Massage Therapy & Autoimmune Disorders
More than 80 autoimmune diseases affect more than 23.5 million Americans, making them among the most prevalent diseases in the country. They can affect any part of the body, and disproportionately affect more women than menтАФin fact, according to the American Autoimmune Related Disease Association, 75 percent of Americans with an autoimmune disease are women.
What is Autoimmune Disease
In autoimmune diseases, the immune system, which ordinarily defends the body against outside infection, mistakes the bodyтАЩs own cells, tissues and organs as foreignтАФand attacks them accordingly. Some diseases involve one part of the body, such as multiple sclerosis, in which the immune system attacks the central nervous system. Others, such as systemic lupus erythematosus, are systemic, affecting the entire body. Commonly known autoimmune diseases include rheumatoid arthritis, celiac disease, GravesтАЩ disease, HashimotoтАЩs thyroiditis and Type 1 diabetes. What causes autoimmune diseases is an area of great interestтАФand great debateтАФwithin the scientific community, with experts suggesting a complex interaction of genetic and environmental risk factors. Some recent studies have pointed to Epstein-Barr virus as a possible culprit in the development of lupus and some other autoimmune diseases.
Because autoimmune diseases can affect different parts of the body, treatment and management may involve specialists from different fields, such as rheumatology, endocrinology, neurology or gastroenterology. But one thing autoimmune diseases share is inflammation. тАЬEssentially they are all inflammatory diseases, regardless of what tissues they are affecting,тАЭ says Kait Gardiner, LMT, CNMT, whose practice, Gardiner Wholistic Health, is based in New York City. While there is currently no cure, treatments such as corticosteroids are used to temporarily reduce inflammation, particularly when the symptoms of a disease тАЬflare.тАЭ There is a lack of research on massage therapy and autoimmune diseases overall, although a 2017 review in Complementary Therapies in Clinical Practice4 found benefits to massage, particularly related to pain, when used to treat a range of conditions that included autoimmune diseases such as diabetes, dermatitis and multiple sclerosis.
More often, studies have focused on specific diseases. A 2017 study in Evidence-Based Complementary and Alternative Medicine compared deep tissue massage with therapeutic massage in 27 men diagnosed with ankylosing spondylitis, an inflammatory autoimmune condition of the spine and back. While the study did not find significant differences between the two techniques, the results suggested that both may show benefit and warranted further study. Another recent survey of individuals living with lupus in the United Kingdom (Lupus, January 2018) revealed that massage and acupuncture are used commonly enough to also warrant further research into their benefits for the disease.
Different for Everyone
Even within one autoimmune disease, there can be a wide range of experience. тАЬNone of these diseases look the same in different people,тАЭ says Betsy Blazek-OтАЩNeill, M.D., who practices at the Allegheny Health Network Center for Complementary and Integrative Health. Severity of symptoms can vary by person and can change every day. тАЬAny time you are doing massage therapy on somebody with a chronic medical condition, you have to get a sense of how it affects them [and] how you want the massage to be beneficial,тАЭ says Dr. Blazek-OтАЩNeill. She points out that some types of massage might actually make people experience more severe symptoms, particularly those types that utilize strong pressure. Some medications, such as NSAIDs used to treat pain, may lead to easier bruising or even bleeding. Prednisone, which is used to suppress the immune system, can also lead to bruising and fluid retention.
