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Treating Surgical Pain Using Massage

Massage is an ancient form of therapy that has played a major role in the medical landscape of many communities. The Ancient Greeks and Romans used it as a way of maintaining their athletes’ and soldiers’ health. Galen, who is considered to be one of the greatest physicians and medical researchers in history, developed an early form of sports massage to treat gladiators. Modern day massage hasn’t strayed far from these roots. Massage is still used to maintain an overall sense of good physical and mental health. As a form of manual therapy, it’s primarily used to relax muscles, soothe tense knots, reduce stress and relieve any other conditions that may have been made worse by muscular tension. The most common types of massage therapy include:

  1. Swedish massage – typically uses effleurage (long, gliding strokes), petrissage (kneading pressure), vibration (fine, rapid shaking), friction (deep, circular movements), tapotement (quick tapping of the hands on muscles) and reiki
  2. German massage – a combination of Swedish massage with therapeutic baths
  3. Acupressure – like acupuncture but uses fingers instead of needles
  4. Shiatsu – finger pressure massage meant to boost circulation and restore energy balance
  5. Rolfing or Aston variations – deep pressure is applied to the fascia in order to correct body alignment
  6. Feldenkrais method – meant to make movements easier and correct bad habits that place unnecessary strain on muscles and joints
  7. Alexander technique – meant to correct bad posture and movements that lead to body strain and tension
  8. Tragerwork – gently, rhythmic touch that releases tension in posture

Massage is well-known for its relaxing nature and therapeutic benefits on the body and mind. It’s usually used as a way of escaping from the tension of daily life, but studies have suggested there’s more to massage therapy than relaxation. According to research published in Pain Medicine, a peer reviewed medical journal, massage may be more effective in treating pain and anxiety experienced after surgical procedures.

Can massage help with surgical pain?

Pain management is often a critical challenge for people who are about to undergo or are recovering from surgical and operative procedures. When the postoperative pain is managed at the acute stage (there and then) or during the next postsurgical period, patients usually recover from their surgery and resume their normal daily activities without any complications. However, a substantial number of patients experience chronic post-surgery pain (CPSP) or persistent postsurgical pain which is pain that lasts longer than two to three months after the surgery. One study whose aim was to assess the cause of chronic pain found that 23 per cent was due to the surgery itself. Such pain creates psychosocial and economic burdens on patients, and is a major problem for public health.

Pain related to surgery has been found to be closely associated with multiple functional outcomes such as quality of sleep, mood and quality of life. People who are about to have surgery often understandably experience fear and anxiety. This complicates pre and post-surgical pain management, and increases the chance of CPSP developing as a result. As the pain becomes increasingly chronic, the fear and anxiety grow stronger. This leads to particular avoidance behaviours, which interferes with the patient’s daily activities and takes a negative toll on their psychological wellbeing and quality of life.

Researchers from the Samueli Institute in Alexandria, Virginia, conducted a systematic review and meta-analysis to examine the effectiveness of massage therapy in treating pain, function and overall health in people who have had surgery. In the original report, authors of the study wrote:

“Massage therapy is commonly practised among patients seeking pain management. However, its efficacy is unclear. This systematic review and meta-analysis is the first to rigorously assess the quality of the evidence for massage therapy’s efficacy in treating pain, function-related and health-related quality of life outcomes in surgical pain populations.”

The researchers then scoured databases for eligible controlled trials through February 2014 and assessed them using the SIGN 50 Checklist. A meta-analysis was applied at the outcome level.

A total of 12 high quality and four low quality studies were examined in the review. A variety of massage techniques, including M technique massage, Swedish massage and effleurage, were compared with a range of named controls, including relaxation, attention, standard care, routine care, usual care, standard analgesia, vibration therapy and no treatment.

The majority of studies focused on the effects massage had on pain, stress, mood, sleep and overall health in patients who suffered from postoperative pain or were undergoing or recovering from various surgeries. Massage sessions varied from one 10 minute session to 12 daily 10 minute sessions over a six day period. The mean age of participants was 49.8 years and 67 per cent were male.

From the evidence that was used, it seems as though massage therapy is particularly efficacious in decreasing pain intensity, severity and overall anxiety in patients who are undergoing surgical procedures. This study is the first reported attempt to collect the current literature and evidence surrounding massage therapy for treating function-related issues in surgical patients.

Can massage help with surgical healing?

Previous studies have shown that massage can improve mood and pain intensity experienced by people who have or are about to undergo surgery. But can massage therapy enhance and accelerate the rate at which patients recover from their surgery?

A 2007 study found that massage reduced anxiety after surgery, which had a reversal effect on the pain experienced and gave patients a more positive outlook on their recovery journey. In an article published by ABC News, Dr Daniel Hinshaw, who was the study’s senior author, said of the study: “In patients getting massage, the acute response was equivalent to a [dose] of morphine, which was pretty remarkable.”

The idea for the study originated years ago when Dr Hinshaw would ask nurses to give elderly patients a massage as a way of providing pain relief. He said he had long been concerned about the pain and suffering caused by surgery, and thought about ways in which it could be decreased.

He conducted a massage trial, which involved 605 veterans undergoing chest or abdominal surgery. They were randomly assigned to one of three groups. One received standard medical care, one received a daily 20 minute back massage and the third received 20 minutes of individual attention but no massage. The veterans were then asked to rate their feelings of pain and anxiety on a scale of 1 to 10. It was found that pain and anxiety levels declined much faster in the massage group than any of the other groups.

However, massage only brought about short term benefits. Although it was effective in reducing stress and anxiety in patients who were undergoing or had had surgery, massage had to be continued on a regular basis in order for it to have any long term effects. For most people, massage is a highly effective, natural way of reducing stress and promoting an overall good sense of physical, mental and emotional wellbeing. When you’re more relaxed, you are less anxious, you sleep better and you don’t experience as much pain – which is what anybody would want before and after surgery.

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