Massage & Bodywork

May/June 2012

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education PATHOLOGY PERSPECTIVES | BODY AWARENESS | FUNCTIONAL ANATOMY | SOMATIC RESEARCH The Epidemic of Pain Massage as a Solution By Diana L. Thompson The Centers for Disease Control and Prevention (CDC) announced late last year that deaths involving prescription pain medications have more than tripled over the past decade.1 According to the Los Angeles Times's analysis of the data, deaths by drug overdose now outnumber traffic fatalities.2 Even over-the-counter pain medications are not without complications of death. According to Janet D. Pearl, MD, "Over-the- counter products—while easing pain and reducing inflammation—can present problems, especially if taken with alcohol or in excess of recommended doses. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can cause ulcers or bleeding in the gastrointestinal tract, even if taken properly. Also, acetaminophen can be toxic to the liver in doses greater than 4 grams (and even less if taken with alcohol or by someone with liver disease). Acetaminophen is also contained in other medications, so an accidental overdose is possible if you're not careful."3 "For chronic pain, narcotics should be the last chronic pain.5 resort," says Thomas Frieden, MD, director of the CDC in Atlanta, which issued the report.4 But more than 116 million American adults live with In an effort to identify how to help those in pain, yet curb unnecessary prescriptions, pain projects are forming locally, nationally, and internationally. Government funding for pain research is increasing. In the report, Relieving Pain in America, the Institute of Medicine has charged the US Department of Health and Human Services with creating a comprehensive plan to address chronic pain as a complex disease, not just a symptom of injury and illness.6 Blogs such as Pain-Topics.org are also joining the debate, analyzing the data, and suggesting that while drug abuse is a problem, opioids are not the killers they are portrayed to be. Pain is the true epidemic at hand.7 As the debate rages, how are doctors helping their patients cope with chronic pain if the trend is to cut back on prescription pain medication? Sites such as Sciencedaily. com and WebMD promote exercise, tai chi, and yoga for pain relief, and occasionally suggest enlisting the help of a physical therapist. Rarely do these sites mention massage when recommending alternatives for coping with pain. As frustrating as this is, I understand why these websites are not promoting massage therapy. When I look for supporting evidence, of the 1,782 current studies on chronic pain, only 10 trials are studying the effects of massage therapy on pain.8 According to a National Institutes of Health survey on the use of complementary and alternative medicine, Americans choose massage therapy as their number one out-of-pocket, practitioner-based expense for treating pain, stress, and the negative side effects of conventional medicine.9 This statistic is our best friend and must be flaunted to influence the government-sponsored conversations on pain, the policy-makers' conversations on pain, and the community- based conversations on pain. Most of all, the doctors treating people with chronic pain need to hear this statistic repeatedly and see studies showing evidence that massage provides relief from pain, assistance with pain management, and a reduction in the emotional side effects of pain. 48 massage & bodywork may/june 2012

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