{"id":25119,"date":"2022-06-10T10:14:40","date_gmt":"2022-06-10T02:14:40","guid":{"rendered":"https:\/\/www.spinefitchiro.com\/?p=25119"},"modified":"2022-06-10T17:15:52","modified_gmt":"2022-06-10T09:15:52","slug":"case-study-whats-the-role-of-massage-soft-tissue-therapy-in-migraine-and-headache-recovery","status":"publish","type":"post","link":"https:\/\/spinefitchiro.com\/cn\/case-study-whats-the-role-of-massage-soft-tissue-therapy-in-migraine-and-headache-recovery\/","title":{"rendered":"Case Study: What&#8217;s The Role of Massage\/Soft Tissue Therapy In Migraine and Headache Recovery?"},"content":{"rendered":"<p style=\"text-align: justify;\"><span style=\"font-weight: 400;\">Massage often gets a bad rep in the world of rehabilitation or physiotherapy. If you\u2019re someone who follows the latest spotlights and trending fitness\/rehabilitation influencers on Instagram or Twitter, you might have come across \u2018discussions\u2019 (which look very similar to arguments and Internet fights!) where the therapeutic benefit of massage therapy is fought over and debated \u2014 often with the eye-catching conclusion that <\/span><i><span style=\"font-weight: 400;\">\u201cMassage is over-rated\u201d<\/span><\/i><span style=\"font-weight: 400;\">, <\/span><i><span style=\"font-weight: 400;\">\u201cMassage is unlikely to help your pain for the long-term\u201d<\/span><\/i><span style=\"font-weight: 400;\">, or even the well-intentioned <\/span><i><span style=\"font-weight: 400;\">\u201cMovement is Medicine, not lying on a bed and getting massaged\u201d<\/span><\/i><span style=\"font-weight: 400;\">!\u00a0<\/span><\/p>\n<p>&nbsp;<\/p>\n<a href=\"https:\/\/www.spinefitchiro.com\/wp-content\/uploads\/2022\/06\/3dcc136a-9c3e-4835-8f2a-3685ea2839af_text.gif\"><img fetchpriority=\"high\" decoding=\"async\" class=\"aligncenter size-full wp-image-25120\" src=\"https:\/\/www.spinefitchiro.com\/wp-content\/uploads\/2022\/06\/3dcc136a-9c3e-4835-8f2a-3685ea2839af_text.gif\" alt=\"\" width=\"400\" height=\"225\" \/><\/a>\n<p>&nbsp;<\/p>\n<p style=\"text-align: justify;\"><span style=\"font-weight: 400;\">While we get the point \u2014 we just want people to start moving, getting active, and live a healthier lifestyle without relying on passive care \u2014 I think that <\/span><b>we\u2019ve thrown the baby out with the bathwater<\/b><span style=\"font-weight: 400;\">. If massage absolutely didn\u2019t work, there wouldn\u2019t be a need for registered massage therapists (RMT), nor their often two-year full-time courses, nor their acknowledgement and involvement in many Health Care Professions Act internationally such as in the US, Canada, and Australia.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-weight: 400;\">While not a panacea for relieving every possible body ache and pain out there, massage (or often called soft tissue therapy) has many other positive effects that are scientifically backed to provide therapeutic benefits\u2026 Provided it is used at the <\/span><b>right time for the right person<\/b><span style=\"font-weight: 400;\">.<\/span><\/p>\n<p>&nbsp;<\/p>\n<h4 style=\"text-align: justify;\"><b>How does massage help \u2014 scientifically?<\/b><\/h4>\n<p style=\"text-align: justify;\"><span style=\"font-weight: 400;\">If we take a stroll through the literature and look at what a recent<\/span><a href=\"https:\/\/academic.oup.com\/painmedicine\/article\/17\/7\/1353\/2223191\" target=\"_blank\" rel=\"noopener\"> <span style=\"font-weight: 400;\">systematic review<\/span><\/a><span style=\"font-weight: 400;\"> says about massage, we find that the body of evidence generally agrees that massage therapy improves\u00a0 various patient-reported functional outcomes among populations experiencing musculoskeletal pain (e.g. back pain, neck pain, etc).