some pain researchers, physical damage to a nerve is only half of the equation. A recent theory proposes that some nerve injuries result in a release of neurotransmitters and immune system chemicals that enhance and sustain a pain message. Even after the injury has healed or the damage has been repaired, the pain continues. Control of this abnormal type of pain is difficult.

Diagnosis

Before treating sciatic pain, as much information as possible must be collected. The individual is asked to recount the location and nature of the pain, how long it has continued, and any accidents or unusual activities prior to its onset. This information provides clues that may

point to back strain or injury to a specific location. Back pain from disk disease, piriformis syndrome, and back strain must be differentiated from more serious conditions such as cancer or infection. Lumbar stenosis, an overgrowth of the covering layers of the vertebrae that narrows the spinal canal, must also be considered. The possibility that a difference in leg lengths is causing the pain should be evaluated; the problem can be easily be treated with a foot orthotic or built-up shoe.

Often, a straight-leg-raising test is done, in which the person lies face upward and the healthcare provider raises the affected leg to various heights. This test pinpoints the location of the pain and may reveal whether it is caused by a disk problem. Other tests, such as having the individual rotate the hip joint, assess the condition of the hip muscles. Any pain caused by these movements may provide information about involvement of the piriformis muscle, and piriformis weakness is tested with additional leg-strength maneuvers.

Further tests may be done depending on the results of the physical examination and initial pain treatment. Such tests might include magnetic resonance imaging (MRI) and computed tomography (CT) scans. Other tests examine the conduction of electricity through nerve tissues, and include studies of the electrical activity generated as muscles contract (electromyography), nerve conduction velocity, and evoked potential testing. A more invasive test involves injecting a contrast substance into the space between the vertebrae and making x-ray images of the spinal cord (myelography), but this procedure is usually done only if surgery is being considered as an option. All of these tests can reveal problems with the vertebrae, the disk, or the nerve itself.

Treatment

Massage is a recommended form of therapy, especially if the sciatic pain arises from muscle spasm. Symptoms may also be relieved by icing the painful area as soon as the pain occurs. Ice should be left on the area for 30–60 minutes several times a day. After two or three days, a hot water bottle or heating pad can replace the ice. Chiropractic or osteopathy may offer possible solutions for relieving pressure on the sciatic nerve and alleviating the accompanying pain. Biofeedback may also be useful as a pain control method. Bodywork, such as the Alexander technique, can assist an individual in improving posture and preventing further episodes of sciatic pain.

Acupuncture is another alternative approach that appears to offer relief to many persons with sciatica, as indicated by several clinical trials in the United States and Europe. The World Health Organization (WHO) lists sciatica as one of 40 conditions for which acupuncture is recognized as an appropriate complementary treatment.

Practitioners of Ayurvedic medicine regard sciatica as a disorder resulting from an imbalance in vata, one of three doshas or energies in the human body. The traditional Ayurvedic treatment for vata disorders is vasti, or administration of an oil-based enema to cleanse the colon. An Ayurvedic herbal preparation that is used to treat sciatica is made from the leaves ofNyctanthes arbor tristis, which is also known as Parijat or "sad tree." A recent study of an alcohol-based extract of this plant indicates that it is effective as a tranquilizer and local anesthetic, which supports its traditional Ayurvedic use.

Western herbalists typically treat sciatica with valerian root to relax the muscle spasms that often accompany sciatica, and with white willow bark for pain relief.

Homeopathic remedies for sciatica include Ruta graveolens, Colocynth (for sciatic pain that is worse in cold or damp weather), or Magnesium phosphoric (for lightning-like pains that are soothed by heat and made worse by coughing).

Allopathic treatment

Initial treatment for sciatica focuses on pain relief. For acute or very painful flare-ups, bed rest is advised for up to a week in conjunction with medication for the pain. Pain medication includes acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, or muscle relaxants. If the pain is unremitting, opioids may be prescribed for short-term use, or a local anesthetic will be injected directly into the lower back. Massage and heat application may be suggested as adjuncts.

If the pain is chronic, different pain relief medications are used to avoid long-term dosing of NSAIDs, muscle relaxants, and opioids. Antidepressant drugs, which have been shown to be effective in treating pain, may be prescribed alongside short-term use of muscle relaxants or NSAIDs. Local anesthetic injections or epidural steroids are used in selected cases.

