A B M P m e m b e r s e a r n F R E E C E a t w w w. a b m p . c o m / c e b y r e a d i n g M a s s a g e & B o d y w o r k m a g a z i n e 43
PATHOLOGY PERSPECTIVES
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numbers.
This isn't for lack of trying! I looked
for research on SA MS and massage;
I found nothing. Then I searched for
recommendations about exercise—which
can sometimes serve as an indication
about the safety of massage therapy—
and found that exercise and stretching
are not among the conventional
treatment options for this problem.
I discussed this question with a couple
of medical professionals in my circle, and
the conclusion we came to was this: if
someone needs statins, and has identified
SA MS, then rigorous massage therapy
is probably not an ideal intervention.
Instead, what their massage therapist
can do is strongly advise them to pursue
this problem with their prescribing
physician. Statin medications can be
adjusted for dosage or type—and if this is
not satisfactory, then other strategies for
lowering cardiovascular risks can be tried.
To make a confident prediction about
the safety of massage therapy for a client
with SA MS, we need to know why people
sometimes develop musculoskeletal pain as
a side effect of statin use, and that is still
an open question. One theory suggests
that the enzymes limited by some statins
also impact growth and repair in muscles
and tendons, but this has not been firmly
established yet. Research suggests that statin
use may negatively affect the structural
integrity of some connective tissues. Some
patients with SA MS experience a rise
in creatine kinase levels, which suggests
muscle inflammation. And statins have a
low-but-not-zero association with muscular
breakdown that can cause kidney damage
and potentially dangerous rhabdomyolysis.
For all these reasons, my advice is to
proceed with caution. The best choice is to
encourage the client to consult with their
prescribing physician so they can make
adjustments, or change their dosage or
prescription to a different statin that doesn't
cause SA MS. Then, we can design a massage
therapy strategy that is customized to fit that
client's ability to adapt to the homeostatic
challenges our work may bring about.
But if a person has
some milder or subtler
signs of SA MS, and
if they choose not
to pursue a change
in medication, then
any massage therapy
must be conservative
and incremental—
not looking for big
changes (that require
substantial homeostatic
adaptation), but for
smaller, cumulative
improvements in
symptoms.
Do you have clients
who have SA MS? Do
they seek massage
therapy to help with
their symptoms?
Perhaps now you have
some clearer ideas about
the risks and benefits
of working with this
population. Please
do us all a favor, and
with the permission
of the client and the
cooperation of their
prescribing physician,
write a case report about
massage therapy for
someone with SA MS,
and share your wisdom
with the world.
Ruth Werner, BCTMB,
is a former massage
therapist, a writer, and
an NCBTMB-approved
provider of continuing
education. She wrote A
Massage Therapist's Guide
to Pathology (Lippincott
Williams & Wilkins, 2016),
now in its sixth edition,
which is used in massage
schools worldwide.
Werner is available at
www.ruthwerner.com.