\u00a0<\/span><\/p>\n<p>&nbsp;<\/p>\n<a href=\"https:\/\/www.spinefitchiro.com\/wp-content\/uploads\/2022\/06\/nihms-140696-f0001.jpg\"><img decoding=\"async\" class=\"aligncenter size-full wp-image-25122\" src=\"https:\/\/www.spinefitchiro.com\/wp-content\/uploads\/2022\/06\/nihms-140696-f0001.jpg\" alt=\"\" width=\"588\" height=\"370\" srcset=\"https:\/\/spinefitchiro.com\/wp-content\/uploads\/2022\/06\/nihms-140696-f0001.jpg 588w, https:\/\/spinefitchiro.com\/wp-content\/uploads\/2022\/06\/nihms-140696-f0001-300x189.jpg 300w\" sizes=\"(max-width: 588px) 100vw, 588px\" \/><\/a>\n<p>&nbsp;<\/p>\n<p style=\"text-align: justify;\"><span style=\"font-weight: 400;\">Big picture. Short summary. Massage therapy, or anything involving touch\/pressure, affects the neurological pathways between the brain and the target site.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-weight: 400;\">Our muscles contain structures sensitive to pressure and stretch (mechanosensitive structures). When activated through massage (that\u2019s pressure and stretch on the muscles!), it allows for signalling to occur, inducing relaxation and reducing pain signals.<\/span><\/p>\n<p>&nbsp;<\/p>\n<h4 style=\"text-align: justify;\"><b>A real life case study\u2026\u00a0<\/b><\/h4>\n<p style=\"text-align: justify;\"><span style=\"font-weight: 400;\">Patient X* came in last year complaining of a <\/span><b>12-year long history of neck pain and headaches<\/b><span style=\"font-weight: 400;\">. She had been going for regular chiropractic adjustments twice monthly to temporarily relieve her pain as, due to health conditions, she was not able to sustain a physical activity regimen.\u00a0<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-weight: 400;\">Due to the period of COVID-19 lockdown and an even greater reduction in activity levels, she began to develop<\/span><b> constant headaches everyday for 2 months <\/b><span style=\"font-weight: 400;\">which affected her ability to work in front of the computer. Painkillers were also part of her daily regimen, and sometimes the headaches would progress into migraines that kept her in bed, to the point where her regular chiropractic adjustments were only providing relief for a day.\u00a0<\/span><\/p>\n<p>&nbsp;<\/p>\n<a href=\"https:\/\/www.spinefitchiro.com\/wp-content\/uploads\/2022\/06\/fetchimage.jpeg\"><img decoding=\"async\" class=\"aligncenter wp-image-25124\" src=\"https:\/\/www.spinefitchiro.com\/wp-content\/uploads\/2022\/06\/fetchimage.jpeg\" alt=\"\" width=\"450\" height=\"253\" srcset=\"https:\/\/spinefitchiro.com\/wp-content\/uploads\/2022\/06\/fetchimage.jpeg 700w, https:\/\/spinefitchiro.com\/wp-content\/uploads\/2022\/06\/fetchimage-300x169.jpeg 300w\" sizes=\"(max-width: 450px) 100vw, 450px\" \/><\/a>\n<p>&nbsp;<\/p>\n<p style=\"text-align: justify;\"><span style=\"font-weight: 400;\">Trust me when I say that our first consultation was NOT the most pleasant of encounters! And she really couldn\u2019t be blamed, because who would be cheerful when you\u2019ve been experiencing a constant head and neck pain for 2 months and someone is trying to ask you questions and get you moving in ways that you wouldn\u2019t normally want to be doing? (That\u2019s our initial consultation)\u00a0<\/span><\/p>\n<p>&nbsp;<\/p>\n<ul style=\"text-align: justify;\">\n<li style=\"font-weight: 400;\" aria-level=\"1\">\n<h5><b>Assessment\u00a0<\/b><\/h5>\n<\/li>\n<\/ul>\n<p style=\"text-align: justify;\"><span style=\"font-weight: 400;\">The assessments ruled out any serious matters contributing to her headache, such as high blood pressure (controlled with medication, normal on the day itself), night sweats, sudden weight loss, pain worsening in the early mornings or nights (possible indication of a space-occupying lesion). A lack of any paresthesias, referred\/radiating pain, and negative nerve tension tests minimised the possibility of a slipped disc or nerve issue.