For that reason, Gardiner, who has worked with clients with diseases such as rheumatoid arthritis, psoriasis, ankylosing spondylitis, CrohnтАЩs and celiac diseases, and thyroid disorders, stresses that it is important to ask about all the medications clients might be taking. тАЬIf patients are taking pain relief medications, they might think you can go as deep as you want,тАЭ she says. тАЬYou have to know as a therapist when to stop and recognize that deeper work isnтАЩt always better.тАЭ She stresses researching medications that are not familiar. тАЬYou really need to understand what symptoms your client is dealing with that day and continue to check in as youтАЩre working,тАЭ says Gardiner. тАЬNo amount of information is too much.тАЭ
Addressing Pain
According to Dr. Blazek-OтАЩNeill, autoimmune diseases like lupus or rheumatoid arthritis can cause muscular/skeletal pain, leading patients to look for relief through massage therapy. тАЬSome people want massage specifically designed to alleviate certain kinds of pain and directed at painful areas such as the lower back, shoulders or neck.тАЭ Ankylosing spondylitis in particular affects the spine, causing swelling between the vertebrae and, over time, may even fuse them together. Ashley Stafford, LMT, who runs Tranquil Therapy in Philadelphia, is particularly careful when applying pressure if a client is experiencing pain or tenderness. тАЬI find a tender point and stretch the skin around it. If itтАЩs very painful, I avoid the area and tell them to go to a doctor.тАЭ She likes a technique called DermoNeuroModulation, which she has found helpful with clients who are sore to the touch. тАЬI also recommend yoga or tai chiтАФgentle practicesтАФto get the body used to doing new movements.тАЭ She says she works very slowly, especially as she gets to know a client, and keeps detailed notes that she goes over and adds to often. When Gardiner works with a client who is recovering from a flare, or exacerbation, of symptoms, she likes to use myofascial release and passive range of motion techniques, as well as neuromuscular therapy тАЬjust to open up and alleviate some of the restrictions in the tissues.тАЭ Effleurage can also help increase circulation. тАЬBasic circulation is important, especially if youтАЩre doing deep work,тАЭ she says. For clients experiencing pain or achiness, Gardiner may use bolstering to support knees and head, or conduct a session in a side-lying or supine position, or even do chair work. тАЬEspecially with arthritic conditions where there may be a lot of pain involved, there may be positions they canтАЩt get into,тАЭ she says. She recommends that therapists stay flexible depending on how their client is feeling. тАЬIt can change at a momentтАЩs notice, so be open to changing your format." Gardiner also notes that, when dealing with chronic pain, clients tend to close in on themselves. тАЬThey get very protective of their bodies,тАЭ she says. тАЬThey contract in on themselves and become locked into their own bodies. This affects their posture and range of motion.тАЭ To counteract this tendency, she uses postural alignments and other techniques тАЬto make space in the joints and allow connective tissue to work through its full range of motion.тАЭ She stresses that itтАЩs important to use techniques that allow clients to be more active and in less pain.тАЬItтАЩs a vicious cycleтАФcontract, pain spasm, contract. ItтАЩs a very valuable role we have as massage therapists to help break that cycle.тАЭ
Reconnecting to the Body
Other symptoms can affect the overall body, as well. For instance, Gardiner points out, gastrointestinal symptoms like cramping can lead to postural misalignment, while the fluctuating hormone levels of autoimmune thyroid diseases can cause energy and weight issues. She has noticed that fascia may be particularly тАЬrigidтАЭ in clients with thyroid issues, so she finds myofascial release particularly helpful. Chronic diseases also bring emotional issues. More тАЬvisibleтАЭ autoimmune diseases such as psoriasis can cause people to feel embarrassed. And even just the nature of an autoimmune disease can make people feel disconnected from their own bodies. тАЬIt can be as simple as the stress of knowing that your body is attacking itself,тАЭ says Gardiner. The often-difficult process of diagnosis can add to that stress. According to an AARDA study, it took an average of 4.6 years for people with a serious autoimmune disease to get a diagnosisтАФand 46 percent had been told they were тАЬchronic complainersтАЭ or too concerned with their health.
For people with autoimmune diseases, Dr. Blazek-OтАЩNeill says the most common outcomes of massage therapy is decreased stress, improved sleep and decreased pain symptoms. тАЬI think people with autoimmune diseases feel like their body has betrayed them in some way,тАЭ she says. тАЬTheir body is doing something it is not supposed to do and it alienates them from their body. Massage therapy can help them get in touch with their body in a positive way.тАЭ
Source:
https://www.amtamassage.org/publications/massage-therapy-journal/massage-autoimmune-disorders/