Massage Treatment for Lower Back Pain How to Relieve Back Pain With Massage Therapy

That yearly massage may do more than just pamper. It also could help relieve chronic back pain. Read on as experts answer the most common questions about adding massage therapy to your back pain treatment plan... One of the best treatments for lower back pain may be one you instinctively crave: a relaxing massage. “Massage therapy improved function and decreased pain more than usual care,” according to a 2011 study conducted by Dan Cherkin, Ph.D., senior investigator of the Group Health Research Institute in Seattle. The benefits last for at least six months, Cherkin says. A trained, experienced massage therapist evaluates your back differently than a doctor or physical therapist does. “A massage therapist's significant experience with hands-on care [allows] her to perform a manual assessment of the soft tissues,” which can add to the information your doctor has gathered, says Paul Cooke, M.D., a physiatrist at the Hospital for Special Surgery in New York City. Massage treatment offers other healing benefits too, such as a chance to relax. “When we deal with chronic pain on a daily basis, it affects our daily activities,” says Joan Ishibashi, a licensed massage therapist at the Cleveland Clinic’s Center for Integrative Medicine in Ohio. Massage treatment is conducive to relaxation, says Michael Schneider, D.C., Ph.D., a chiropractor and assistant professor at the School of Health and Rehabilitation Sciences at the University of Pittsburgh. “The aromatherapy, music, soft lighting and therapeutic touch all help you relax emotionally – and that helps your muscles relax too,” he says. Find out how to incorporate massage into your back pain treatment with these expert tips. 1. How does massage treatment help relieve back pain? Each time you strain or pull a muscle, small tears form in the muscle fibers, says Davis Reyes, a physical therapist at the Hospital for Special Surgery in New York City. When they heal, scar tissue forms in hard lines and doesn’t necessarily conform to the existing muscle. These can interfere with muscle function, and massage can remedy that, he says. “Massage works on these soft-tissue injuries to actually work out that scar,” Reyes adds. This helps the muscles work more efficiently and can improve the success of strengthening or stretching routines. Another benefit is increased blood flow to the area, which speeds the healing process, says Jaclyn Bonder, M.D., instructor and director of women’s health at the Rusk Institute of Rehabilitation Medicine at NYU Langone Medical Center in New York City. 2. How should I choose a massage therapist? First, ask for referrals from your doctor or physical therapist. Then check online resources, such as the American Massage Therapy Association. Checking qualifications can be tricky because licensing requirements vary by state – and some, such as Minnesota, Oklahoma, Kansas, Idaho and Wyoming, have no requirements. Most licensed massage therapists have at least one year of formal training, chiropractor Schneider says. But more important is how therapists respond to patients, and the best way to assess that is to ask your friends and family for referrals, he adds. Then, when you’re scheduling an appointment, “ask massage therapists questions about their training, experience and methods,” Schneider says. Choose the type of therapist and environment that feels best to you. “Look for someone who has the touch you like, whether you prefer gentle or deep-tissue work,” he suggests. Don’t endure a vigorous deep-tissue massage if you find it uncomfortable. “If you don’t like that type of massage, it may only cause you to tense up more,” Schneider says. If possible, find someone skilled in a variety of techniques who can tailor their approach to your needs. “Many massage therapists today don’t stick to just one approach,” Reyes says. “They use a combination of approaches based on your situation.” 3. What types of massage treatment relieve back pain? The one that feels best to you, Cherkin says. His study showed no significant difference in results between people who received a structural massage – one that focused on treating tissues directly associated with the pain – and those who simply received a light, relaxing full-body massage. There are more than 250 different types of massage to choose from, says Associated Bodywork & Massage Professionals (ABMP), an organization for practitioners. According to ABMP, some common techniques and benefits include: Acupressure: The fingers apply pressure to the same points on the body targeted in acupuncture. This helps to release muscular tension, increase circulation and stimulate the body’s healing mechanisms. Deep-tissue massage: A massage therapist works on the deeper muscles and fascia (fibrous connective tissue), which may be especially helpful for people with chronic muscular pain, injury, or inflammation from tendinitis and arthritis. It’s often used in combination with other techniques. Myofascial release: The gentle use of pressure to relieve fascial constrictions. This method is especially helpful in relieving back pain, cervical pain, fibromyalgia, scoliosis, neurological dysfunction, restriction of motion, chronic pain and headaches. Reflexology: In this technique, based on an ancient Chinese therapy, pressure is applied to specific reflex areas in the foot, hands and ears that correspond to other parts of the body. Swedish massage: Using five basic strokes (kneading, rolling, vibrational, percussive and tapping), this massage manipulates the soft tissues of the body. It promotes relaxation and also helps dissolve scar tissue adhesions and improve circulation, which may help speed healing and reduce swelling. 