Managing Pain with Massage V.S. Opioids

Pain is the most common reason Americans access the health care system, reports M.D. Halena Gazelka, chair of the Mayo Clinic’s Opioid Stewardship Program. It accounts for a whopping 80% of an individuals reason to seek medical attention. Gazelka adds, “It (pain) is a leading cause of disability and a major contributor to health care costs.” Pain can be difficult to treat, more so if it is chronic. In this day and age the first—and sometimes only—option considered for pain management was a prescription, most commonly for opioids.

“Chronic pain is the most common cause of long-term disability."

Cindy Steinberg, National Director of Policy and Advocacy for the U.S. Pain Foundation, explains how our understanding of chronic pain is evolving. She details how neuroscience has come to show us that Chronic Pain itself is a disease of the brain and nervous system. “So, regardless of the original etiology of the pain, chronic pain becomes the disease or becomes a co-morbid disease.” As an example, a patient that develops neuropathy as a result of preexisting diabetes, the neuropathy becomes a co-morbid disease of chronic pain. Steinberg notes this importance because, “lacking that understanding may cause some physicians to ignore the pain and continue to search for a disease rather than accepting that chronic pain must and can be managed so that most people can still be functional and have some quality of life,”.

According to the NIH’s National Institute on Drug Abuse, the opioid epidemic costs the United States roughly $78.5 billion a year in health care, lost productivity, addiction treatment and criminal justice.

The cost is far too large for anyone not to question, search and examine other avenues of pain management. Not to mention that these figures do not account for the loss of human life. Approximately 130 people who die every day because of an opioid overdose. But to completely understand the opioid epidemic, it is important to first grasp how large of a problem pain and pain management is in the United States. Gazelka not only chairs at the Mayo Clinic's Opioid Stewardship Program, she also was appointed to federal Health and Human Services Pain Management Best Practices Inter-Agency Task Force in 2018. According to her, “An estimated 50 million Americans suffer from chronic pain, and for some 20 million, pain significantly impacts their life.” This pain is known to affect more Americans than any other disease or ailments combined. This statistic is backed by the Centers for Disease Control and Prevention who add that chronic pain affects more people than diabetes, heart disease and cancer combined. In order to find relief many people have turned to prescription opioids, which carry a serious risk of addiction, abuse, and overdose, in addition to several side effects.

While the United States struggles with the devastative effects the opioid epidemic is taking on lives, the economy and society, AMTA believes it's important to consider the role massage therapy can play in relieving pain. A recent economic model indicates that as many as 5 million people in the United States could potentially benefit from massage therapy for pain relief. In doing so, this would reduce the number of people with an addiction disorder by over 100,000 per year.

M.D. Charles E. Argoff highlights some key elements when creating a lifestyle that responds to chronic pain without the use of opioids. He generates a list that includes an interdisciplinary plan for pain relief that incorporates exercise, non-prescription medication, cognitive behavioral therapy, treatment for depression and anxiety, sleep, diet, stress reduction, and therapies such as massage and acupuncture. In multiple cases, research supports integrative approaches such as massage therapy to better address pain. Massage Therapy is also known to help with pain relief, anxiety and improving health-related quality of life. It is important to ask your doctor about massage therapy and whether or not it is the right direction in terms of treating pain. In many cases it may provide short-term relief for certain types of pain, or biofeedback, which uses electrical sensors to help you learn to reduce your heart rate and relax your muscles. Other alternative options include acupuncture—the expert placement of thin needles in specific pressure points to ease pain. This technique may be helpful for headache pain and other conditions, according to a 2018 meta-analysis in the Journal of Pain.

Argoff makes note that living with chronic pain is exhausting and can become depressing for some people. It is also important to note that in some cases, pain relief may also involve the use of prescription medications (both opioid and non-opioid), anti-seizure drugs, antidepressants, surgery, nerve blocks, or an intrathecal pump, which is placed internally and delivers medication directly to the spinal fluid.

According to the 2018 AMTA Massage Therapy Journal 37% of clients receiving massages did so for pain relief and pain management reasons. 26% used the therapy for injury recovery and rehabilitation. Only 16% said to have used massage therapy for soreness, stiffness, and muscle spasms.

"Years of research evidence support the efficacy of massage therapy for many important health treatments, especially for pain relief and pain management."

These treatments include using massage therapy for Chronic Pain Management for things such as back pain, headache, carpal tunnel syndrome, osteoarthritis, neck and shoulder pain, and fibromyalgia. AMTA's 2019 Massage Therapy Journal noted that 88% of Americans believe massage can effectively reduce pain. This idea that massage therapists' role in integrative health care has become widely accepted in major hospitals and medical practices. There is significant evidence supporting the inclusion of massage therapy for many important patient health conditions, including those for chronic pain management, behavioral health treatment, rehabilitation and physical training, and acute medical conditions.