Touching Pain: Massage Therapy Techniques To Support Adaptive Body Awareness for Self-Management of Chronic Pain Related to Spondylosthesis

Posted:Monday, August 4, 2014

Honorable Mention
Krina Patel
Cortiva Institute
Boston, MA

Abstract
Background: Massage therapy techniques increase body awareness. Body awareness can be adaptive or maladaptive. Adaptive body awareness is shown to have a positive effect in the acceptance and management of chronic pain. Spondylolisthesis is a structural condition often accompanied with chronic pain.
Purpose: The present report investigates the efficacy of massage therapy techniques in enhancing and sustaining adaptive body awareness for the self-management of chronic pain related to Spondylolisthesis. Participant:  A 57-year-old female initially diagnosed with congenital spinal abnormality by a physician and subsequently with both congenital and degenerative Spondylolisthesis by a chiropractor presents with chronic low and upper back pain and frequent episodes of intense pain in these same areas usually brought on by physical activity. Client is familiar with general massage and acupuncture treatments.
Intervention: Therapeutic massage with the clear goal of increasing adaptive body awareness was introduced during a 4-week period. Five treatment sessions, each 45 minutes in duration used a treatment protocol that included diaphragmatic 4 breathing, various massage techniques in a ‘massage flow’ to relieve muscle tension and recommended home care. Verbal instructions encouraging patient to experience body awareness and sensations of muscles relaxing during massage were integral to the protocol.
Results: Client recorded a decrease in intense pain episodes between treatments, decrease in use of pain medication, no perceptible change in intensity of pain episodes and a better understanding of how to manage her chronic pain.
Conclusion: Patient feedback and therapist observation suggest that therapeutic massage with the clear goal of enhancing and sustaining adaptive body awareness through a treatment protocol carried out as a touch based dialogue between client and therapist may decrease pain-related anxiety and avoidance and increase capacity to accept and manage pain. This in turn may improve functioning and overall sense of wellness.