As the pain allows, physical therapy is introduced into the treatment regime. Stretching exercises that focus on the lower back, buttock, and hamstring muscles are suggested. The exercises also include finding comfortable, pain-reducing positions. Corsets and braces may be useful in some cases, but evidence for their general effectiveness is lacking. However, they may be helpful to prevent exacerbations related to certain activities.

With less pain and the success of early therapy, the individual is encouraged to follow a long-term program to maintain a healthy back and prevent re-injury. A physical therapist may suggest exercises and regular activity, such as water exercise or walking. Patients are instructed in proper body mechanics to minimize symptoms during light lifting or other activities.

If the pain is chronic and conservative treatment fails, surgery to repair a herniated disk or to cut out part or all of the piriformis muscle may be suggested, particularly if there is evidence of nerve or nerve-root damage.

A new minimally invasive surgical treatment for sciatica was introduced in 2002. It is known as microscopically assisted percutaneous nucleotomy, or MAPN. MAPN allows the surgeon to repair a herniated disk with less damage to surrounding tissues; it shortens the patient's recovery time and relieves the pain of sciatica as effectively as more invasive surgical procedures.

Expected results

Most cases of sciatica are treatable with pain medication and physical therapy. After four to six weeks of treatment, an individual should be able to resume normal activities.

Prevention

Some sources of sciatica are not preventable, such as disk degeneration, back strain due to pregnancy, or accidental falls. Other sources of back strain, such as poor posture, overexertion, being overweight, or wearing high heels, can be corrected or avoided. Cigarette smoking may also predispose people to pain, and should be discontinued with the onset of pain.

General suggestions for avoiding sciatica or preventing a repeat episode include sleeping on a firm mattress; using chairs with firm back support; and sitting with both feet flat on the floor. Habitually crossing the legs while sitting can place excess pressure on the sciatic nerve. Sitting for long periods of time can also place pressure on the sciatic nerves, so it is recommended to take short breaks and move around during the work day, during long trips, or in other situations that require sitting for extended periods of time. If lifting is required, the back should be kept straight and the legs should provide the lift. Regular exercise, such as swimming and walking, can strengthen back muscles and improve posture. Exercise can also help maintain a healthy weight and lessen the likelihood of back strain.

 
 
 
 
 
 
 
 

Knee pain

Definition
 

Knee pain refers to any aching or burning pain in the knee joint. Knee pain can be a symptom of numerous conditions and diseases, including knee stress, osteoarthritis, injury, gout, infection, and bursitis.

Description

Knee pain is very common. Each year, millions of Americans visit the doctor for knee pain. It is the most frequent reason for visits to an orthopedist (bone and joint surgeon).

  
 
To understand the various causes of knee pain, it is important to know how the knee functions. The knee refers to the joint where the femur (thigh bone) meets the tibia (largest lower leg bone). In front of this joint lies the patella (knee cap). The joint is lined by a membrane called a synovial sac. The synovial sac produces synovial fluid which acts as a lubricant much in the way that oil lubricates the moving parts of machinery. Other tissues that make up the knee joint include cartilage, muscles, tendons, and ligaments. The upper end of the tibia has cartilaginous shock absorbers called menisci (singular meniscus). Other protective structures are the bursae, which cushion areas of friction in the joint. Most of the muscles involved with joint mobility originate in the thigh, cross the knee joint, and attach to the tibia.

The knee supports two to three times a person's body weight. It is a complex joint that allows for a considerable range in mobility. In addition to simple flexion (bending) and extension (straightening) movements, the knee joint is designed to allow for rotation, gliding, and rolling movements. To allow for complex mobility and joint stability, joint strength is sacrificed, making the knee vulnerable to injury.

Causes & symptoms

Knee pain is a symptom of many different diseases and conditions. Short-term knee pain may be the result of excess stress on the knee. Possible causes of knee pain include:

  • Arthritis. Osteoarthritis (joint degeneration), rheumatoid arthritis (joint inflammation), and septic arthritis (joint infection) can cause knee pain.
  • Bursitis. Inflammation of the bursae of the knee can cause knee pain. Bursitis, sometimes called house-maid's knee, can be caused by infection, gout, rheumatoid arthritis, injury, illness, or chronic irritation (crawling or kneeling).
  • Cysts. A cyst is a fluid-filled sac. Cysts associated with the knee can cause swelling and knee pain or discomfort.
  • Fracture. Breakage or crack in any of the bones associated with the knee joint can cause knee pain.
  • Gout. A faulty chemical process leads to high levels of uric acid in the blood which causes inflammatory arthritis, crystal deposits in joints, joint destruction, and joint pain.
  • Ligament injury or instability. The ligaments supporting the knee may be injured or strained by persons who participate in sports, particularly football, rugby, lacrosse, basketball, skiing, soccer, and volleyball. Other accidents can also cause ligament damage.
  • Loose bodies. This condition refers to any loose objects that float around the knee and cause problems. They also are called "joint mice" because of their elusive nature.
  • Meniscus conditions. Damage, usually in the form of a tear, to the menisci can result from degenerative changes associated with advancing age or sports-related injury. Sports that commonly cause menisci damage include football, basketball, soccer, tennis, lacrosse, and skiing.
  • Osteonecrosis. Degeneration of the bones associated with the knee cause pain and deformity.
  • Patellofemoral pain. Also known as anterior knee pain syndrome, this condition is characterized by pain around the knee cap. The exact cause of patellofemoral pain is unknown but is probably related to muscle inadequacy, lack of flexibility, rapid growth, or bone positioning.

Diagnosis

Knee pain can be diagnosed and treated by an orthopedic surgeon. Diagnosis is based primarily on medical history and physical exam. The diagnosis begins with a detailed medical history to fully characterize the knee pain. The knee will be bent to determine the range of motion and palpated (felt with the hands) to detect the presence of any abnormalities. The physical exam may include any of a number of different tests designed to detect injuries by manipulating the knee and leg. X rays may be taken. In some cases more advanced testing may be carried out using magnetic resonance imaging (MRI), computed tomography (CT), or contrast arthrography (x ray following injection of a contrast solution).

Treatment

Most alternative treatments for knee pain aim at reducing pain, inflammation, and stiffness. Persons experiencing long-term or severe knee pain should consult a physician to determine the underlying cause.

  • Massage. Joint pain may be relieved by massaging the area above and below the painful joint. Massaging with ice packs may interfere with pain signals and replace them with temperature signals.
  • Reflexology. Knee pain may be relieved by working the knee reflex points.
  • Rolfing. This deep, sometimes painful, massage therapy may speed healing and reduce pain.

   

Herbals

Several herbal remedies are recommended to relieve knee pain. Some remedies are used externally, while others involve internal use of herbs.

The following herbs may relieve knee pain and/or associated symptoms when used externally:

  • basil and sage oil rub: knee pain
  • comfrey (Symphytum officinale) oil rub: joint stiffness and aching joints
  • eucalyptus (Eucalyptus globulus) essential oil rub: swelling
  • ginger (Zingiber officinale) root hot compress or bath: joint stiffness, arthritis, and degenerative joint disease
  • lavender (Lavandula officinalis) essential oil rub: joint stiffness and aching joints
  • mustard (Sinapsis alba) powder bath or paste (with alcohol): knee pain
  • red pepper (Capsicum) lotion: arthritic pain and swelling
  • St. John's wort (Hypericum perforatum) oil rub: joint stiffness and aching joints
  • wintergreen (Gaultheria procumbens) oil rub: chronic pain

The following herbs may relieve knee pain and/or associated symptoms when used internally:

  • celery (Apium graveolens) decoction or tincture: swollen joints and gout
  • chamomile (Matricaria recutita): spasms and swelling
  • deadly nightshade (Atropa belladonna) plaster: swollen joints
  • devil's claw (Harpagophytum procumbens) tablets: swollen joints
  • flaxseed (Linus usitatissimum) oil: lubricates joints
  • geranium (Pelargonium odoratissimum): chronic pain
  • Jamaican dogwood (Piscidia erythrina): pain and swelling
  • lemon (Citrus limon) juice: swollen joints
  • prickly ash (Zanthoxylum americanum) tea: joint pain
  • white willow (Salix alba) tablets or decoction: swollen joints and joint pain
  • wild lettuce (Lactuca virosa): pain and swelling

Other remedies

Various other alternative treatments that can be helpful in relieving knee pain include:

