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18/Aug/2017

Let’s talk about carpal tunnel syndrome, and what, if anything, massage therapy can do for it.

What are the symptoms of carpal tunnel syndrome?

The main symptoms of carpal tunnel syndrome are pain, numbness, burning, tingling, weakness and/or clumsiness in the hand or fingers, not including the pinky finger.  Symptoms often come on at night, and may radiate sensation up to the shoulder.

What causes the symptoms?

Carpal tunnel syndrome symptoms are caused by pressure on the median nerve, which runs down through the wrist and innervates the hand and all fingers but the pinky.  The pressure often comes from the carpal tunnel, a small passageway in the wrist that the nerve passes through.  This passageway is comprised of bones and ligaments, most notably the transverse carpal ligament. Pressure at other points along the nerve pathway may produce similar symptoms as well.

What causes the carpal tunnel to press on the median nerve?

Typically the pressure is due to swelling in the carpal tunnel.  Some causes for this swelling include:

  • Heredity
  • Pregnancy
  • Swelling/fluid retention
  • Health problems such as diabetes, hypothyroidism and rheumatoid arthritis
  • Repetitive hand or wrist movements, especially with the wrist flexed (bent down)

Can carpal tunnel be self-treated?

There are several self-treatments that have reportedly helped with carpal tunnel syndrome:

  • Avoid repetitive hand and wrist movements, and let the wrist rest longer between activities
  • Apply ice to the wrist periodically
  • Soak the wrist in epsom salt
  • Wear a wrist splint or hand brace at night

Can carpal tunnel syndrome be treated by a professional?

Treatments involving a second party include the following:

  • Surgery
  • Medication
  • Physical therapy
  • Yoga
  • Massage therapy

How effective is massage therapy in treating carpal tunnel syndrome?

A 2010 study by the Touch Research Institute at the University of Miami School of Medicine showed that regular massage therapy can decrease carpal tunnel syndrome pain and other symptoms, including improving the client’s grip strength.  Treatment often includes myofascial release all along the median nerve, from neck to hand, with the goal of relaxing any muscles pressing on the nerve.  The therapist may also include lymphatic massage(if swelling is involved), swedish techniques, stretches, nerve gliding, and direct compression to tight muscle fibers. Many clients experience relief after the first session, but it typically takes from three to six sessions to get long-term results.

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18/Aug/2017

Diagnosing fibromyalgia isn’t as straightforward as you may think.

While it may seem a “no-brainer” that the path towards healing from chronic pain lies in obtaining a diagnosis the reality of receiving one can be anything but easy. Pain which appears to be emanating from fractured vertebrae may actually be caused by a pinched nerve. Lower back pain may originate in knotted muscles mid-back. For the fibromyalgia sufferer, the difficulty is compounded by the fact that no test currently exists for a definitive diagnosis. The diagnosis is a clinical one which is made when a physician applies pressure to 18 specific points over the body. If at least 11 of these are tender to the touch and the patient has a history of diffuse musculoskeletal pain, a positive diagnosis is made. Often this diagnosis only comes after thousands of dollars in tests and numerous visits to a wide range of specialists. It is once test results read normal and a host of other maladies have been eliminated that a diagnosis often finally occurs.

My own journey with fibromyalgia began with a sore shoulder. My primary care physician referred me to an orthopedist specializing in shoulders. He in turn prescribed physical therapy after consulting x-rays. Three physical therapists, two orthopedists specializing in shoulders and one in spines, two rheumatologists’ visits and thousands of dollars in tests and treatments later, I finally received my diagnosis of fibromyalgia. I count myself fortunate as my journey only lasted 10 months. For many it can take years.

What have I learned from this journey? First and foremost, don’t give up. Some days it will take every ounce of strength and courage you possess just to roll out (and I mean that literally on those days where every movement causes pain) of bed in the morning. Do it anyway.

