Back on Track

Massage therapy can help manage chronic back pain

WE'VE ALL SUFFERED the soreness associated with an overly exuberant exercise session. But did you know that most Americans experience pain from another less-strenuous activity? Surprisingly, it's sitting. Chronic back pain, which is the second most common cause of disability and a top reason for missing work, can be the result of improper posture while sitting and standing.

Back pain also can be caused by being overweight or inactive, says Michael McGillicuddy, owner of USA ProSports and the Central Florida School of Massage Therapy. "More than 60 percent of Americans are overweight and a lot of back pain comes from people being overweight," McGillicuddy says. Carrying extra weight, poor posture, and repetitive or overuse movements all can put strain on the low back, as can sleeping on a bad mattress and using a workstation that isn't set up ergonomically. The pain you feel is caused by localized ischemic muscle tissue. That basically means that the muscle is in spasm and isn't getting enough blood flow, which decreases flexibility and mobility.

"The combination of extra weight and weak abdominals causes the pelvis to tilt forward, which is what often leads to low back pain," explains Jeffrey Forman, Ph.D., program coordinator of the massage therapy program at DeAnza College in Cupertino, Calif. He cites other muscle imbalances that can play a role in back pain, including weak gluteus maximus muscles as well as tight hip flexors, hamstrings and low back muscles. "You really have to do exercises and stretches to work on these muscles," he says, but cautions that doing the right exercises is essential. "Something like straight-leg sit-ups can actually aggravate your pain."

Trip Your Trigger

What happens next is known as the pain-spasm-pain cycle. Those muscles trigger the brain to send them into spasm and lock them down to-theoretically- stop the pain. But the spasm causes more pain, which, you guessed it, convinces the brain to send the muscles into spasm. And, as it turns out, the brain isn't terribly accurate, McGillicuddy says. "Your brain doesn't turn off specific muscles. So you're also going to feel tightening and pain in your upper back, your hips, your glutes and your hamstrings. Your brain is trying to make all those muscles and joints not move."

Massage gets to the root of the pain by relaxing those tight muscles and addressing trigger points to put a stop to the pain cycle. Massage also increases blood flow to the affected muscles, which brings in healing oxygen and nutrients, and helps remove the waste products of cellular metabolism. All of this activity reduces swelling and stiffness and increases flexibility to help eliminate pain.

Massage therapy also releases endorphins and boosts your levels of serotonin and dopamine, all hormones your body produces to help you feel good, promote healing and pain management, and calm the nerves sending those cyclical pain signals.

From the Brain to the Back

According to a 2001 study by the Touch Research Institute at the University of Miami (TRI), massage helps with chronic back pain in other ways by positively affecting other contributing factors, such as:

• Depression and anxiety
• Sleep problems
• Range of motion

With benefits like that, it's easy to see why Forman considers massage essential food for the body. "You should have one at least once a week."

If you've been experiencing back pain for three weeks or more, it would be wise to consult your doctor for a complete physical.

-By Jenn Woolson