  • Acupressure. Pressing the Stomach 36 point located below the knee caps tones muscles and relieves joint pain anywhere in the body. Pressing the Spleen 9 points located below the kneecap on the inside of each leg relieves knee pain.
  • Acupuncture. Inflammation and pain may be relieved by acupuncture. The large intestine meridian is the most effective channel for pain relief. A National Institutes of Health consensus panel found that acupuncture may be an effective treatment for osteoarthritis pain.
  • Aromatherapy. Aromatherapy with essential oils is sometimes recommended. The essential oil of peppermint relieves pain and decreases inflammation. The essential oil of rosemary relieves pain and relaxes muscles.
  • Chinese medicine. Knee sprain and contusion (bruise) are treated by application of Shang Ke Xiao Yan Gao (Relieve Inflammation Paste of Traumatology) and ingestion of Die Da Wan (Contusion Pill). Once the initial pain and swelling have been reduced, the patient can apply Shang Shi Zhi Tong Gao (Relieve Damp-Inducing Pain Medicinal Plaster).
  • Exercise. Regular moderate exercise can reduce pain by improving the strength, tone, and flexibility of muscles. The endorphins released while exercising may also be helpful.
  • Food therapy. Following a detoxification diet may restore nutritional balance to the body and relieve joint pain. Animal proteins may induce joint pain caused by such inflammatory conditions as arthritis, so following a vegetarian diet may be helpful.
  • Homeopathy. Rhus toxicodendron is recommended for joint and arthritis pain that is worse in the morning and relieved by warmth. Kali bichromium is indicated for persistent, severe pain. Other homeopathic remedies can be designed for specific cases by a homeopathic practitioner.
  • Hydrotherapy. A warm compress can relieve joint stiffness and dull pain. A cold compress or ice pack can relieve sharp, intense pain.
  • Magnetic therapy. Magnetic fields may increase blood flow and block pain signals

Allopathic treatment

Knee pain may be relieved by taking such nonsteroidal anti-inflammatory drugs as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). More severe pain may be treated with such prescription pain relievers as tramadol or a narcotic. Additional treatment for knee pain depends upon the underlying cause and may include injection of drugs into the knee, surgery, wearing a brace, and/or physical therapy. Surgical treatment depends on the cause; but in the case of osteoarthritis, some patients face actual replacement of the joint. However, in 2002, a new device was introduced that postponed the need to replace an arthritic knee. The device is made of chrome and fits between the natural structures of the knee.

Expected results

Most causes of knee pain respond well to conservative treatments and resolve within 4–6 weeks. Knee pain caused by injury or disease may require surgery and lengthy rehabilitation.

Prevention

Strengthening the leg muscles may help prevent knee pain caused by overworking the joint. In addition, a stronger knee may prevent injury to the joint. Squats are an easy exercise that will strengthen the quadriceps (front thigh muscles) and hamstrings (back thigh muscles). The yoga warrior posture strengthens the muscles around the knee and increases range of motion.

 
 
 

Sprains & strains - Ankle Pain 

Definition

Sprain refers to damage or tearing of ligaments or a joint capsule. Strain refers to damage or tearing of a muscle.

Description

When excessive force is applied to a joint, the ligaments that hold the bones together may be torn or damaged. This results in a sprain, and its seriousness depends on how badly the ligaments are torn. Any ligament can be sprained, but the most frequently injured ligaments are at the ankle, knee, and finger joints.Strains are tears in the muscle. Sometimes called pulled muscles, they usually occur because a muscle lacks the flexibility, strength, or endurance to perform a certain activity. The majority of strains occur where the muscle meets the tendon, although they may occur in the middle of the muscle belly as well.

Children under age eight are less likely to have sprains than are older people. Children's ligaments are tighter, and their bones are more apt to break before a ligament tears. People who are active in sports suffer more strains and sprains than less active people. Repeated sprains in the same joint make the joint less stable and more prone to future sprains. Muscle strains are also more likely to occur in muscles that have been previously injured.

Causes & symptoms

There are three grades of sprains. Grade I sprains are mild injuries in which there is a stretching or mild tearing of the ligament, yet no joint function is lost. However, there may be tenderness and slight swelling.

Grade II sprains are caused by a partial tear in the ligament. These sprains are characterized by obvious swelling, localized tenderness, pain, joint laxity, difficulty bearing weight if the injury is to a lower extremity, and reduced function of the joint.

Grade III, or third degree, sprains are caused by complete tearing of the ligament. There is severe pain, loss of joint function, widespread swelling, and the inability to bear weight if in the lower extremity. While a Grade III sprain may be very painful when it occurs, it is sometimes not painful after the injury because the ligament fibers have been completely torn and nothing is pulling on them. If this is true, the injury will be accompanied by a significant loss in joint stability.