Second, don’t be afraid to question doctor prescribed treatments or procedures. I had never visited a physical therapist prior to fibromyalgia. I blindly accepted that the treatment would make me better even as my pain and lack of mobility increased. Physical therapy was in reality one of the worst treatments I could do as it often focuses on repetitive motions and strength conditioning which can quickly cause flare-ups for fibro sufferers.

Third, don’t be afraid to seek additional medical opinions or change medical professionals if one isn’t working for you. It took three physicals therapists before I found one who really listened to me and who became a key player in obtaining my diagnosis. One of the three made me feel that I was a hysterical female whose symptoms were all in her head. Get rid of anyone who makes you feel that way!

Four, seek out medical professionals and therapists who really listen to you. It was only after I found a physical therapist and orthopedist who listened to me and to each other that I was referred to my rheumatologist who was able to make my diagnosis. My massage therapist at Nimbus is a skilled listener. Because of that, in conjunction with an expertise in myofascial release massage, we have been able to tailor make a therapy plan that works best for me.

Five, keep a journal or log of your daily activities and symptoms.

At my lowest point, daily activities such as eating breakfast, washing and drying my hair and putting on my coat could only be accomplished with great difficulty and pain or with assistance. I now have full range of motions in my arms, shoulders and legs. I often walk a mile per day and lead a fairly normal life as long as I “listen” to my body. You can get there too. It all begins with a decision to either literally roll out of bed or to throw the covers over your head, stay in bed and cry. Choose to roll out (although an occasional covers over the head and good cry can be therapeutic as long as the next day you roll!)

Thanks to Nina at Nimbus Massage who acted as my arms and typed this blog for me when my arms were too fatigued to do so. It is only because of Nimbus’ skillful and compassionate care that I continue to move with ease most days and can write this blog.

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18/Aug/2017

Living Through Pain and Frustration – Tips and Techniques for Fibromyalgia Self Care

Slightly more than five years ago after thousands of dollars in medical expenses and numerous tests that all indicated “normal” test results, I finally received a diagnosis of fibromyalgia and began my journey of living with this painful and frustrating condition. During my journey, I have discovered a number of tips that can make the daily struggle of living with fibromyalgia a little easier and can alleviate some of the pain and discomfort. Soon after I was diagnosed, I stumbled upon a book by Dr. Ginevra Liptan entitled Figuring Out Fibromyalgia. Many of the ideas listed below came from this book and her subsequent publication The Fibro Manual. If you are struggling with fibro, I urge you to get a copy of The Fibro Manual. The information contained in this recent publication has been invaluable to me and my path towards healing and fibromyalgia self care .

At my very lowest point, I could not lift my arms to my mouth to eat my morning cereal. Now I have recovered my full range of motion and am the most flexible that I have ever been. You can get better. While listening to the radio station WPER Positive Hits 90.5, I heard Theresa Mills state that the word HOPE stands for Hold On Pain Ends. It is my prayer that each one reading this will find at least one thing that can make his/her daily life with this dreaded condition a little easier. As with anything concerning your health, please check with your doctor or healthcare provider before taking any supplements or starting a regime of exercising and stretching.

Since pain, fatigue and stiffness at times can make daily routines difficult, I have found a few tricks and tools to make daily living easier, especially on those bad days.

Protecting Fibro Backs

A long pair of tongs can be helpful for picking up things when bending or reaching is out. Use them to retrieve dropped items from the floor, take clothes out of the dryer, or reach things out of the cupboard.

A speaker phone can save your neck and back! Instead of crooking your neck to the side and holding the phone to your ear (remember that static locked positions are your enemy), put the phone on speaker to avoid prolonged awkward positioning.

If you love to read, you probably have realized that holding up a book or even a newspaper for a prolonged period of time may be too much. Using a tablet, books on tape, or a reading stand can help. (I have also found the tablet to be easier on my body for emailing and light computer usage.)

