PS Ingraham. Central Sensitization in Chronic Pain: Pain itself can change how pain works, resulting in more pain with less provocation. PainScience.com. 5428 words. Pain itself often modifies the way the central nervous system works, so that a patient actually becomes more sensitive and gets more pain with less provocation. This is called “central sensitization.” (And there’s peripheral sensitization too.) Sensitized patients are not only more sensitive to things that should hurt, but also to ordinary touch and pressure as well. Their pain also “echoes,” fading more slowly than in other people. BACK TO TEXT

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To understand this difference, it’s helpful to first think of the body’s fascia and muscles in layers. Notice in this image the many overlappinglayers of these tissues. Fascia is a connective tissue which permeates the entire body – literally holding the body together, wrapping around every muscle, nerve, organ, blood vessel, and bone. These wrappings are all interconnected in a three-dimensional maze. The muscle layers run superficial to deep in the body.
“If your hands and fingers start to scream while you're working, you need to modify what you're doing,” says Bykofsky. “Also, if you notice that you’re sore at the end of your work day, Bykofsky also recommends that you “do the things you suggest to your clients: ice, apply something to help, perhaps take an anti-inflammatory, and, the hard one, rest!”  

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Sports massage was developed to help athletes prepare their bodies for optimal performance, recover after a big event, or function well during training. However, contrary to what the name suggests, you don't have to be an athlete to benefit from sports massage. Sports massage emphasizes prevention and healing of injuries to the muscles and tendons and can be beneficial for people with injuries, chronic pain or restricted range of motion.

Deep tissue massages are not for everyone, and it’s very important to find a well-trained therapist. If you’re actively healing from surgery, have nerve damage or an existing injury, you’re wearing a cast or brace, or you’re pregnant, then talk to your doctor before seeking a massage therapist. Although it’s rare, massages that are poorly performed can sometimes cause increased pain, inflammation and other complications in high-risk patients. (16)


In the US, licensure is the highest level of regulation and this restricts anyone without a license from practicing massage therapy or by calling themselves that protected title. Certification allows only those who meet certain educational criteria to use the protected title and registration only requires a listing of therapists who apply and meet an educational requirement.[123] It is important to note that a massage therapist may be certified, but not licensed. Licensing requirements vary per state, and often require additional criteria be met in addition to attending an accredited massage therapy school and passing a required state specified exam (basically the certification requirements in many states). In the US, most certifications are locally based. However, as of March 2014, some states still do not require a license or a certification.[citation needed] However, this is thought to change eventually as more regulatory bodies governing the profession of massage are established in each state. Furthermore, some states allow license reciprocity where massage therapists who relocate can relatively easily obtain a license in their new state. Not all states provide this option.[124]
Swedish massage is the most popular type of massage in the United States. It involves the use of hands, forearms or elbows to manipulate the superficial layers of the muscles to improve mental and physical health. Active or passive movement of the joints may also be part of the massage. The benefits of Swedish massage include increased blood circulation, mental and physical relaxation , decreased stress and muscle tension, and improved range of motion.

Some research has shown that massage therapy can be effective during pregnancy due to its anxiety-lowering effects, and women who receive massages before and during labor tend to experience decreased depression, anxiety, and leg and back pain. Results from one study found that women who received massages prior to and during labor had significantly less pain, plus their labors were on average three hours shorter and required less need for medication.

