resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Applying the Thin Skull Principle
The "thin skull" principle, also known as the "you take your victim as you find them" principle, is a legal principle that can be summed up by the following statement.
Medicine is Clumsy, Don't You Be
All medical systems have clumsiness in them. If the technique isn't, the practitioner is. Everyone in every form of medicine is striving to improve. That is why we call it practice.
Integrating Art with Clinical Practice for Patients with PTSD: The Artemis Project
Are you restricted by those one-on-one clinic dynamics? Why not join colleagues and clients in experimental group settings? Three of us volunteered to do just that in Austin on behalf of women veteranss from all branches of the service.
The Tide is Rising in the Acupuncture Profession
Former President Ronald Regan said, "When the tide rises all boats float." The tide is rising for the acupuncture profession. Many forces outside the profession are helping the tides to rise.
Functional Hip Impingement (Part 1)
Every time I sit down to write an article, I realize how much more there is to know about musculoskeletal pain. I also learn something new every time. (I want to give special thanks to Lucy Whyte Ferguson for assisting with this article.)
Animal Acupuncture: A Case Study in the Treatment of Traumatic Injury in the Equine
The rise of animal acupuncture in the U.S. began in the early 1970's as a result of the work by members of the National Acupuncture Association in Westwood, Calif.
The Acupuncturist's Problem
I want share with you some observations and insights into what seems to be the most common problem my colleagues in the acupuncture profession struggles with. If you also struggle with this problem, I hope you get a valuable "aha" moment from reading this.
Low Back Pain in Professional Golf: A Common Muscular Relationship
Every sport creates its own unique demands on the body. Some sports require such a myriad of body positions that assessing pathology is often difficult and unpredictable.
How Much Do You Know About the Benefits of Birds Nest?
Edible bird's nest is the nest made by the Swiftlet bird of Southeast Asia that is usually prepared as a soup and prized in Chinese culture as a healthful delicacy.
A House Divided?
The American Chiropractic Association's House of Delegates voted on 30 resolutions at its annual business meeting in Washington D.C., but two in particular took immediate center stage due to their controversial nature.
Optimism = Compassion = Trust
A randomized clinical trial recently published online in JAMA Oncology examined how patients viewed their doctor based upon how the practitioner presented bad news to the patient.
A View From the ER
The University of Western States has inked an innovative agreement with local nonprofit health system Legacy Health whereby UWS sports-medicine fellows can experience observational clinical rotations in emergency-room settings within the Legacy system.
PCOM Granted Regional Accreditation
Pacific College of Oriental Medicine (PCOM) recently announce it has received regional accreditation from the Western Association of Schools and Colleges (WASC). This achievement reflects five years of hard work on the part of faculty, staff, and students.
Sleep, Less Sleep or No Sleep?
I had a dream I wasn't getting enough sleep. It was a very realistic dream, even though I was probably slightly awake and not really deep dreaming. Most likely I had been dozing, caught in that twilight of sleep and wakefulness.
5 Tips for Using Pinterest to Market Your Practice
Pinterest is a very popular, but often under-utilized, social media platform where people can bookmark, or "pin," fun and interesting things from all across the internet.
5 Simple Steps to Create an Effective Marketing Calendar
In the educational experience of most healthcare practitioners, business and marketing are overlooked topics.
Turning a Blind Eye to History – and Reality
The American Medical Association is taking the Supreme Court's Feb. 25, 2015 decision exactly as it always does – by turning a blind eye to history, legal precedent and reality.
The Challenges of Integrating Eastern and Western Medicine
My Masters thesis was titled, "The Challenges of Integrating Eastern and Western Medicine," which highlighted several reasons why it is hard for these two worlds to mix.
Talking to Patients About Lumbar Facet Denervation (Medial Branch Neurotomy)
Lumbar facet denervation, more appropriately termed medial branch neurotomy (MBN), is a procedure that may be considered when patients suffer from recalcitrant non-radicular axial back and/or leg pain.
Term Limits: What's in a Word?
It was the French historian and philosopher Voltaire who once declared the Holy Roman Empire was neither holy nor Roman nor an empire.
July, 2013, Vol. 13, Issue 07
Massage Brings Relief to People Suffering from Headaches
By Massage Therapy Foundation Contributor
Contributed by MK Brennan, MS RN LMBT and Jolie Haun, PhD EdS LMT
With the common stressors in daily life, complaints of tension and migraine headaches are not uncommon.This month's Massage Therapy Foundation review shares findings from two studies that suggest massage can provide relief for people suffering from headache pain. The authors of these articles report that episodic tension type headaches impact up to 42% of the population and migraines impact approximately 10%.
Traditionally, tension headaches and migraines have been treated with medications – so much, the term, "medication overuse headache" (MOH) has evolved. MOH refers to headaches that persist despite the regular use of drugs for treatment. Needing an alternative effective treatment for the debilitating pain of headaches, the authors of these articles suggest massage therapy presents a potentially reasonable alternative.
The first study, "Changes in Psychological Parameters in Patients with Tension-type Headache Following Massage Therapy: A Pilot Study" by Moraska and Chandler, evaluated a structured massage therapy program, focusing on myofascial trigger points and psychological measures associated with tension-type headaches. Moraska and Chandler noted that there seems to be a cycle of physical pain, decreased productivity and a psychological impact of tension headaches that contribute to stress, anxiety and depression. This theoretical assumption warranted the use of the State-Trait Anxiety Inventory, Beck Depression Inventory, the Perceived Stress Scale and the Daily Stress Inventory to measure participants' outcomes.