\u00a0<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-weight: 400;\">What was left was the positive findings of hyperactivity and sensitivity of all the muscles around the neck and shoulders \u2014 commonly a protective mechanism from constant pain \u2014 and poor joint mobility of the cervical region. Our working diagnosis was<\/span><a href=\"https:\/\/www.spinefitchiro.com\/condition\/tension-cervicogenic-migraine-headaches\/\"> <b>cervicogenic headaches,<\/b><\/a><span style=\"font-weight: 400;\"> whereby the excessive stress around her neck and shoulders was causing her to develop headaches developing into migraines on high-stress days.<\/span><\/p>\n<p>&nbsp;<\/p>\n<ul style=\"text-align: justify;\">\n<li style=\"font-weight: 400;\" aria-level=\"1\">\n<h5><b>Treatment<\/b><\/h5>\n<\/li>\n<\/ul>\n<p style=\"text-align: justify;\"><span style=\"font-weight: 400;\">So, what can be done for those who can\u2019t exercise, are experiencing a moderate to severe type of headache constantly, and are wanting an alternate option to reduce her painkiller usage and return her high-stress work to a more functional capacity?\u00a0<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-weight: 400;\">That\u2019s where sports massages can come in, especially for those experiencing a high level of muscle tension that contributes to their symptoms.<\/span><\/p>\n<p>&nbsp;<\/p>\n<a href=\"https:\/\/www.spinefitchiro.com\/wp-content\/uploads\/2022\/06\/figure_4.3-1024x707-1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-25126\" src=\"https:\/\/www.spinefitchiro.com\/wp-content\/uploads\/2022\/06\/figure_4.3-1024x707-1.jpg\" alt=\"\" width=\"500\" height=\"345\" srcset=\"https:\/\/spinefitchiro.com\/wp-content\/uploads\/2022\/06\/figure_4.3-1024x707-1.jpg 1024w, https:\/\/spinefitchiro.com\/wp-content\/uploads\/2022\/06\/figure_4.3-1024x707-1-300x207.jpg 300w, https:\/\/spinefitchiro.com\/wp-content\/uploads\/2022\/06\/figure_4.3-1024x707-1-768x530.jpg 768w\" sizes=\"(max-width: 500px) 100vw, 500px\" \/><\/a>\n<p>&nbsp;<\/p>\n<p style=\"text-align: justify;\"><span style=\"font-weight: 400;\">She came in regularly for sports massages for <\/span><b>6 months<\/b><span style=\"font-weight: 400;\">; initially once a week, and then dropped the frequency to once every two weeks, and subsequently even further to coming as and when needed. The <\/span><b>soft tissue therapy<\/b><span style=\"font-weight: 400;\"> focused a lot on targeting the muscles around her neck (suboccipitals, scalenes, SCM) and the midback (e.g. trapezius, rhomboids, levator scapula), and sometimes even further down to the latts.\u00a0<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-weight: 400;\">There were also sessions where <\/span><b>lymphatic drainage <\/b><span style=\"font-weight: 400;\">was done as a form of soft tissue therapy, which can come in really beneficial during the days she was experiencing extra sensitivity and pain. The biochemical substances causing pain which are released during a migraine or headache flare can be manually guided to move away from already sensitive areas (Discussed in papers from<\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/2672665\/\" target=\"_blank\" rel=\"noopener\"> <span style=\"font-weight: 400;\">1989<\/span><\/a><span style=\"font-weight: 400;\">, up until<\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/27338942\/\" target=\"_blank\" rel=\"noopener\"> <span style=\"font-weight: 400;\">2016<\/span><\/a><span style=\"font-weight: 400;\"> where researchers found that a combination of massage and lymphatic drainage significantly reduced migraine attack frequency over a period of 4 weeks).<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-weight: 400;\">Towards the end of the 5th month and going into the 6th month, she was <\/span><b>back to full force<\/b><span style=\"font-weight: 400;\"> at work, minimal occurrence of headaches that she was able to self-manage herself, and\u00a0 a much happier outlook on life. I\u2019ll quote her \u2014 <\/span><b>\u201cI haven\u2019t felt this level of nearly no pain in the past decade.