Strains, like sprains, are also graded in three different categories. Grade I strains are considered mild. They are categorized by some localized swelling with no significant disruption of the muscle tendon unit. Stretching or contraction of the muscle may be painful.

Grade II strains indicate some disruption of the muscle tendon unit. They will often show a loss of strength and limitation in active motion, but the muscle has not been completely disrupted.

Grade III, or third degree, strains indicate a complete rupture in the muscle tendon unit. This injury is likely to be very painful and often the individual will report hearing a loud pop or snap when the injury occurred. The site of injury is often quite visible and there will be a significant defect in the muscle that can be felt with the fingers. A Grade III muscle strain will often have very serious bruising with it as well.

Diagnosis

Grade I sprains and strains are usually self-diagnosed. Grade II and III sprains are often seen by a physician, who may x ray the area to differentiate between a sprain and other serious joint injuries. Since muscles don't show up on x ray, Grade II and III muscle strains are usually diagnosed by physical examination.

Treatment

While the primary problem with sprains and strains is a torn or damaged ligament or muscle fiber, additional complications may develop as a result of swelling and immobilization of the injured area. In order to prevent these complications from worsening, alternative practitioners endorse RICE: Rest, Ice for 48 hours, Compression (wrapping in an elastic bandage), and Elevation of the sprain or strain above the level of the heart.

Nutritional therapists recommend vitamin C and bioflavonoids to supplement a diet high in whole grains, fresh fruits, and vegetables. Anti-inflammatories, such as bromelain (a proteolytic enzyme from pineapples) and turmeric (Curcuma longa), may also be helpful. The homeopathic remedy Arnica (Arnica montana) may be used initially for a few days, followed by Rhus tox(Rhus toxicodendron) for joint-related injuries or Ruta rutagraveolens for muscle-related injuries. Arnica gel or ointment, such asTraumeel, or a homeopathic combination of arnica and other remedies, has also been found effective with certain joint sprains.

Traditional Chinese medicine has been effectively used to treat soft tissue injuries like sprains and strains. Acupuncture is used to treat pain and speed the healing process in the damaged tissues by moving blocked energy from the area. The radiant heat of moxibustion may also be used to speed up the healing response in the damaged tissues.

Specialized forms of massage and soft tissue manipulation may be used by a variety of practitioners. Massage has significant effects in enhancing local circulation, promoting earlier mobility, and speeding the healing response in the damaged tissue. It will most often be used in combination with other approaches, including stretching and range of motion exercises.

Allopathic treatment

Grade I sprains and strains can be treated at home. Basic first aid for sprains consists of RICE (Rest, Ice, Compression, and Elevation). Such over-the-counter pain medication such as acetaminophen (Tylenol) or ibuprofen (Motrin) can be taken for pain.

People with grade II sprains or strains may often be referred to physical therapy. Crutches or splints may be used during the healing process to help maintain stability. Surgery may be required for Grade III sprains or strains as a greater amount of damage will often prevent adequate healing without surgery.

Expected results

Moderate sprains and strains heal within two to four weeks, but it can take months to recover from severe injuries. Until recently, tearing the ligaments of the knee meant the end of an athlete's career. Improved surgical and rehabilitative techniques now offer the possibility of complete recovery. However, once a ligament has been sprained, it may not be as strong as it was before. A muscle that has been strained is also more susceptible to reinjury.

Prevention

Sprains and strains can be prevented by warming up before exercising, using proper form when performing activities and conditioning, being careful not to exercise past the point of fatigue, and taping or bracing certain joints to protect them from injury.

 
 
 
 
 

Myofascial Release for Chronic Pain - Plantar Fasciitis...

Chronic pain is pain that lasts longer than three months or that continues well beyond the time when healing would be expected to be complete. It is one of the most difficult conditions for medical practitioners to diagnose and treat. The most common type of chronic pain is lower back pain.

Three factors complicate the treatment of chronic pain. First, chronic pain is not always associated with a specific injury or disease. Second, chronic pain is rarely constant; it often comes and goes for no obvious reason. Third, pain intensity is subjective and depends on a description by the patient. Because alternative practitioners tend to treat the whole body rather than one particular system, they often find success in relieving nonspecific chronic pain. Myofascial release is one alternative therapy used to treat chronic pain.

