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In a majority of healthcare settings, the number one complaint of massage-seeking clients is chronic low back pain. By using a variety of bodywork techniques to relax the major muscles of the lower back, many practitioners gear their practice towards these individuals. While direct manipulation of the contracted, pain-causing low back muscles can bring clients great relief, there are some simple, often forgotten applications that can enhance conventional massage’s therapeutic results.

Clinical studies continually conclude that massage therapy helps people who are suffering with chronic aches and pains on either side of their lumbar vertebrae. Some of the most common bodywork modalities proven to reduce low back pain through circulation enhancement include Swedish massage, acupressure, myofascial release, neuromuscular therapy and deep tissue massage. Therapists who integrate these different types of circulatory massage are often rewarded by client reports of immediate pain relief. Unfortunately, this pain relief is often short-lived. By incorporating the four tactics listed below, practitioners can prolong their clients’ pain relief far beyond the confines of the massage table:

  1. Heat Therapy – While the qualities of warmth and heat have long been associated with comfort and relaxation, heat therapy goes further by providing both pain relief and healing benefits for many types of lower back pain. Heat’s ability to dilate constricted blood vessels can calm back muscle spasms prior to deep tissue massage, while driving a car, sitting at a desk or lying in bed. Applying a hot pack or taking a hot bath are two of the simplest ways to apply heat.
  2. Core Strengthening – Weak muscles can cause back pain. A strong core distributes the stresses of weight-bearing and protects the back. In general, the muscles of the core run the length of the trunk and torso, and when they contract they stabilize the spine, pelvis and shoulder girdle and create a solid base of support. Core strengthening can include exercises on a stability ball or wobble board, Pilate’s and yoga.
  3. Stretching – Shortened muscles can cause back pain. Tight back muscles, gluteal muscles, and even tight hamstrings or quadriceps can disrupt spinal alignment and cause pain. Stretching these muscle groups improves spinal mobility to prevent or reduce back pain.
  4. Cranial-Sacral Therapy – This gentle healing modality is intended to free cerebral-spinal fluid restrictions within the closed system of the cranium, spinal column and sacrum. Although most people’s association of cranial-sacral therapy’s effectiveness is restricted to the head and neck, this osteopathic-based form of bodywork can also release sacral adhesions, thereby relieving low back pain.

By incorporating these four tactics into a treatment plan, massage therapists can lengthen the time their clients experience low back pain relief. For clients with chronic low back pain, here are some examples of ways to implement these suggestions:

  • Being careful not to burn your client, lay a hot pack on his/her lumbar muscles before working on that area.
  • Advise your clients to take a hot bath or use a hot pack at the end of their day, or whenever their back hurts the most.
  • Do your research and prepare a handout sheet with instructions for core strengthening exercises and low back stretches. Confirm that the exercises and stretches are safe for your client and encourage a gentle progression.
  • Many clients will appreciate the additional effort of you modeling the exercises and stretches for them.
  • If you haven’t already, learn how to apply cranial-sacral therapy. Remember that freeing restrictions along the cranial-sacral system can improve chronic pain located adjacent to the spine or sacrum.

As long as safety remains the practitioner’s primary consideration, heat therapy, core strengthening, low back stretching and cranial-sacral therapy lengthen the pain-free moments of each day. By combining an integrated regimen of massage therapy techniques with the four commonly overlooked applications described above, massage therapists can help their clients attain prolonged relief from chronic low back pain.

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References:

Cherkin, D.C., Eisenberg, D., et al, Randomized trial comparing traditional Chinese medical acupuncture, therapeutic massage, and self-care education for chronic low back pain, Archives of Internal Medicine, 2001.

Hernandez-Reif, M., Field, T., et al., Lower back pain is reduced and range of motion increased after massage therapy, International Journal of Neuroscience, 2001.

http://sportsmedicine.about.com, Building Core Strength takes More than Abdominal Exercises, Elizabeth Quinn, about.com, 2008.

Massage Eases Lower Back Pain, Increases Range of Motion, Massage Magazine, July/August 2001.

www.bigbackpain.com, Back Exercises, bigbackpain.com, 2008.

www.massagemag.com, Chronic Low Back Pain Eased by Massage, Massage Magazine, Inc., 2008.

www.spine-health.com, Benefits of Heat Therapy for Lower Back Pain, Vert Mooney, MD, spine-health.com, 2008.