When taking a car trip, use pillows to prop up your arms and a towel or pillow to bolster your neck. A heat wrap (or heated seats if you’re lucky) can come in handy, too.

Driving can be your worst enemy of fibromyalgia self care; if you must do it often or for a single prolonged period of time (which could be as little as 10 minutes if you are really flared up). I never drive without a travel-sized pillow under each of my arms. The pillows fill the space between my lap and the wheel so I am not holding my arms locked in a stationary position with no support.

Stretch every day. I always begin my daily stretching in the shower so that the heat of the water also aids in loosening my muscles. Then. as soon as I towel off I continue with additional stretching while I am still loose and warm. Do each stretch slowly but avoid too much repetition (maybe two-three reps of each).

Tools for Fibromyalgia Self Care

Pillows, pillows, pillows … in the car, at the table, on the couch, in the bed. Extra pillows can keep you propped and supported. At bedtime make sure your primary pillow gives your neck good support. Fill in with support pillows as needed especially for the hips, arms and shoulders. Find a good mattress topper or mattress. Foam works best for me. Also, lavender aromatherapy can help enhance sleep.

Use a small ball, like a tennis ball or trigger point ball, to help roll out knots. You can lean against it on a wall, or lay on it on the ground, and take it with you when you travel.

A Theracane, basically knobs on a stick, can help you get precise pressure on your tender points. And it is great for reaching your neck, back, and shoulders without exerting yourself too much.

Heat wraps deliver moist heat help relax muscle tension. You can find ones that heat up in the microwave like a rice pack or aromatherapy pillows from Mother Earth.

Foam rollers target broad areas of your body at once. They are great for general tautness and large muscle groups.

Use your large exercise ball as a support when you stretch- especially good for stretching your back.

Magnesium, such as in an epsom salt bath or oil, can help ease muscle soreness and tension.

Lavender aromatherapy serves as both a natural stress reducer and sleep aid.

A Cranio Cradle can also help traction your neck and encourage rest.

The great outdoors is free. Get outside every day. No matter how bad you feel. The movement and sunshine (and nature) can help keep you going and connected to the world.

Many thanks to the staff at Nimbus Massage. Their compassionate, knowledgeable and skillful therapists literally keep me moving while maintaining my pain at tolerable levels. Without their encouragement and assistance, I would never have compiled this list of tips and tools. They are truly awesome!!

Additional Resources

Some quality sources of information that have helped me include:

The Fibro Manual by Dr. Ginevra Liptan.

Healing Through Trigger Point Therapy by Devin J. Starlanyl and John Sharkey

The Fibromyalgia Partnership and their quarterly publication Fibromyalgia Frontiers.

YouTube always has helpful fibromyalgia self care videos for how-to’s on stretching and using tools.

 

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18/Aug/2017

Arthritis Feels Like …

Stiffness, aching joints, losing strength and movement: all hallmarks of “Ol’ Arthur” coming to visit. Over 50 million Americans live with arthritis. The most prevalent form of arthritis, osteoarthritis, occurs when the lining at the end of a bone thins. This leads to pain, stiffness, swelling, inflexibility, diminished strength, and decreased mobility.

Many people use therapeutic massage as a method of easing the chronic pain and stiffness associated with osteoarthritis. Although massage cannot reverse or cure arthritis, it can help relax the muscles that tighten around the joints, which eases pain. Many people also use massage to maintain their flexibility. In some cases, people use therapeutic massage to help manage their symptoms when they plan to get joint replacement surgery, but have to postpone.

The team and Nimbus has experience working with clients who have osteoarthritis. Many of our member have arthritis has a primary or secondary reason for seeking massage. When working with people who have arthritis, we take a gentle yet targeted approach around the affected joints. We tailor our techniques to each person’s goals – maintain flexibility, pain relief, pre-hab for surgery – and work with each person to individualize a program that works for them.

