The Pain Cycle
     
     The pain cycle is a complex chain of events, which reinforce each other. It often begins with injury or illness, but each element, especially stress, can add to or even start to cycle. Massage is unique in addressing most of the pain cycle elements.

Pain
      You perceive pain when your body releases chemicals that stimulate nerves to send pain messages to the brain. These are difficult, and dangerous, to ignore.
       Always look for and treat the cause of your pain. At the same time, you can use massage to directly affect how you experience chronic, persistent pain. Research suggests that massage stimulates release of natural pain-relievers such as endorphins. It can also reduce the devastating grip of pain as you focus on the pleasant sensation of relaxation.

Muscle tension
       Muscles automatically contract around any painful site to support and protect the area. If pain is resolved quickly, muscles relax. If pain persists, muscles can become habitually contracted. Sometimes contractions press on nerves causing tingling, numbness, and more pain.
        Massage helps by stretching tight muscles and by stimulating the nervous system to relax muscle tension.

Reduced circulation
        Like a sponge that is squeezed, a contracted muscle can't hold much fluid. Tight muscles reduce circulation, allowing waste products for inflammation and normal muscle function to accumulate. This can leave you feeling fatigued and sore, reducing your energy reserves. It can also irritate nerves, causing pain to spread throughout the tense area.
        Massage releases contracted muscles and pushes circulation toward the heart. Also, as massage relaxes the nervous system, blood vessels dilate to increase blood flow. Waste products are flushed away and replaced with healing oxygen and nutrients.

Trigger Points
        Over time, areas with poor circulation form trigger points - highly irritable spots that refer pain, tingling or other sensations elsewhere in the body, usually in predictable pattern. As muscles tense around referred pain, the pain cycle spreads.
        Trigger points respond well to standard massage techniques such as sustained pressure, ice massage, and muscle stretching.

Muscle Shortening
       Eventually, the body lays down connective tissue throughout any contracted area with poor circulation. While helpful for healing injuries, this natural reaction and "glue" muscles and their connective tissue coverings into a shortened state.
Massage increases circulation, rehydrating and softening connective tissue so it can be lengthened by stretching and kneading.

Restricted Movement
       Irritating waste products, painful trigger points, and shortened muscles make even simple actions difficult and tiring. As your capacity for movement and exercise decreases, you lose the most important means for maintaining good circulation throughout your body, risking pain in new areas.
       Massage helps restore normal movement by releasing trigger points, removing waste products, and stretching shortened muscles. In addition, because you feel better after a massage, you may discover renewed energy and motivation for physical activity.

Stress and Pain
      Our physical reactions to stress reflect how we evolved in prehistoric times. Muscles tense for action and circulation decreases to areas not needed to fight or run. This helped cavemen survive the saber-toothed tiger, but unfortunately does not help with modern stresses such as family conflicts, work deadlines, or money worries. When stress is unrelieved, our bodies tense further into an anxious, irritable posture. Stress induced muscle tension and impaired circulation can and do contribute directly to the pain cycle.
       To make matters worse, chronic pain itself is a major source of stress. It drains you emotionally, robbing you of the patience and stamina you need just to get through a day. It interrupts your sleep, leaving you tired and irritable. You worry about its cause and if you will ever get better. As pain makes normal activity difficult, your anxiety increases. Will you be able to keep working? Where will you get the money for treatment? Will you become dependent on others?

Massage and stress
        Massage acts on the nervous system to counteract the body's response to stress, relaxing muscle tension and allowing heart rate, blood pressure and circulation to return toward normal. Many people sleep better after a massage, which helps to body heal and renews emotional reserves. To the extent massage relieves pain, even temporarily, it reduces stress by giving you some control over your situation.
        A massage also helps you become aware of unconsciously held tension, and how it feels to relax. This helps you recognize and release tension later, before it creates a problem.
        Finally, allowing someone else to give you the care and comfort of a relaxing massage can give you much needed emotional support in a time of stress.

How much massage is right?
        This depends on your general health, when the pain started and what caused it. For long-term benefits you usually need series of massages. Follow-up massage in times of stress can help keep old pain from flaring up. You may find massage so beneficial that you make it a regular part of your life.

What else should you do?
        Always seek medical advice for pain since it can indicate a serious health condition. Also, because massage is not appropriate for all conditions, let your primary care practitioner know you are receiving massage, and always inform your massage practitioner about any medical problems.
        Also, massage can relieve chronic pain on many levels, but often works best with other supportive measures. Rest, exercise, nutrition, and appropriate medication can all help you feel better. Stress counseling and relaxation techniques such as biofeedback or medication can also give significant relief.