How Does Myofascial Release Help with Chronic Pain?

Chronic pain can be caused by many conditions that create uneven stress on the fascia, or the thin, strong connective tissue that covers muscles and bones and surrounds internal organs such as the heart, lungs, and intestines.

These conditions include:

  • Back strain or injury
  • Fibromyalgia
  • Whiplash
  • Injury to joints
  • Repetitive Stress Injuries (RSI)
  • Carpal Tunnel Syndrome (CTS)
  • Strains and sprains from falls
  • Plantar fasciitis
  • Physical stress
  • Psychological stress
  • Chronic Fatigue Syndrome (CFS)
  • Arthritis
  • Psychological stress
  • Poor posture

As the myofascial release practitioner performs gentle stretching and compression of the fascia and the muscles, the body relaxes and uneven tension on the fascia begins to self-correct. This release of tension affects the entire body because all fascia is interconnected. Some patients find that strong emotions are released along with physical tension. This emotional release can be especially helpful to patients whose stress and chronic pain has a psychological component.

There are no scientific studies that exactly explain how Myofascial Release works. Nevertheless, practitioners believe that correcting uneven strain on the fascia releases tension. This increases free movement of the fascia, helps muscles to move more easily, and relieves chronic pain throughout the body.

What is Myofascial Release?

Myofascial Release is a type of bodywork that helps release uneven stress in the fascia and restores equal muscle tension by increasing flexibility of the fascia. Normal, healthy fascia is flexible and provides a seamless, interconnected web that supports body structures.

Sprains, strains, scarring from surgery or injury, inflammation, disease, trauma from falls, repetitive stress, and even poor posture create uneven stress on the fascia. When the fascia is stressed, it loses its flexibility and no longer moves normally when the body moves. This creates unequal tension on muscles and causes them to lock or alter the way they move. This tension can result in chronic pain. Myofascial Release uses soft tissue massage techniques to restore the flexibility of the fascia and release tension from muscles. Occasionally Myofascial Release is referred to as connective tissue massage.

What Happens During a Myofascial Release Session?

Myofascial Release sessions usually last about one hour and can occur from one to three times a week. During the initial session, the practitioner and the client will discuss the client’s pain, treatment goals, and how Myofascial Release will help achieve those goals. The practitioner will also do a visual evaluation of the client’s posture and movement to help pinpoint potential sources of the pain. There is no standard protocol for a Myofascial Release session. Therapy is individualized based on the client’s pain and the feedback the practitioner gets from working with the client’s body.

The client usually wears a bathing suit or sports bra and pants to provide the practitioner maximum access to the body. No lubricant is used. The practitioner will use light pressure, compression, and traction to stretch the affected fascia. The process is slow and generally comfortable for the client. The process increases blood flow to the site and encourages the fascia to relax, unwind, and correct itself.

The practitioner also uses gentle pressure to find any painful trigger points and determines which part of the body needs work based on the feedback obtained from touch. Often only one or two parts of the body are worked on in a single session. Nevertheless, because all fascia is connected, working on one area will benefit the entire body. Normally the client will not feel stiff or sore on the day following treatment. Occasionally deeper, more intense pressure is needed if the fascia is tightly bound, and this may result in some brief soreness.

Although the client may begin to feel better after a single session, it generally takes three or more sessions before seeing relief of specific symptoms. Clients should check with their insurance company about coverage for payment. If Myofascial Release therapy is prescribed by a physician or administered by a licensed physical or occupational therapist, a specific number of sessions may be covered by insurance.

Who Does Myofascial Release?

In the United States, there is no national body that certifies practitioners of Myofascial Release. Although some form of Myofascial Release has been done since the 1940s, John T. Barnes, a physical therapist, popularized the technique in the 1990s. Many people trained in Myofascial Release are physical or occupational therapists, osteopathic physicians, or chiropractors who have taken special classes, often taught by Barnes, to learn the technique. Other practitioners of Myofascial Release have training in additional bodywork techniques such as Rolfing, Swedish massage, and deep-tissue massage.

 
 
 
 
 
 
Fibromyalgia...
 

Myofascial Release for Chronic Pain

Chronic pain is pain that lasts longer than three months or that continues well beyond the time when healing would be expected to be complete. It is one of the most difficult conditions for medical practitioners to diagnose and treat. The most common type of chronic pain is lower back pain.