\u201d<\/b><span style=\"font-weight: 400;\"> And while the addition of a physical exercise programme may have hastened her progress, this gives us a treatment for those whom it may not be possible.<\/span><\/p>\n<p>&nbsp;<\/p>\n<h4 style=\"text-align: justify;\"><b>Conclusion<\/b><\/h4>\n<p>&nbsp;<\/p>\n<a href=\"https:\/\/www.spinefitchiro.com\/wp-content\/uploads\/2022\/06\/e095444f72836df28b0842de9f76b21e.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-25128\" src=\"https:\/\/www.spinefitchiro.com\/wp-content\/uploads\/2022\/06\/e095444f72836df28b0842de9f76b21e.jpg\" alt=\"\" width=\"480\" height=\"300\" srcset=\"https:\/\/spinefitchiro.com\/wp-content\/uploads\/2022\/06\/e095444f72836df28b0842de9f76b21e.jpg 480w, https:\/\/spinefitchiro.com\/wp-content\/uploads\/2022\/06\/e095444f72836df28b0842de9f76b21e-300x188.jpg 300w\" sizes=\"(max-width: 480px) 100vw, 480px\" \/><\/a>\n<p>&nbsp;<\/p>\n<p style=\"text-align: justify;\"><b>Massage has its time and place.\u00a0<\/b><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-weight: 400;\">While strength, function, and a healthy lifestyle is always advocated for, how does one get started on all those things when pain is at the forefront of a patient\u2019s condition?\u00a0<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-weight: 400;\">Trained as professionals in the field of muscles, joints, and nerves, we utilise clinical reasoning and equip ourselves with as many logical and effective tools in our toolbox so that we are ready to treat the individual where they are at.\u00a0<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-weight: 400;\">And sometimes, that can look like massage and soft tissue therapy before we bring out movement, function, and strength.\u00a0<\/span><\/p>\n<p>&nbsp;<\/p>\n<p style=\"text-align: justify;\"><b>A note to physiotherapists: <\/b><span style=\"font-weight: 400;\">You DON\u2019T need the ability to massage to be a good physiotherapist. Instead, you need the ability to rationalise and choose when it is needed and when it isn\u2019t, and how to listen to what the patient is really telling you.\u00a0<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-weight: 400;\">\u2014\u2014\u2014\u2014\u2014\u2014\u2014\u2014\u2014\u2014\u2014\u2014\u2014\u2014<\/span><\/p>\n<p style=\"text-align: justify;\"><i><span style=\"font-weight: 400;\">*Name &amp; details undisclosed for privacy purposes.\u00a0<\/span><\/i><\/p>\n<p style=\"text-align: justify;\"><i><span style=\"font-weight: 400;\">[This article was written by Hannah, our physiotherapist who specialises in sports massage for those with chronic pain.]<\/span><\/i><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 10pt;\"><em><span style=\"font-weight: 400;\">Sources:<\/span><\/em><\/span><\/p>\n<ul>\n<li style=\"font-weight: 400; text-align: justify;\" aria-level=\"1\"><span style=\"font-size: 10pt;\"><em><span style=\"font-weight: 400;\">Bialosky, J. E. et al. (2009) The mechanisms of manual therapy in the treatment of musculoskeletal pain: a comprehensive model. <\/span><span style=\"font-weight: 400;\">Manual therapy,<\/span><span style=\"font-weight: 400;\"> 14(5), 531\u2013538. <\/span><a href=\"https:\/\/doi.org\/10.1016\/j.math.2008.09.001\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">https:\/\/doi.org\/10.1016\/j.math.2008.09.001<\/span><\/a><\/em><\/span><\/li>\n<li style=\"font-weight: 400; text-align: justify;\" aria-level=\"1\"><span style=\"font-size: 10pt;\"><em><span style=\"font-weight: 400;\">Bishop, M. D. et al. (2015) What effect can manual therapy have on a patient&#8217;s pain experience?