Eighteen participants between the ages of 21-65 years were recruited through flyers placed in doctor's offices and advertisements in local newspapers. All of the enrolled participants had episodic or chronic tension headaches. Exclusion criteria included anyone taking anti-depressants or anti-psychotic medications. The 2004 International Headache Society guidelines for episodic or chronic tension-type headaches (TTH) were used in determining the inclusion criteria. An episodic TTH is defined as one that occurs 15 days or less per month. A chronic one occurs 15 or more days in a month. Two participants did not complete participation in the study; one due to a motor vehicle accident and the other because of insufficient headache diaries.
The study was designed to have four 3-week phases: baseline (one 3-week period), massage (two 3-week periods) and follow-up (one 3-week period). In the baseline phase of the study, participants kept a headache diary to assure that they met the guidelines. Guidelines included each headache lasting at least four hours or longer and less than one migraine headache per month. The massage sessions were two 45 minute sessions per week over the two 3-week periods for a total of 12 massages in six weeks. During the week, there was at least a 48 hour span between the massages. Moraska and Chandler reported, "Massage was directed toward soft tissues of the cervical and cranial regions with an emphasis on reducing myofascial trigger point (MTrP) activity." (p.88)
Participants were randomly assigned to one of the six participating massage therapists and remained with that same massage therapist throughout their participation in the study. The therapists were experienced practitioners and received training for the study's massage protocol. In addition, conversation was limited during sessions and the participant's headache history was not discussed with the massage therapist. Study measures were completed by the participants at the start of the study, at 3-week intervals and at the end of the study. Additionally, the Daily Stress Inventory was administered over 7-day periods during baseline and the final week of massage. Psychological measures were administered on days other than when massage was provided in effort to avoid the massage session having influence on the outcomes of those measures.
Moraska and Chandler reported a significant reduction in stress, anxiety and depression for the participants after six weeks of massage, but not at three weeks. Additionally, the frequency, intensity and duration of the participants' headaches were reduced following the 12 massage sessions. Since the authors linked TTH pain with an increase in stress, anxiety and depression, a decrease in the pain through massage treatment may have impacted psychological outcomes. Study limitations include small sample size and a lack of a comparison group, resulting in limited power of results. Though this study clearly has some limitations, findings warrant further examination in a larger sample with a control group. It should also be noted the massage therapists who participated did receive specialized training beyond what a typical massage therapist might have.
The second study was "Reduction of Current Migraine Headache Pain Following Neck Massage and Spinal Manipulation" by Noudeh, Vatankhah and Baradaran. This study focused on reducing the pain intensity of the participants with acute onset migraine headaches. The authors recruited 10 male patients between the ages of 18 and 65 with acute onset of a migraine headache as defined by the International Headache Society diagnostic criteria for Massage Without Aura (MWO) and Massage With Aura (MWA). Potential participants who had secondary cause for the migraine, were not able to complete the data tools, or could not receive massage/manipulation due to skeletal disorders were excluded from the study.
Participants' pain was assessed using the Visual Analog Scale (VAS) with the numerical value of 1 indicating no headache pain and 10 indicating the worst pain possible. The VAS was administered prior to the massage/manipulation intervention. The two-step treatment protocol lasted no more than five minutes. First, massage techniques were applied to the trapezius and supraspinatus muscles, as well as the posterior and lateral neck muscles. Next, skeletal manipulation of the cervical and upper thoracic spine was done. The VAS was administered again after the massage/manipulation session. The authors also asked the participants about possible side effects following the session and their satisfaction with the physical intervention. The participants remained at the clinic (i.e. study site) for an hour after the intervention to assure that the headache did not recur; if it did, an analgesic was offered. Two participants did not remain in the clinic for this period of time; they chose to leave because they said they needed to sleep.
The authors report that 8 out of 10 participants had at least a 50% reduction in their pain level immediately following the massage/manipulation. However within the hour wait period following, three participants did request oral analgesics and one participant was treated with intravenous therapy and intramuscular medication though the authors state that there was no recurrence of the headache for any of the participants. Limitations of this study include the lack of a control group and no way to determine if it was the massage, manipulation or the combination of the two that was responsible for the participants' reduced pain.
Though different in nature, these two studies provide preliminary evidence that massage can be effectively used to treat individuals who suffer from tension and migraine headaches. These studies findings warrant further examination in larger samples to determine if findings can be replicated to support conclusive findings and dosage recommendations.
The convergent data reported in these two studies contribute to the field of massage, providing supportive evidence for the use of massage for a prevalent condition that affects a significant portion of the general population. Since headaches, both acute/chronic TTH and migraines are common, many massage therapists are likely to have clients with these painful and sometimes debilitating conditions. Knowing how massage may impact the pain and the psychological outcomes associated with headaches can be helpful in determining treatment options and providing the best possible care for clients.
To learn more about the effects of massage therapy for conditions such as headaches, migraines and more, you can review the Massage Therapy Foundation article archives, read accepted MTF Research Grant abstracts, or search Pub Med for massage therapy studies.
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