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This is not only an inaccurate and potentially harmful picture of this type of therapy, but such misguided practices can bruise muscles, elicit a defensive reaction in a client’s body, and worsen pain cycles. Properly executed deep tissue work should not cause the client to grit their teeth in agony as the therapist coerces the body into submission! If you find yourself clenching, shortening or holding your breath, or gritting your teeth, then it’s TOO DEEP. Even when it gets intense, it should not go above about a 7 on the pain scale: enough to “hurt so good,” but not enough that you want to leap off the table (and never come back).
Another study examined the popular claim that reflexology treatment benefits bronchial asthma. Ten weeks of active or simulated (placebo) reflexology were compared in a controlled trial of 40 outpatients with asthma. Objective lung function tests (peak flow morning and evening, and weekly spirometry at the clinic) did not change. Subjective scores (describing symptoms, beta2-inhalations and quality of life) and also bronchial sensitivity to histamine improved on both regimens, but no significant differences were found between groups receiving active or placebo reflexology. The researchers concluded that they had found no evidence that reflexology has a specific effect on asthma beyond placebo influence [16].
Connective tissue stimulation. A lot of therapists are keen on stretching connective tissues — tendons, ligaments, and layers of Saran wrap-like tissue called “fascia.” I’m not a huge fan of this style, but certainly it’s a way of generating many potent and novel sensations, which may be inherently valuable to us — another form of touch. Although “improving” the fascia itself is implausible and unproven, perhaps fascial manipulations affect bodies indirectly, just as a sailboat is affected by pulling on its rigging. People have written whole books full of speculation along these lines. So, as long as the sensations are not like skin tearing (that’s an ugly pain for sure), you might choose to tolerate this kind of massage if it seems to be helping you.
Massage therapists who have received specialized training and are certified in prenatal massage know how to position and support the woman's body during the massage, modify techniques, and avoid certain areas and techniques during pregnancy. Most will have a special table that allows the woman to rest comfortably and safely during the massage. Ideally, you should seek out a practitioner who is experienced and licensed in prenatal massage.
Reflexology is a bodywork technique that uses pressure points in the feet and hands in an effort to stimulate organs and systems throughout the body. Reflexology practitioners claim they can treat a wide range of maladies simply by manipulating these pressure points. The general idea is similar to that of other forms of alternative and Eastern medicine, such as acupuncture: clear blockages in the flow of the body's life force (or Qi) and healing will follow.

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With no lotion or oil to cause sliding, it becomes possible to fully get a hold of the shortened fascia; this is necessary in order to lengthen it. Slow, sustained strokes are what can change this tissue from a short, hardened state to a lengthened, fluid state. The process is not unlike stretching salt water taffy. You’ve got to get a hold of it, warm it up, and work it very slowly. The work may sometimes be intense, eliciting moderate discomfort as old adhesions and chronic dysfunctional patterns are altered. But that leads to a much more fluid, easy sense in the body.
Shoulder pain. A 2017 study published in the Journal of Physical Therapy Science reports that shoulder pain is one of the most common musculoskeletal disorders, affecting as many as 66.7 percent of the population. The study goes on to say that massage therapy can often help reduce this type of pain, sometimes in a matter of days, though 36 sessions appeared to offer the greatest level of relief.
Six papers meet the inclusion criteria and were summarized and reviewed. Both Thai and  Swedish massages are reported to relieve chronic low back pain by enhancing physical functions;  providing pain relief, improving disability and range of motion, improving psychological functions;  reducing anxiety and improving mood. Although based on different theoretical frameworks, they appear to be equally effective in relieving chronic low back pain.
Aromatherapy is the use of essential oils to promote healing and a feeling of well being and relaxation in the recipient. The essential oils are extracted from the parts of herbs and plants and contain all the properties of the plants themselves. There are several ways of applying the oils, including adding the oils to your bath, or inhaling them, but the most popular and effective is through massage.

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Some reflexologists who deny that they diagnose or treat disease claim that the majority of health problems are stress-related and that they can help people by relieving the "stress" associated with various diseases or body organs [1]. This type of double-talk is similar to chiropractic claims that "subluxations" lower resistance to disease and that "adjusting" the spine to correct subluxations will improve health. All ten of the books I have inspected mention scores of health problems that reflexology has supposedly helped.

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Adequate recovery is also a major factor in avoiding the over-training syndrome. Over-training is characterized by irritability, apathy, altered appetite, increased frequency of injury, increased resting heart rate, and/or insomnia. It occurs when the body is not allowed to recover adequately between bouts of heavy exercise. Therapeutic massage helps you avoid over-training by facilitating recovery through general relaxation, and its other physiological effects. 

Our private Steam is a great way to relax and detoxify the body. Following the steam, enjoy a nice hot rinse with our five jet shower. Shampoos and soaps are provided as well as fresh, clean towels. Not only is it great for colds and the flu but can also benefit those suffering from bronchitis. It's also a great way to loosen up those muscles preceding a massage. 

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The Athletico blog is an educational resource written by Athletico employees. Athletico bloggers are licensed professionals who abide by the code of ethics outlined by their respective professional associations. The content published in blog posts represents the opinion of the individual author based on their expertise and experience. The content provided in this blog is for informational purposes only, does not constitute medical advice and should not be relied on for making personal health decisions.

