The complementary therapy may help relieve pain, improve circulation and reduce stress.
By Heidi Godman, Contributor

The Benefits of Therapeutic Massage for MS​


Massage therapy is most effective for people with early-stage MS. (Getty Images)
You may think of massage as a way to relax or relieve tired muscles. But for people with multiple sclerosis, massage can be much more than that. “We see a therapeutic change when we help people with MS. They look and feel better than when they came in, and they move better,” says Nancy Porambo, a licensed massage therapist in Jim Thorpe, Pennsylvania, who specializes in neuromuscular massage therapy.
MS and Muscle Challenges
With MS, the body attacks the covering of the nerves (called the myelin sheath) as well as the nerve fibers in the brain, optic nerves and spinal column. In most MS patients, this damage occurs in waves or flare-ups, and then goes into remission. In a smaller percentage of MS patients, the attack never stops.
The damage left behind by the attacks and the scars that form as the body attempts repairs make it harder for nerves to communicate. This can cause many problems, such as cognitive decline and mood disorders. Damage to the central nervous system also means that muscles may not get the message to coordinate properly, they may freeze or become rigid (spastic), they may tire easily, hurt and weaken without use. “When you have scarring to the myelin sheath, it doesn’t allow for a normal flow of electrical impulses. Movements slow down. It’s not coordinated or smooth,” Porambo says.
Resulting muscle problems can lead to trouble walking or maintaining balance and difficulty using your arms or hands to eat, dress, bathe or use a computer.


How Massage Helps
Therapeutic massage for MS has a physical effect beyond relaxation. Significant benefits for MS patients appear to be reduced spasticity and pain, improved circulation and increased muscle and joint flexibility.
“I have had some patients report good results in terms of less pain, less spasticity and better mobility with massage,” says Dr. Robert Shin, a neurologist at MedStar Georgetown University Hospital in Washington.
Porambo says stress reduction also winds up being an important benefit of therapeutic massage for MS. A small 2016 study suggested that massage therapy was associated with an improved quality of life, along with decreased fatigue and pain.

Research finds support groups for multiple sclerosis patients can help ease anxiety and depression.


Massage therapists use a number of techniques such as kneading, compression, pressure, effleurage (long, gliding strokes) and deep, circular movements to increase blood flow to muscles. “It allows the tissues to become hydrated with blood and helps to restore normal muscle tone,” Porambo explains. “It takes just the right amount of pressure to induce blood flow, soften tissues and assist in reducing rigidity.”
Reduced spasticity then allows for relaxation and pain relief. “The body slows down, and the sympathetic nervous system gets a break, which is rejuvenating and allows the body to heal,” Porambo says.
That relaxation also leads to reduced stress. “It calms the body and restores balance,” Porambo says. “Sometimes that one hour in therapy is the only quiet time they have to rejuvenate themselves physiologically and psychologically.”


Types of Massage
Porambo says a massage therapist will first evaluate the MS patient to find problem areas and determine how to treat them. A therapist may then use a number of approaches, such as:

• Swedish massage. “This a lighter massage, the least invasive,” Porambo explains. “It uses kneading and effleurage."
• Deep muscle massage, which includes strokes that work deep into the tissues.
• Neuromuscular massage therapy, which focuses on trigger points causing pain or spasm (for example, neck problems that lead to pain in the arms and hands).

Precautions to Consider
Porambo says massage therapy is most effective for people with early-stage MS. "When you get to the late stages, spasticity may be harder to reverse,” she explains.
Massage therapy would be inappropriate in MS if you:

• Are experiencing a flare-up. “We’d only exacerbate that by going in too deeply, and it could be painful,” Porambo says.
• Struggle with neuropathy – pain, numbness or tingling – in the lower legs and toes. “Pressing too deeply wouldn’t be helpful,” Porambo explains.

According to the National MS Society, massage may also be unsafe for people with swelling (edema), osteoporosis (brittle bones that break easily), ulcers or an enlarged liver or spleen. People with cancer, arthritis, heart disease or recent injuries should also check with their physicians before pursuing massage therapy.
Otherwise, massage therapy appears to be safe and potentially helpful. “As long as the massage therapist is reputable and as long as the patient is in relatively good physical condition, I would not have any safety concerns about the treatment,” Shin says.


