Do You Know About Neuromuscular Massage Therapy?

The most effective type of massage therapy for lower back pain is neuromuscular therapy. Neuromuscular therapy is also called trigger point myotherapy. The American Academy of Pain Management recognizes this form of massage therapy as an effective treatment for back pain caused by soft tissue injury (such as a muscle strain).

Neuromuscular Massage Therapy Technique

Neuromuscular therapy consists of alternating levels of concentrated pressure on the areas of muscle spasm. The massage therapy pressure is usually applied with the fingers, knuckles, or elbow. Once applied to a muscle spasm, the pressure should not vary for ten to thirty seconds.

Massage Therapy Can Reduce Muscle Pain

Causes of Back Muscle Spasms Video

Muscles that are in spasm will be painful to the touch. The pain is caused by ischemic muscle tissue. Ischemia means the muscle is lacking proper blood flow, usually due to the muscle spasm. This in turn creates the following undesirable process:

• Because the muscle is not receiving enough blood, the muscle is also not receiving enough oxygen

• The lack of oxygen causes the muscle to produce lactic acid

• The lactic acid makes the muscle feel sore following physical activity.

After the muscle is relaxed through massage therapy, the lactic acid will be released from the muscle, and the muscle should start receiving enough blood and oxygen.

• See Can Massage Help Your Back Problem?

Neuromuscular therapy will feel painful at first, but the pressure of the massage should alleviate the muscle spasm. At this point, it is extremely important to communicate with the massage therapist regarding the pressure - whether the pressure is too much, too little, getting better, getting worse. The therapist should listen and respond accordingly. The massage therapy pressure should never be overly painful. In fact, most people describe the pressure as “good pain”.

What to Expect After Massage Therapy

Following a neuromuscular therapy massage, any soreness that presents itself should fade after twenty-four to thirty-six hours. The muscles that were tight should remain noticeably more relaxed for four to fourteen days, depending on stress

This article was originally posted on Spine-Health.com and was written by Beth Mueller R.M.T

Video: Understanding Different Types of Back Pain

Are you having trouble treating your back pain? This video explains why back pain can be so difficult to diagnose and treat.

When you learn about your body, you are in control of how to support it well & correctly.

Click the photo to watch a short educational video!

Getting the Right Massage for Low Back Pain

Massage therapy can provide substantial healing and pain relief for people suffering from low back pain caused by muscle tension and strain, if the correct muscles are targeted.

I asked certified massage therapist Kate Fish, who works at in a chiropractor's office, to explain how she helps heal her clients' pain with massage.

See Chiropractic Treatments for Lower Back Pain

She explained that isolating and rejuvenating the main back muscles that can have the biggest effect on low back pain caused by stressed muscles.

See Pulled Back Muscle and Lower Back Strain

Kate stresses that two important muscles, the quadratus lumborum (QL) and the gluteus medius, may play a bigger role in causing pain than most people realize, saying, "If you strain either of these muscles, the pain can be severe and debilitating.

Dysfunction in these muscles (the QL and the gluteus medius) can lead to severe and debilitating low back pain." Tweet this to share on Twitter.

Kate recommends that you specifically ask your massage therapist to spend 60 minutes on these two muscles.

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1. Quadratus lumborum (QL) muscle massage

Ask your therapist to massage the QL muscle while you lie on your side for 20 minutes on each side (40 minutes total).

The QL muscle, which connects the last rib to the pelvis, is responsible for pelvic stability and structural alignment. It is a common source of low back pain.

See Back Muscles and Low Back Pain

The muscle can become irritated when the lower body is engaged while the upper body is still. For example, activities that could irritate the QL muscle are:

See Office Chair, Posture, and Driving Ergonomics

See Running and Lower Back Pain

• Lifting that requires leaning over something (such as getting groceries out of a trunk)
• Leaning over a sink while doing dishes
• Sitting slumped in a chair
• Running on uneven pavement

Sharp, stabbing pain, urgent pain in the low back is a symptom of a hypertonic (tight) QL.

This muscle must be stretched and massaged simultaneously by your therapist in order to reduce lower back pain. Typically, clients can get relief by combining treatment of the QL muscle with 20 minutes of massage on the gluteus medias.

Back Strains and Sprains Video

2. Gluteus medius massage

After working on the QL muscle, ask your therapist to focus on the gluteus medius for 20 minutes.

The gluteus medius is a posterior hip (or buttocks) muscle that frequently causes pain when the QL muscle is irritated. The gluteus medius becomes inflamed as it tries to compensate for the QL’s dysfunction. Your massage therapist should focus on simultaneously stretching and massaging the gluteus medius as you lie on your stomach.

Kate has been able to provide significant pain relief to numerous clients by using these massage techniques in only one session. She recalls,

"One of my clients had experienced severe low back pain for 3 months. After his doctor ordered an MRI, he was worried he would have to have surgery. He visited the chiropractor where I worked as a massage therapist, and I assessed that his QL was ischemic (so tight that the blood supply got cut off). Working on these specific muscles, I loosened them and increased their blood flow, and the client was pain-free after one session."

See Pulled Back Muscle Treatment

Most likely, your massage therapist is well-versed in the muscles that cause back pain, but don’t hesitate to speak up and specifically request this type of massage if you suspect your pain is due to muscle dysfunction.

This article originally appeared on Spine-Health.com and was written by Allison Walsh.