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Massage used in the medical field includes decongestive therapy used for lymphedema[10] which can be used in conjunction with the treatment of breast cancer. Light massage is also used in pain management and palliative care. Carotid sinus massage is used to diagnose carotid sinus syncope and is sometimes useful for differentiating supraventricular tachycardia (SVT) from ventricular tachycardia. It, like the valsalva maneuver, is a therapy for SVT.[52] However, it is less effective than management of SVT with medications.[53]
Flushing. If massage can “improve” any tissue — unknown — one way it might do it is through simple hydraulics: physically pumping tissue fluids around, and/or stimulating the circulation of blood and lymph. I won’t get into the evidence about it here. Suffice it to say that it might be true, and if it’s true then it may not much matter if the process is uncomfortable. While gentler massage may feel pleasant and satisfying, it is possible that more biological benefits can only be achieved hydraulically — whether it’s comfortable or not. This is even more plausible because of trigger points: it’s likely that the tissue fluids of a trigger point are quite polluted with waste metabolites, and the need for flushing is greater, but it’s especially uncomfortable to squish those polluted patches of tissue.
Ever gone to a county fair, music festival, or conference and envied other people getting chair massages? Passed by the chair massage section in an airport? Or, maybe you're lucky enough to work at a company that offers 15- to 20-minute massages as a regular benefit. Onsite, chair massages are done while you're seated fully clothed in a portable, specially designed chair. They usually involve a massage of your neck, shoulders, back, arms, and hands.
As a Reflexologist works each reflex, it triggers a release of stress and tension in the corresponding area or body zone, as well as an overall relaxation response. The release of tension unblocks nerve impulses and improves the blood supply to all parts of the body. Because reflexology works from the inside, it also has a balancing effect on each gland, organ and body region. . . ." [10]
Deep tissue massage is best for giving attention to certain painful, stiff "trouble spots" in your body. The massage therapist uses slow, deliberate strokes that focus pressure on layers of muscles, tendons, or other tissues deep under your skin. Though less rhythmic than other types of massage, deep tissue massage may be therapeutic -- relieving chronic patterns of tension and helping with muscle injuries, such as back sprain.

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An author found that a patient who afflict multiple sclerosis and choose reflexology as the complementary treatment for a period of time had notable symptom relief. It is measured by considering urinary symptoms, parenthesis, spasticity, and muscle strength as the parameters. All parameters showed a remarkable improvement except for muscle strength.30

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Ugly pain in massage therapy is, by my definition, never okay. Ugly pain is often caused by things that are not going to offer even minimal, delayed benefits, and may even be dangerous. It’s important to be able to spot ugly pain for what it is and completely eliminate it from any therapy you’re receiving. What kinds of handling may cause “ugly” pain?

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A person receiving a deep tissue massage usually lays on the stomach or back in one position, while deep pressure is applied to targeted areas of the body by a trained massage therapist. The massage is beneficial mostly because it helps stimulate blood flow and relieve muscle tension, while at the same time lowering psychological stress and releasing “happy hormones” like serotonin and oxytocin.

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Changes should be implemented immediately instead of in stages, so that patients can go to any reflexology centre without any doubt. The entire centres, spas or even small booth that offer reflexology treatment must obtain a certificate from the Ministry of Health. It is suggested that each centre to have a medical form about patient's details, medical history, and screening form. It is already issued by the Ministry of Health but none of the centres has ever applied.

Manual lymphatic drainage is a technique used to gently work and stimulate the lymphatic system, to assist in reduction of localized swelling. The lymphatic system is a network of slow moving vessels in the body that carries cellular waste toward the heart, to be filtered and removed. Lymph also carries lymphocytes, and other immune system agents. Manual lymphatic drainage claims to improve waste removal and immune function.[47][48][49]


A person receiving a deep tissue massage usually lays on the stomach or back in one position, while deep pressure is applied to targeted areas of the body by a trained massage therapist. The massage is beneficial mostly because it helps stimulate blood flow and relieve muscle tension, while at the same time lowering psychological stress and releasing “happy hormones” like serotonin and oxytocin.

