
For many people bodywork therapies, such as massage, chiropractic and osteopathy are an effective way to support themselves when they are managing pain and particularly chronic pain. At a recent symposium on pain it was surprising to hear that the research really wasn’t there to support the use of bodywork therapies for reducing chronic pain long term, however there were studies to show that it did have benefit in the short term for symptom relief. The absence of studies does not mean that it doesn’t work it just means that not a lot of research has been done.
The research that has been undertaken does show the value of an holistic approach to treatment for chronic pain and include the use of graded exercise therapy, cognitive behavioural therapy as well as bodywork. So what are the best options for people when they are experiencing pain and how do you decide what will work for you?
Generally if the problem is structural its ideal if you can be assessed by a chiropractor or osteopath. An osteopath can support patients with manual therapy interventions including exercise prescription, needling and education to improve movement and reduce pain. Osteopaths also work on soft tissue with either massage or gentle activation. Chiropractors tend to focus more on the spine and alignment and will do manual adjustments to improve the nerves and their function.
When you are considering massage therapy look at what type of pressure you can cope with? For example for those who cannot deal with a strong massage it might be worthwhile looking at lymphatic massage, reflexology or gentler therapies such as craniosacral therapy. Let’s consider the relative strengths and benefits of each style so that you can decide what will best provide you with support.
Remedial Massage
Remedial massage assists in improving soft tissue or muscle function by improving the flow of blood to the area. It can also support you through recovery from an injury and reduce pain. Remedial massage can be tailored to the pressure that you can tolerate but generally involves a stronger style of treatment.

Lymphatic Massage or Manual Lymph Drainage
This is a gentle style of massage which works on the superficial lymph structures that sit below the skin. This is ideal for anyone recovering from surgery or an injury with significant swelling. The gentle flowing strokes can assist to improve the flow of lymph and reduce swelling and pain. Ideally with a lymphatic therapist look for someone who has done additional training such as the Dr Vodder course in Applied MLD. The therapists who complete this training are often qualified in other tools such as low level laser, taping and bandaging. This type of therapy works well for those who have been treated for cancer to support them particularly after the loss of lymph nodes.
Reflexology
Predominantly working on the feet , reflexology can assist with pain management through pressure on the soles in areas related to the underlying source of pain. By identifying areas that are congested or unbalanced the therapist can assist with the flow of energy to assist in healing. Reflexology can slow down nerve transmission which may interrupt pain pathways. It also helps with releasing endorphins which can then make you feel better. Reflexology assists with circulation and increases the flood of blood and nutrients around the body. Reflexology by promoting the relaxation response is an effective way to release stress and tension.
Reflexology is often used in palliative care settings as it is a gentle therapy where the client does not need to be mobile.
Craniosacral Therapy
Craniosacral therapy is a type of bodywork that relieves compression in the bones of the head, sacrum and spine. It uses gentle pressure on the head, neck, and back to relieve the stress and pain caused by compression. It’s thought that through the gentle manipulation of the bones in the skull, spine, and pelvis, the flow of cerebrospinal fluid in the central nervous system can be balanced which then improve the body’s ability to heal.
Craniosacral therapy is deeply relaxing and it will often take 48-72 hours for the full benefit to develop. It is common to see improvements in sleep after a treatment and it is useful for people who have had a history of concussion or indeed other trauma.
To find a practitioner who is appropriately qualified make sure you refer to the natural therapy association websites such as atms.com.au and also look for referrals from your other practitioners.
If you are recovering from surgery or an injury and would like more information about the best strategies for managing chronic pain please have a look at the recent Understanding and Managing Chronic Pain webinar on my website.