Three factors complicate the treatment of chronic pain. First, chronic pain is not always associated with a specific injury or disease. Second, chronic pain is rarely constant; it often comes and goes for no obvious reason. Third, pain intensity is subjective and depends on a description by the patient. Because alternative practitioners tend to treat the whole body rather than one particular system, they often find success in relieving nonspecific chronic pain. Myofascial release is one alternative therapy used to treat chronic pain.

How Does Myofascial Release Help with Chronic Pain?

Chronic pain can be caused by many conditions that create uneven stress on the fascia, or the thin, strong connective tissue that covers muscles and bones and surrounds internal organs such as the heart, lungs, and intestines.

These conditions include:

  • Back strain or injury
  • Fibromyalgia
  • Whiplash
  • Injury to joints
  • Repetitive Stress Injuries (RSI)
  • Carpal Tunnel Syndrome (CTS)
  • Strains and sprains from falls
  • Plantar fasciitis
  • Physical stress
  • Psychological stress
  • Chronic Fatigue Syndrome (CFS)
  • Arthritis
  • Psychological stress
  • Poor posture

As the myofascial release practitioner performs gentle stretching and compression of the fascia and the muscles, the body relaxes and uneven tension on the fascia begins to self-correct. This release of tension affects the entire body because all fascia is interconnected. Some patients find that strong emotions are released along with physical tension. This emotional release can be especially helpful to patients whose stress and chronic pain has a psychological component.

There are no scientific studies that exactly explain how Myofascial Release works. Nevertheless, practitioners believe that correcting uneven strain on the fascia releases tension. This increases free movement of the fascia, helps muscles to move more easily, and relieves chronic pain throughout the body.

What is Myofascial Release?

Myofascial Release is a type of bodywork that helps release uneven stress in the fascia and restores equal muscle tension by increasing flexibility of the fascia. Normal, healthy fascia is flexible and provides a seamless, interconnected web that supports body structures.

Sprains, strains, scarring from surgery or injury, inflammation, disease, trauma from falls, repetitive stress, and even poor posture create uneven stress on the fascia. When the fascia is stressed, it loses its flexibility and no longer moves normally when the body moves. This creates unequal tension on muscles and causes them to lock or alter the way they move. This tension can result in chronic pain. Myofascial Release uses soft tissue massage techniques to restore the flexibility of the fascia and release tension from muscles. Occasionally Myofascial Release is referred to as connective tissue massage.

What Happens During a Myofascial Release Session?

Myofascial Release sessions usually last about one hour and can occur from one to three times a week. During the initial session, the practitioner and the client will discuss the client’s pain, treatment goals, and how Myofascial Release will help achieve those goals. The practitioner will also do a visual evaluation of the client’s posture and movement to help pinpoint potential sources of the pain. There is no standard protocol for a Myofascial Release session. Therapy is individualized based on the client’s pain and the feedback the practitioner gets from working with the client’s body.

The client usually wears a bathing suit or sports bra and pants to provide the practitioner maximum access to the body. No lubricant is used. The practitioner will use light pressure, compression, and traction to stretch the affected fascia. The process is slow and generally comfortable for the client. The process increases blood flow to the site and encourages the fascia to relax, unwind, and correct itself.

The practitioner also uses gentle pressure to find any painful trigger points and determines which part of the body needs work based on the feedback obtained from touch. Often only one or two parts of the body are worked on in a single session. Nevertheless, because all fascia is connected, working on one area will benefit the entire body. Normally the client will not feel stiff or sore on the day following treatment. Occasionally deeper, more intense pressure is needed if the fascia is tightly bound, and this may result in some brief soreness.

Although the client may begin to feel better after a single session, it generally takes three or more sessions before seeing relief of specific symptoms. Clients should check with their insurance company about coverage for payment. If Myofascial Release therapy is prescribed by a physician or administered by a licensed physical or occupational therapist, a specific number of sessions may be covered by insurance.

Who Does Myofascial Release?

In the United States, there is no national body that certifies practitioners of Myofascial Release. Although some form of Myofascial Release has been done since the 1940s, John T. Barnes, a physical therapist, popularized the technique in the 1990s. Many people trained in Myofascial Release are physical or occupational therapists, osteopathic physicians, or chiropractors who have taken special classes, often taught by Barnes, to learn the technique. Other practitioners of Myofascial Release have training in additional bodywork techniques such as Rolfing, Swedish massage, and deep-tissue massage.