A good massage is truly a treat and offers many health benefits, but as you've noted, massage places tend to offer lots of options on their services menus. In fact, there are over 200 different massage techniques and types, all treating different needs and providing various benefits. Let's break it down. Here are nine of the most popular types of massages and when you might want to choose them.

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Pre-event and post-event massage therapies are tailored for distinct purposes. Pre-event treatment is used as a supplement to an athlete’s warm-up to enhance circulation and reduce excess muscle and mental tension prior to competition. It is tailored to the needs of the athlete and his/her event and can be relaxing or stimulating as appropriate. Post-event massage, on the other hand, is geared towards reducing the muscle spasms and metabolic build-up that occur with rigorous exercise. Various sports massage techniques enhance the body’s own recovery process improving the athlete’s ability to return to training and competition, and reducing the risk of injury.
The pathways postulated by reflexologists have not been anatomically demonstrated; and it is safe to assume that they do not exist. Similar rationales are used employed by iridologists (who imagine that eye markings represent disease throughout the body) and auricular acupuncturists who "map" body organs on the ear (a homunculus in the fetal position). The methodology is similar in both of these; and some commentators consider pressing on "acupuncture points" on the ear or elsewhere to be forms of reflexology, but most people refer to that as acupressure ("acupuncture without needles). The Reflexology Research Web site displays charts for foot and hand reflexology. The fees I have seen advertised have ranged from $35 to $100 per session.

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An author found that a patient who afflict multiple sclerosis and choose reflexology as the complementary treatment for a period of time had notable symptom relief. It is measured by considering urinary symptoms, parenthesis, spasticity, and muscle strength as the parameters. All parameters showed a remarkable improvement except for muscle strength.30
20 asthmatic patients were chosen to be the subject for active treatment and another 20 patients were chosen to have reflexology session. According to a recent research conducted by the author, there are no significant differences between the groups having active session and placebo session of reflexology.33 However, when the analysis of the symptoms diaries was carried out, the results showed that there were significant differences between both groups especially when it was conducted together with subconscious unblinding pattern of study.33
The Elements Promise™ is not transferable and may not be redeemed for cash, bartered or sold. Void where prohibited or otherwise restricted by law. Substitute massage session equal in value and duration to original massage session; gratuity not included. Substitute massage session cannot be combined with any other offer. Other restrictions may apply; see individual studios for details.
The recently increased demand for evidence-based practice challenges the researchers to provide a relevant but holistic assessment of reflexology. Despite the recent vast use of reflexology, minimal attention has been given to the ethical issues related to the research on reflexology. In the view of public health and safety, we argue that the research on reflexology should adhere to the same ethical requirements for all clinical research.

Couples massage is a good choice when lovers are in the throes of early romance, and can't bear to be apart. They want to share everything, even their massage. Many couples treatments are specifically designed with romance in mind, including time alone in a rose-petal-strewn tub, a bottle of Champagne with strawberries and chocolate, and lounging time by a fire after the treatment. Part of what you are paying for is a time in the room, which works best when it's a beautiful romantic setting. 
Flushing. If massage can “improve” any tissue — unknown — one way it might do it is through simple hydraulics: physically pumping tissue fluids around, and/or stimulating the circulation of blood and lymph. I won’t get into the evidence about it here. Suffice it to say that it might be true, and if it’s true then it may not much matter if the process is uncomfortable. While gentler massage may feel pleasant and satisfying, it is possible that more biological benefits can only be achieved hydraulically — whether it’s comfortable or not. This is even more plausible because of trigger points: it’s likely that the tissue fluids of a trigger point are quite polluted with waste metabolites, and the need for flushing is greater, but it’s especially uncomfortable to squish those polluted patches of tissue.
The practice of using essential oils dates back to Egyptian times (it’s been said Cleopatra was a fan). Today, aromatherapy is used to promote well-being and stimulate the senses in a wide range of spa treatments, varying from massage to facials to hydrotherapy. Fragrant essential extracts sourced from plants, flowers, and herbs are mainly applied Show more
Research shows that firmer massages with more pressure can result in a significant reduction in arthritis pain compared to lighter massages. Lighter massage tends to be arousing (not relaxing) because often the heart rate goes up. However, with moderate pressure, heart rate usually goes down, and this stimulates relaxation and reduced tension. (13)

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