Back Pain: Intervertebral Disc Conditions

The term ‘disc’ is short for the ‘intervertebral discs’, the spongy cushions that separate the block-like bones (vertebrae) of the spine. These discs have a number of important functions including shock absorption, keeping the vertebral column stable and giving the vertebrae ‘pivot points’ to allow movement. 

A disc is made of two parts: the elastic outer shell (annulus fibrosis) and the jelly-like contents (nucleus pulposis). It can handle quite a lot of pressure without damage, but certain types of pressure can damage the shell and push its contents out. 

Symptoms of disc problems

The symptoms of a damaged disc can vary according to its location and severity. Many people who show evidence on scanning of damaged discs have no symptoms. This means that, most commonly, there are no symptoms at all. However, general signs may include:

• Back pain
• Pain radiating down the legs
• Worsening pain associated with bending over or sitting down for a long time
• Worsening pain associated with activities like coughing or sneezing
• Numbness or pins-and-needles in an arm or leg.

Risk factors for disc problems

Some people are more susceptible to disc problems than others. Risk factors include:

• Obesity
• Poor muscle tone
• Lack of regular exercise
• Cigarette smoking
• Advancing age
• Poor posture
• Incorrect lifting techniques.

Often, however, there is no recognisable risk factor present.

Types of disc problems

Common disc-related problems include degenerative disc disease, ruptured (or ‘slipped’) disc and sciatica (nerve pain).

Degenerative disc disease

The discs of a young child are plump and moist, but the water content reduces with age until the discs are comparatively thin and hard. As a result of this, friction between the bones is thought to increase, resulting in growths called bone spurs around the discs.

In many cases, these age-related changes cause no problems, but some people experience a painful condition called degenerative disc disease. The most common symptom is back pain caused by holding the same position (either sitting or standing) for too long. It’s among the most common causes of chronic back pain in older people. 

Ruptured disc

The term ‘slipped disc’ suggests that a disc has moved out of position, but this is not accurate. The discs are held firmly in place by various structures (including ligaments, muscles and the vertebrae themselves).

Terms like ‘ruptured’, ‘herniated’ or ‘prolapsed’ describe the situation better, as the real problem is not that the entire disc ‘slips’, but rather that a crack in the tough outer shell of the disc allows the soft jelly-like contents to ooze out. When this material comes into contact with other structures, especially the spinal nerves that run nearby, this can cause pain and alter nerve function. 

The most common site for a ruptured disc is the lower back, and chronic lower backache can be a symptom. As we get older, the risk of rupturing a disc declines because the discs dry out and the contents are less able to ooze through any cracks.

Sciatica

Sciatica is nerve pain from the sciatic nerve that runs from the spine into the buttock and down the back of the leg. A common cause of sciatica is a ruptured disc. The spinal cord normally has room to slide up and down inside the spinal column whenever the body moves. However, a bulging disc can protrude into the spinal column and press against the spinal nerves, hampering its movement and causing pain. 

Diagnosis of disc problems

Diagnosis of disc problems involves:

• Taking a medical history (to determine risk factors and predisposing conditions)
• A physical examination.

Other investigations are carried out if surgery may be required.

Treatment for disc problems

The majority of disc problems will resolve regardless of treatment. Bed rest is occasionally best for initial management of severe sciatica, but most people can keep active with some restrictions according to the level of pain. Good pain control and allowing the person to move is often a good approach. 

Some common treatments include:

• Heat treatment
• Regular massage
• An exercise program designed to improve strength and flexibility
• Non-steroidal anti-inflammatory drugs (NSAIDs) or steroids
• Pain-relieving medication
• An injection of anti-inflammatory steroids into the region of the disc
• Uncommonly, in severe cases of ruptured disc, an operation may be needed to trim the protruding bulge (laminectomy)
• Also uncommonly, in severe cases of degenerative disc disease, an operation may be needed to remove the disc and fuse together the two vertebrae on either side.

Remember, most disc problems resolve without specific treatment. 

Self-help for disc problems

Given time and the right conditions, a ruptured disc can heal itself. Ongoing maintenance can reduce the risk of disc problems in the future. Be guided by your doctor or health professional, but general suggestions include:

• Try not to sit still for long periods of time.
• Avoid lifting heavy objects.
• Remember that movements such as bending and twisting (especially at the same time) can increase pressure on your damaged disc.
• Work on increasing your abdominal strength. Strong stomach muscles help to support the back. People who work hard on their abdominal muscles probably have much less recurrence of back pain over the long term, but only if they keep doing the exercises.
• Pay attention to posture while sitting, standing and walking.
• Flexibility exercises, performed regularly, can improve mobility and help reduce muscle tension and back pain.
• Include a gentle program of back-strengthening exercises.
• Yoga is recommended by some practitioners as an excellent form of strengthening and stretching for people with back problems.

Other causes of back pain

There are many other causes of back pain, so see your doctor if pain is strong. Important other reasons for back pain include:

• Muscular pain – probably even more common than disc rupture. It is usually localised to the back, without the pain spreading to the legs and very likely to fix itself without specific treatment
• Fracture – especially in elderly people, or those with osteoporosis
• Malignancy – some cancers can present with back pain. See your doctor if you have strong pain, night pain, have experienced weight loss or any other symptoms you are worried about.

Where to get help

• Your doctor
• Physiotherapist
• Osteopath

Things to remember

• Intervertebral discs are spongy cushions found between the vertebrae of the spine.
• Common problems include degenerative disc disease and ruptured (or ‘slipped’) disc.
• Risk factors for disc problems include obesity, advancing age, lack of exercise and incorrect lifting techniques.

This article originally appeared on www.betterhealth.vic.gov.au