What to Look For
If you’re interested in pursuing therapeutic massage for MS, get the green light from your doctor first. Then, look for a licensed massage therapist who is trained to work with people with MS. “A trained therapist will know how much pressure to place on tissue and understand the depths of tolerance so the nerves aren’t overstimulated,” Porambo says.
She also points out that massage is just one component of feeling better. Exercising, eating a healthy diet, getting adequate sleep and taking the appropriate MS medications are all crucial parts of a treatment plan. “Managing MS can be stressful,” Porambo says. “Massage therapy can help people on many levels.”

• Phyllis Hanlon

Michael Desrochers had it all—a wife, three children, a successful corporate job—until a $6,000-a-month cocaine addiction shattered his life.For 10 years, his costly habit held him captive and robbed him not only of his family and career, but also his health.
In 2000, at the age of 38, Desrochers’ doctor informed him that he wouldn’t live to see 40. A nervous breakdown and the concern of his parents and his then-girlfriend led him to the Bellwood Treatment Center in Toronto, Ontario, Canada, where he began to reclaim his life.
In addition to intensive psychotherapy and strict adherence to a 12-step program, Desrochers received nutrition counseling and massage therapy, which he credits for kick-starting the healing process.
He was so convinced that the massage component of his treatment was largely responsible for his recovery that upon discharge he became a certified massage therapist and founded the Coal Harbour Natural Health Clinic in Vancouver, British Columbia, Canada.
Desrochers is not alone. In the U.S. in 2017, opioids, alcohol, methamphetamine, cocaine and fentanyl all wreck havoc in the human body. Among the 92 million Americans who used prescription opioids in 2015, 11.5 million misused them, according to the National Institutes of Health’s National Institute on Drug Abuse.
Massage therapy can help.
Massage for RecoveryTreatment trends for addiction have taken a decidedly holistic path in recent years, according to Daniel Gatlin, Ph.D., who as of this writing was clinical director of Renaissance Malibu Holistic Treatment Center in California, a substance-abuse treatment center.
He said that previous therapy included attendance at Alcoholics Anonymous (AA) meetings, lectures and group sessions.
“But addiction affects all aspects of a person—mind, body, spirit,” he said. “You need a program to deal with how the individual has been functioning. Many are disconnected from their bodies and in a toxic state, depending on the degree of deterioration.”
In the early stages of therapy, massage starts the detoxification process and allows an individual to be touched again.
“They have to reconnect with themselves before they can reach out to others,” Gatlin said, adding that this hands-on approach reaches deep core issues that sustain self-destruction.
At Renaissance, massage is integrated into every other treatment modality, which might include individual, group and experiential therapy, physical exercise, relationship-building workshops or spirituality exercises.
Gatlin said people suffering from addiction often follow a sedentary lifestyle with no physical activity in their daily routines.
“They live a kind of ritualized existence,” he said. “Massage makes them more flexible, decreases worries [and] racing thoughts, and increases their energy level.
Massage for recovery … “becomes a tool for greater energy and self-awareness, both physical and emotional. Learning self-care is a big part of recovery,” he said.
Margaret Grace Stine, who as of this writing was a massage therapist and reiki practitioner at Renaissance, utilizes bodywork to balance the spirit.
“This helps people see that there are other solutions to problems in life,” she said. The initial response to massage involves relief from physical pain, which often unleashes a range of emotions. “Touch releases them and the things they’ve been holding onto,” Stine said.
Once massage has cleared an internal space, treatment specialists say, the patient can then begin to accept and process new information.
Research StudiesTiffany Field, Ph.D., founder and director of the Touch Research Insittute at the University of Miami School of Medicine, has been conducting studies on the benefits of massage for various medical issues since 1992.
In one study of massage for recovery, 27 percent of subjects stopped smoking after learning a self-massage technique they practiced each time a craving occurred.
Another study documented a reduction in symptoms of cocaine addiction in premature babies who were massaged; this therapy also fostered their growth. In a third study, women diagnosed with bulimia and anorexia experienced fewer symptoms following massage.
Field explained that massage stimulates the vagus, one of 12 cranial nerves, which slows heart rate, facilitates food absorption, and reduces cortisol (stress) and other neurotransmitters.
“Depressed people have little vagal activity,” she said. “Addictions are highly related to depression and lower dopamine and serotonin levels.”
The Butler Center for Research at Hazelden, in Minnesota, also conducts trials on effective alcohol-and-drug-addiction treatment methods.
Recent studies have found that the addition of massage to a standard treatment program reduces anxiety and promotes behavioral change. Patty Hall, who as of this writing was manager of Hazelden’s Wellness and Related Services department, emphasized the ability of massage to calm the body and help people “deal with life on life’s terms.”
A multidisciplinary team creates an individualized treatment plan that includes massage to help clients cope with the feelings that drove them to their particular addiction in the first place, according to Sue Hoisington, executive director of mental-health services at the Hazelden Foundation.
Restoring BalanceDesrochers’ clinic also bases its treatment techniques on scientific findings. “It’s not just feel-good therapy,” Desrochers said. “Massage is the preliminary modality to counseling. It elicits the parasympathetic system and breaks down barriers and your ego.”
Desrochers considers addiction a “dis-ease” with emotional underpinnings that correlate to problems in the body. He asserts that each individual possesses unique dynamics and perspectives, as well as different levels of anger. “The body of an addict is fighting to find balance. There is adrenal stress and thyroid imbalance, a whole raft of issues,” he said.
“Addicts are sensitive individuals. The emotional part of life is overwhelming and their addiction helps them cope. But this produces a self-defeating pattern.” He contends that massage can begin a process of understanding those destructive patterns and empower the individual to change them.
