Massage & Bodywork

July/August 2013

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Pathology Perspectives as the delay between onset and treatment gets longer, complete recovery becomes less possible. For more information on documenting your work in a scientifically credible case report format, check out the five-part Writing a Case Report webinar series in the ABMP Online Education Center at www.abmp.com. Massage and PN The research about massage therapy and pain in general is extremely promising. Pain related to arthritis, cancer, surgery, and many other situations responds positively to welcomed touch. But, because PN can involve hypersensitivity and even allodynia (the perception that all incoming sensation is painful), massage may not always be well-tolerated. No single approach to working with PN has been demonstrated to be the "best." Each massage therapist must call on the most current research, along with his or her education and expertise, to meet our clients' needs. Research suggests that many people with chronic nerve pain seek out complementary and alternative medicine (CAM) modalities, 2 but massage is not among their top choices. Perhaps touch does not seem particularly appealing for someone whose nerve endings feel raw and scraped, especially since inadequate pain control is a leading reason why people look for help among alternative health-care providers. Although the PN patients who seek CAM therapies tend not to seek massage as a first recourse, some studies have found that some people experience significant pain relief with careful bodywork. One of these was a case report called "Case Report of a Patient with Chemotherapy-Induced Peripheral Neuropathy Treated with Manual Therapy (Massage)"3 that led to a pilot study funded by the Massage Therapy Foundation.4 This study will assess the impact of therapeutic massage on the signs, symptoms, quality of life, and local circulation for clients with chemotherapyinduced PN. Preliminary findings from this project were presented as a poster at the International Massage Therapy Research Conference in April 2013. See an interview with the author at www.youtube. com/watch?v=CCzfjGMcvrs&feature=youtu.be. While we wait for the results of this and other research about manual therapies for people with PN, we can do some of our own in-house research. Do you have clients with PN? Do they seem to improve, stabilize, or degenerate with your work? How do you know? If what you're doing doesn't seem to work, where will you look for your next option? The sooner we begin to think analytically about our client outcomes, and begin to write down what happens in the session room, the sooner we can share our successes and failures (which can be just as important) with our colleagues. PN affects one-tenth of our population, and some of those people seek massage for relief. What are you doing to help them? Notes 1. M. Bromberg, "An Approach to the Evaluation of Peripheral Neuropathies," Seminars in Neurology 25, no. 2 (2005): 153–9. 2. B. Brucelli and K. Gorson, "The Use of Complementary and Alternative Medicine by Patients with Peripheral Neuropathy," Journal of the Neurological Sciences 218, no. 1 (2004): 59–66. 3. J. E. Cunningham et al., "Case Report of a Patient with Chemotherapy-Induced Peripheral Neuropathy Treated with Manual Therapy (Massage)," Support Care Cancer 19, no. 9 (2011): 1,473–6. 4. J. E. Cunningham, "Use of Therapeutic Massage to Treat Chemotherapy-Induced Peripheral Neuropathy (CIPN)" (research grant proposal, Massage Therapy Foundation, 2012). Ruth Werner is a writer and educator approved by the National Certification Board for Therapeutic Massage & Bodywork as a provider of continuing education. She wrote A Massage Therapist's Guide to Pathology (Lippincott Williams & Wilkins, 2012), now in its fifth edition, which is used in massage schools worldwide. Contact her at www.ruthwerner.com or wernerworkshops@ruthwerner.com. www.abmp.com. See what benefits await you. 47

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