Before Your Massage

Some things to discuss with your therapist about when you come in for massage as a treatment for osteoarthritis:

  • Your treatment goals.
  • Details of your condition including its onset, symptoms, and severity.
  • How your condition is progressing.
  • Your past history of massage.
  • Other conditions you may experience.
  • Any medications you take and their side effects.

Knowing these things will help your massage therapist plan your session or program.

During Your Massage

During your massage, your therapist may use a blend of techniques depending on your goals.

  • Pain Relief: Find knots and tight areas and apply pressure, add heat, add soothing techniques.
  • Relieving Tension: Apply slow gliding to taut areas, add heat, apply pressure to relax muscle fibers.
  • Maintaining flexibility: Gently move the joint, gentle stretching, find and relax tight muscles.
  • Pre-hab for surgery: Lighter massage to manage stress and anxiety, stimulate lymph flow, and to maintain the  muscles.

The massage therapist will work with you to find a pressure that feels comfortable to you. We typically recommend a moderate pressure that feels comfortable but therapeutic. If anything during the session causes you pain, let the therapist know so they can adjust what they are doing. Massage is not a “no pain, no gain” type of therapy.

After Your Massage

After your session you should feel better. Mild soreness the next day sometimes happens if you have not had much massage. However, let your therapist know if you experience this so they can ease the pressure the next time. Many people find using moist heat, such as an aromatherapy pillow or a long shower, helps enhance the effects of the massage.

Generally speaking, massage work best for people who have mild to moderate cases of osteoarthritis. Although an experienced practitioner can also help people with more advanced cases. If you have a severe joint instability, the treatment focuses more on soothing and pain relief and less on changing the muscle tissue. In severe cases, we recommend checking with your rheumatologist or primary-care provider to make sure they approve of massage for your condition.

If you experience pain, stiffness, inflexibility or other symptoms related to osteoarthritis, massage may be a wonderful addition to your toolbox of ways to ease and manage your condition.

To delve deeper into the topic check out the Arthritis Foundation website section on massage.

 

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18/Aug/2017

Low back pain hurts and can result in pain when trying to stand up or shift position. Aching while trying to sleep. Trouble with bending or lifting.

Low back pain is the most common cause of missed time from work— it affects up to 80% of adults in the US at some point and can be completely incapacitating.

Many factors contribute to back pain including muscular injury, postural irregularities, obesity, problems with the spinal column and discs, and nerve problems. In some cases, no one culprit becomes evident– termed non-specific chronic low back pain. Despite its prevalence, low back pain remains a frustrating malady to treat.

Massage for Low Back Pain

Fortunately, for many people, massage can help ease low back pain. Although research has only just begun to support the efficacy of massage, the evidence that exists suggests both relaxation and therapeutic massage can reduce low back pain. In fact, recent medical guidelines list massage as a go-to therapy for low back pain. The team at Nimbus has helped countless people with their low back pain over the years. If muscular tension or injury has led to the pain, many people find relief in a few short sessions. For underlying factors that will not go away (arthritis, scoliosis, etc…) many manage their pain with ongoing treatments. Here is a list of some causes of back pain and some observations from the Nimbus staff about how massage may or may not help.

Massage may be most helpful for resolving pain or other symptoms in a short series of sessions:

– Muscular pain with recent onset.

– Nerve entrapment (by a muscle) with recent onset– including sciatica.

– Recent injury, sprain, or strain.

Massage may be very helpful for the following cases, however it may take a longer series of sessions:

– Chronic muscular pain.

– Nerve entrapment (by a muscle) that has been on-going– including sciatica.

– Past injury, sprain, or strain.

– Pain from postural or repetitive motion stress.

– Non-specific low back pain.

– SI Joint Dysfunction.

– Tendonitis.

– Piriformis Syndrome.

Massage may be helpful for relieving pain or other symptoms, but will not resolve the underlying issue:

– Arthritis including Osteoarthritis, Rheumatoid Arthritis, Osteoporosis, Ankylosing Spondylitis, and Spinal Stenosis.