Through myofascial massage for recovery, Coal Harbour staff loosens tight connections between tissues to release emotions and detoxify the body. Adhering to the idea that emotions rest in certain organs, therapists utilize Swedish or deep-tissue massage for visceral manipulation.
“The type of massage we do depends on the individual,” Desrochers said. “Working with addicts, we have found that anger is the most prevalent emotion, and the liver is where it rests.”
Root Causes of AddictionAccording to psychologist Doris Jeanette, author of A Natural Process for Opening the Heart, “All addictive behavior, no matter what the symptom—eating too much, sex addiction, drinking too much, obsessive thinking, gambling—all have their source in anxiety.”
She promotes massage to foster body awareness and balance emotional health, noting that talk therapy produces limited response. “Massage helps return us to a relaxed, natural state where holistic health is automatically available,” she said.
Jeanette’s belief in the healing powers of massage runs so deep that when she took a two-month overseas trip, she left her patients in the capable hands of a massage therapist rather than another psychologist.
Brigitte Mars, who was an herbalist, massage therapist and herbology instructor at the Boulder College of Massage Therapy in Boulder, Colorado (which is no longer in business) and author of Addiction Free Naturally, believes that addicts use different substances as a way to ignore certain messages in the body. She cites two underlying reasons for addiction, both of which can be addressed through massage.
First, low blood sugar often triggers an addiction. “So many substances contain [the ability to elevate blood sugar]—alcohol, drugs and even tobacco,” she said. “People are looking to increase the sugar in their systems. Massage helps reduce these cravings by releasing pent-up emotions,”
Mars said. Secondly, she said, individuals with addictions frequently have a poor oxygenation metabolism. “They are often shallow breathers,” she said. “It’s important to breathe more deeply, [and] massage brings awareness to your body and to your breath.”
Mars theorizes that individuals justify their substance abuse as a means of burying pain. “Addicts avoid the emotional baggage that made them seek alcohol or drugs in the first place,” she said.
The use of massage and bodywork enables a person to deal with underlying feelings, she said. Mars believes that craniosacral therapy is particularly useful for people in recovery.
“People [in recovery] feel uneasy and disconnected,” she said. “Craniosacral therapy goes deep within and helps individuals align themselves.”
Mars recommends Swedish massage to increase lymphatic drainage, reduce tension and bring about a mind-body connection.
In addition to increasing circulation and elimination, massage helps to move stuck energy in the body, which, in turn, allows the addict to let go of his emotions, she said. “Often when you let go, you have a craving. The more you can move stuck energy, the quicker that craving will subside.”
Massage MechanicsRenee Barasch, a massage therapist and digestive-health specialist, explained the mechanism of action behind massage: “Massage can physically relax tight muscles that harbor holding patterns due to structural, mechanical or emotional blocks or imbalances,” she said.
“When released through muscle manipulation, [massage] can allow nerve pathways to become open and work in harmony to create balance with the rest of the body, thus facilitating emotional release.”
Barasch agrees that different types of massage affect people in different ways due to varied reactions to stimuli.
“Swedish, soothing or hot-stone massage can help to slow down the nervous system, which will in turn help with becoming less impulsive,” she said.
“When a person is less impulsive, they also have a chance to slow down their thought process and perhaps make a healthful decision that may have, at one time, been a struggle for them as an addicted person.”
Luke Catton knows addiction well. Perpetually high on alcohol, with an occasional dose of ecstasy thrown in, from high school until he was 21, he rode an addictive merry-go-round that eventually led to suicidal thoughts.
In 1999, with the help of his parents, Catton entered Narconon Arrowhead, a residential treatment center for drug-and-alcohol addiction in Canadian, Oklahoma.
His therapy included: life-skills training, a regimen of vitamin-and-mineral supplements, outdoor exercise, consciousness raising and light massage.
In Catton’s sessions, a therapist drew his fingertips lightly over nerve endings in the neck, arms, legs and spine. “This technique helps connect the nerve endings with the brain. It is a regenerating process and opens up the channels in your body,” he said.
Those who respond to a lighter touch receive “feathering,” a two-finger technique that lightly brushes nerve endings from the base of the neck to the base of the spine and from the hips to the toes.
During his first 24 hours at Narconon, Catton received four 10- to 15-minute bodywork sessions. By beginning treatment with massage, Catton said, he was able to proceed with a successful recovery regimen.
“The [touch was] extremely relaxing and made me feel calmer [and] relieved my nervousness and anxiety,” Catton said. As he continued treatment, his case manager oversaw his progress and prescribed massage at regular intervals.
Reach out to AddictsThere are more than 13,000 drug-and-alcohol rehabilitation facilities in the U.S. according to the U.S. Department of Health and Human Services Substance Abuse & Mental Health Services Administration, and there are about 1,000,000 Americans enrolled in a rehab facility—on either an outpatient or inpatient basis—at any given time.
Rehabilitation centers are increasingly incorporating massage and bodywork into treatment programs. Therapists who are interested in working at this type of facility should call the center’s administrative office to inquire about it or set up an informational interview.
Networking with counselors and psychologists who specialize in addiction is another means of expanding a massage practice to recovering clients.
Massage therapists can be effective partners on a recovery health-care team, and healing touch is effective for people in recovery from any type of addiction.
About the Author
Phyllis Hanlon has written nonfiction articles and book reviews as well as human-interest stories, profiles and award-winning essays. Her specialty areas include health and medicine, religion, education and business. She regularly delights in the joys of massage. She has written many articles for MASSAGE Magazine.