<\/span><span style=\"font-weight: 400;\"> Pain management<\/span><span style=\"font-weight: 400;\">, 5(6), 455\u2013464. <\/span><a href=\"https:\/\/doi.org\/10.2217\/pmt.15.39\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">https:\/\/doi.org\/10.2217\/pmt.15.39<\/span><\/a><\/em><\/span><\/li>\n<li style=\"font-weight: 400; text-align: justify;\" aria-level=\"1\"><span style=\"font-size: 10pt;\"><em><span style=\"font-weight: 400;\">Happe, S. et al. (2016) The efficacy of lymphatic drainage and traditional massage in the prophylaxis of migraine: a randomized, controlled parallel group study. <\/span><span style=\"font-weight: 400;\">Neurological sciences: Official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology<\/span><span style=\"font-weight: 400;\">, 37(10), 1627\u20131632. https:\/\/doi.org\/10.1007\/s10072-016-2645-3<\/span><\/em><\/span><\/li>\n<li style=\"font-weight: 400; text-align: justify;\" aria-level=\"1\"><span style=\"font-size: 10pt;\"><em><span style=\"font-weight: 400;\">Trettin H. (1989) Die manuelle Lymphdrainage in der Migr\u00e4nebehandlung&#8211;ein pathophysiologisches Erkl\u00e4rungsmodell [Manual lymph drainage in migraine treatment&#8211;a pathophysiologic explanatory model].<\/span><span style=\"font-weight: 400;\"> Zeitschrift fur Lymphologie. Journal of lymphology<\/span><span style=\"font-weight: 400;\">, 13(1), 48\u201353<\/span><\/em><\/span><\/li>\n<li style=\"font-weight: 400; text-align: justify;\" aria-level=\"1\"><span style=\"font-size: 10pt;\"><em><span style=\"text-align: justify;\">Waters-Banker, C. et al. (2014) Investigating the mechanisms of massage efficacy: the role of mechanical immunomodulation. <\/span>Journal of athletic training<span style=\"text-align: justify;\">, 49(2), 266\u2013273. https:\/\/doi.org\/10.4085\/1062-6050-49.2.25<\/span><\/em><\/span><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Massage often gets a bad rep in the world of rehabilitation or physiotherapy. If you\u2019re someone who follows the latest spotlights and trending fitness\/rehabilitation influencers on Instagram or Twitter, you might have come across \u2018discussions\u2019 (which look very similar to arguments and Internet fights!) where the therapeutic benefit of massage therapy is fought over and&#8230;  <a class=\"excerpt-read-more\" href=\"https:\/\/spinefitchiro.com\/cn\/case-study-whats-the-role-of-massage-soft-tissue-therapy-in-migraine-and-headache-recovery\/\" title=\"Read Case Study: What&#8217;s The Role of Massage\/Soft Tissue Therapy In Migraine and Headache Recovery?\">Read more &raquo;<\/a><\/p>\n","protected":false},"author":1,"featured_media":25132,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[8,6],"tags":[],"class_list":["post-25119","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog","category-health"],"acf":[],"_links":{"self":[{"href":"https:\/\/spinefitchiro.com\/cn\/wp-json\/wp\/v2\/posts\/25119","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/spinefitchiro.com\/cn\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/spinefitchiro.com\/cn\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/spinefitchiro.com\/cn\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/spinefitchiro.com\/cn\/wp-json\/wp\/v2\/comments?post=25119"}],"version-history":[{"count":10,"href":"https:\/\/spinefitchiro.com\/cn\/wp-json\/wp\/v2\/posts\/25119\/revisions"}],"predecessor-version":[{"id":25149,"href":"https:\/\/spinefitchiro.com\/cn\/wp-json\/wp\/v2\/posts\/25119\/revisions\/25149"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/spinefitchiro.com\/cn\/wp-json\/wp\/v2\/media\/25132"}],"wp:attachment":[{"href":"https:\/\/spinefitchiro.com\/cn\/wp-json\/wp\/v2\/media?parent=25119"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/spinefitchiro.com\/cn\/wp-json\/wp\/v2\/categories?post=25119"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/spinefitchiro.com\/cn\/wp-json\/wp\/v2\/tags?post=25119"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}