– Fibromyalgia.

– Scoliosis.

– Degenerative or other disc diseases.

– Ehlers-Danlos Syndrome.

Massage may not be helpful depending on the level of nerve vs. muscular involvement, may help pain or other symptoms:

– Ruptured disc.

– Nerve impingement (by bone)– including sciatica.

– As always, talk to your healthcare provider about your condition, and seek medical help for distressing, severe, or chronic pain.

What to expect during a massage

As with any complex condition, the treatment plan your massage therapist would suggest for your particular case will vary. The therapist will ask many questions concerning your pain, overall health, and history of massage and then discuss a plan with you. In some cases, the therapist may recommend a flowing massage using techniques to elicit relaxation and calm stress. A Massage for Stress & Anxiety can help back pain, and is a good fit for people who do not like structural massage. In other cases the therapist may recommend a more structural approach. If the pain just started recently, this would fall under the Massage for Aches & Pains category. For pain that has lasted more than three months, the Massage for Chronic Pain would be appropriate.  In either of these cases, the therapist may employ firm pressure to tender muscles; vigorous strokes to loosen stuck muscle fibers; sustained moderate pressure to ease taut areas; stretching and movement to move a nerve or muscle; and many more techniques. Depending on what you list as your symptoms, the therapist may check muscles in areas other than your low back including your legs, buttocks, and abdomen.

Home Care

You can also take steps to ease your pain at home. The American College of Physicians recently came out with a list of recommended approaches to easing back pain. Some examples of therapies you can use at home include the following. Apply heat, especially moist heat, like one of our Mother Earth Pillows or a soak. Engage in exercise, tai chi, or yoga. Try mindfulness techniques or progressive relaxation. You can also do self-massage at home with your hands or a gadget such as a trigger point tool or foam roller.

If low back pain hampers your daily living, massage and a good home care program, could help you get your pain under control, naturally.

 

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18/Aug/2017

Throbbing, aching, pounding, stabbing, squeezing … we do not want these things done to our heads! Headaches and migraines can make us want to make the whole world disappear. For those of us who struggle with chronic or recurring headaches, well, it just plain sucks.
Many massage clients who suffer from tension/muscular headaches and migraines indicate that regular massage reduces the frequency and severity of their symptoms. Sometimes, it can also diminish the pain associated with an active headache. Massage is particularly good at helping if there is a stress or muscular component.
When working to alleviate headaches, massage therapists work through the muscles of the scalp, jaw, face, neck, shoulders, and upper back to find and relieve trigger points, taut bands, and tight areas. Your therapist may also blend in general relaxation work, aromatherapy, craniosacral therapy, heat or cold, or stretches to help get you back into shape.
Some common culprits leading to headaches include stress, TMJ, poor posture, trigger points in the neck and shoulders, sinus pressure, vascular issues, and nerve issues. Massage therapists learn techniques designed to work directly or indirectly on most of these underlying causes.
A medical study on massage for migraines seems to support the anecdotal evidence with positive preliminary results. Participants reported reduced frequency of migraine following massage (plus improved sleep). One preliminary study on massage for tension type headaches (TTH) found that Trigger Points “are important components in the treatment of TTH…” but that the placebo also led to people feeling better. Other studies (according to Myofascial Pain and Dysfunction: The Trigger Point Manual by Travell & Simons) have found similar conclusions and have further linked some migraines, and other types of headaches, to Trigger Points.
Not all headaches are created equal. The ones that, so far, seem to have the best chance at responding to massage include: tension headache, migraine, TMJ-related headache, and cervicogenic headache. In our experience working with people with each of these types of headaches, we have seen good results in lessening the frequency and severity of headache-related pain. Typically, a series or regular routine of massage has a better chance at helping people with chronic headaches.
We can work with you to see if massage or a massage program can work for you.
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