• MASSAGE Magazine
• • Issue 245
  • Research
  • Research Published in 2016

Participating in a yoga class, getting a massage or receiving a reiki session all resulted in significant improvements in the sense of well-being among cancer patients, according to recent research. However, the patients who received reiki reported a greater reduction in cancer pain than those who received a massage or participated in a yoga class.
The study, “The effects of yoga, massage and Reiki on patient well-being at a cancer resource center,” involved 150 patients at a cancer resource center. Of these patients, all of whom had a diagnosis of cancer, 137 were women and 13 were men.
These subjects were already self-enrolled in yoga, massage and reiki services at the cancer resource center. For the study, 50 participants from yoga, 50 recipients of massage and 50 recipients of reiki volunteered to fill out a questionnaire before and after they attended the yoga class or received a session of massage or reiki therapy.
The main outcome measure for this study was patients’ self-perceived well-being. This was defined by six specific factors: stress, pain, anxiety, mood, overall health and quality of life. All six factors were assessed on a 10-point scale immediately before and after each patient received the designated therapeutic service.

Results of Integrative TherapiesResults of the research showed that yoga, massage and reiki all contributed to decreased stress and anxiety, improved mood, and enhanced patients’ perception of overall health and quality of life. As far as pain, analysis of the patient surveys showed that reiki therapy resulted in a greater reduction in cancer-related pain than either massage therapy or yoga.
“A fact worth noting is that, although cancer center patrons are able to enroll in any service, when patrons expressed pain concerns to a center staff member, they were encouraged to enroll in Reiki and refrain from yoga and massage, which instead are prime integrative therapies for alleviating stress and anxiety,” stated the study’s authors.
According to the researchers, one of the goals of this study is to help inform program directors at cancer resource centers of the benefits of specific integrative therapies for individual cancer patients. That way, patients can be directed to the integrative therapy that might offer the most help for their particular issues.
“The findings from this study address a void in the literature on how cancer resource centers should best administer integrative cancer therapies—including yoga, massage and Reiki—in accordance with the needs of patients with cancer,” stated the authors.