4. How often should I get a massage treatment? Even if money is no object, limit massage sessions to no more than twice a week, Schneider advises. “More isn’t better,” he says. “If you have a massage two or three days in a row, it’s too much for your body.” And you shouldn’t expect big results after just one visit. “Don’t just go once and decide it’s not going to be helpful,” Schneider adds. If your injury is relatively new and confined to one area of the back, you may find that massage helps relieve back pain in 2-3 sessions, Reyes says. But if your pain has lasted longer and is more widespread, it can take as many as four weeks to see a benefit. If you don’t see results after several sessions, visit a doctor to determine if an underlying condition – such as a herniated disc or arthritis – is causing your pain. Also, visit your doctor if you develop any nerve symptoms, such as pain radiating down your arm or leg, numbness or tingling. That could indicate a more serious problem, such as a herniated disc impinging on a nerve. 5. Can massage treatment make some conditions worse? If an underlying condition is causing your pain – such as a disc issue, arthritis or an injury – check with your doctor before getting a massage. Although massage can’t cure these conditions, it may still offer some relief. That’s because you may be carrying yourself differently to take stress off the sore part of your back. This means some muscles in your back are doing more work than usual, and the added strain can make them spasm. A therapeutic massage – used with other treatments – can help relieve back pain caused by these spasms. If you have an injury, choose a massage therapist who’s trained in therapeutic or medical massage, Bonder says. Also, check with your doctor before getting a massage if you’re taking blood thinners or oral steroid medications. Both drugs can make you bruise easily. And avoid “a massage done over an area of infection, including a superficial skin infection or malignancy,” Bonder advises. The increased blood flow caused by the massage can encourage the spread of infected cells throughout the body, she explains. 6. How can I prolong the effects of massage treatment? Most therapists tell you to drink lots of water after a massage – and doctors agree. “When your massage therapist releases a knot in the muscle, pockets of lactic acid are released,” causing discomfort, Reyes says. “Drinking water helps flush the lactic acid out of your muscles more efficiently.” It’s important to stretch those muscles to keep them flexible. As you start to feel better, add some simple strengthening exercises to prevent re-injury. Ask a doctor or physical therapist to recommend stretches and exercises best for your situation. Your massage therapist may suggest some stretches and exercises too. Stretching is especially important for women in their 50s. “As we get older, our chest, hamstrings and hip flexors become very tight,” Reyes explains. “This can cause neck or low back pain. Keeping those muscles flexible can help prevent this.” Also, be aware of your breathing. Short, shallow breaths can deprive muscles of oxygen. Taking deep, calm breaths “delivers oxygen to the muscles and keeps them healthy,” Ishibashi says. She recommends this simple breathing exercise: Put a hand on your diaphragm, by your rib cage. Slowly breathe in, feeling your hand move out. Slowly exhale, now feeling the motion of your hand moving in. 7. Is massage treatment covered by insurance? Some health insurance plans cover massage, usually under a doctor’s orders. Check with your provider. If it doesn’t, here are some money-saving tips: Choose a simple, relaxing format, such as a Swedish or chair massage. They’re often less expensive than one that uses a specialized technique such as deep-tissue or myofascial, Cherkin says. Call local massage schools to see if they offer low-cost massage treatment, Reyes advises. “To graduate, students need to practice,” he says. “Schools will often offer free or low-cost clinics to give their students experience.” Work out kinks on your own with a tennis ball to massage the muscle, Bonder advises. “Lie on the tennis ball,” she says. “Let it rest on the area that’s most painful and then roll over it in the most natural way you can.” Or try a Backnobber, which hooks over your shoulder so you can massage sore spots to relieve back pain, Ishibashi suggests. “When I’m by myself, I use it to press on knots and trigger points in my back,” she says. “I love it.” For more information and expert advice, visit Lifescript's Pain Management Health Center. How Bad Is Your Back Pain? So your back hurts? Take our back pain quiz to see how severe it really is. You may need to see a doctor but have just been avoiding it, thinking it will get better. On the other hand, your back pain may be more normal than you suspect.