About the StudyAuthors: Mark Rosenbaum and Jane Van de Velde.
Sources: College of Business, Northern Illinois University, DeKalb, Illinois; Reiki Share Project, Villa Park, Illinois. Originally published in June 2016 in the Clinical Journal of Oncology Nursing, 20(3), E77-81.

​Irene Smith
​​Massage News


In the U.S., patients’ use of hospice care is growing. According to a 2014 report from the U.S. Centers for Medicare & Medicaid Services, the number of people receiving benefits for hospice grew 58 percent from 2000 to 2012; also, Medicare’s expenditures on hospice care increased from $2.9 billion to $15.1 billion, or by 80 percent.
By 2013, the most recent year for which statistics are available, the number of hospice providers in this country had grown to almost 6,000. In 2014, between 1.6 and 1.7 million Americans received hospice care at end of life, according to the Na­tional Hospice and Palliative Care Organization.
Gentle massage therapy is oftentimes offered to hospice patients. Here, hospice massage pioneer Irene Smith discusses therapeutic presence and how that can assist massage therapists when providing healthy touch to hospice patients.
 


Depth of VulnerabilityDying persons are vulnerable. They have lost physical defenses due to the loss of muscle mass and physical stamina. They have relinquished social defenses in the need to receive intimate care, and many will give up emotional defenses as they let go of their image in the world, their family, their bodily functions and finally the ability to breathe.
This depth of vulnerability requires the practitioner to create a safe environment or container in which the dying person feels that his or her vulnerability is witnessed, validated and honored.
The foundation for this practice of witnessing is therapeutic presence, a term first used by Carl Rogers, Ph.D., an American psychologist who is known as the father of person-centered therapy.
Therapeutic presence is the quality of self, or the way of being that therapists bring to the therapeutic relationship. It is a state of being, rather than a state of doing.
This state of being involves the practitioner’s ability to be personally grounded and available as a nonjudgmental witness for the dying person’s expression of his or her illness.
 
Presence & ProtocolsAmerican psychologist James F.T. Bugental, Ph.D., described three components of therapeutic presence:

1. Being open and present to all parts of the client experience;

1. Being open to all of one’s own experience as one is with the client; and

1. Being able to respond from the immediacy of 1 and 2, noted above, combined.

The practice of therapeutic presence involves the practitioner in the following protocols:

• The practitioner holds the intention of witnessing, validating and honoring the dying person’s experience, rather than trying to fix, change, cure or correct any specific symptom or condition.

• The practitioner is quiet, observes the dying person and takes several breaths. This is a time of introduction on a deeper level than conversation. Each person has the opportunity to sense the rhythm and vibration of the other person’s energy and their energy together. This time of silent interaction provides a space for trust building and gives the relationship a center from which to deepen.

• The practitioner allows the dying person’s symptoms full expression. For example, in the case of Parkinson’s disease, the practitioner would not try or intend to restrict the movement to provide a touch session. The practitioner would observe the patient’s tremors and assess how he or she might interact with touch as a partner in movement.

• The dying person is allowed a greater sense of acceptance, which raises the self-esteem and deepens the trust in the touch relationship. He or she knows that they can bring themselves fully into the relationship without fear of rejection.

 


Cultivated from WithinNo academic discipline has developed a systematic approach for teaching therapeutic presence as a skill or ability. It is cultivated from personal growth outside the training environment.
The Buddhist meditation practice of mindfulness, however, offers a training ground for the development of therapeutic presence through openness and compassion to one’s own thoughts and feelings, and a nonjudgmental witnessing of oneself.
Being at the bedside with a dying person and possibly caregivers and family members—all of whom may be in various states of grief, not knowing what to do—the cultivated skill of therapeutic presence becomes an oasis of wise non-action.


About the AuthorIrene Smith began her journey as a massage therapist in 1974. She founded and directs Everflowing, an educational outreach program dedicated to teaching mindful touching as an integral component to end-of-life care. Smith is a member of the National Association of Massage Therapists, Hospice Volunteer Association and the San Francisco Bay Area End of Life Coalition. She wrote “Advocate for Yourself in the Health Care Environment” for massagemag.com (June 21, 2016).