Which bodywork therapies help you manage chronic pain more effectively?

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.

Reduce your breast cancer risk

Attending an Integrative Oncology conference online in June 2021 was an interesting experience. The organiser provided an extensive program looking at treatment options and naturopathic support. One in three people will develop cancer at some point and improvements in testing and treatment have resulted in significant improvements in survival rates with those for breast cancer increasing from 75% to 91% over the past twenty years.

In addition to medical treatment there is also useful research on changes that can improve your survival risks and indeed may be useful preventative strategies, particularly if there is a history of breast cancer in the family. These strategies include diet, exercise , therapeutic foods and reducing alcohol consumption.

First up diet! During treatment doctors may advise that diet really doesn’t matter. Largely this is due to the concern that the nausea and lack of appetite resulting from chemotherapy or radiation treatment will result in significant loss of weight and you are less able to sustain treatment. At this stage maintaining kilojoules and weight is key. Post treatment however diet becomes critical.

What is the best diet for reducing your breast cancer risk ? Ideally a plant based whole food diet which still includes adequate amounts of protein from either animal or plant sources. Let’s consider the key components of this type of diet and how it may help.

Eat your vegetables

A wide range of vegetables is ideal and at least three cups of vegetables a day. There are four major reasons why vegetables are critical to good health;

  1. Vegetables provide a wide range of nutrients including key minerals such as calcium, magnesium and potassium.
  2. Vegetables are a good source of fibre for gut flora. The benefits of adequate fibre are significant as it feeds beneficial strains of bacteria in our gut.
  3. The fibre in vegetables which assist the body in processing our hormones down a less proliferative pathway.
  4. The fibre in vegetables results in a slow release of energy, which assists in maintaining blood sugar and a healthy weight range. Being significantly overweight or obese increases your risks.

In addition to vegetables a couple of serves of whole grains daily in the form of good quality sourdough or brown rice is also useful in terms of ensuring adequate fibre.

One to two serves of fruit

The polyphenols in fruit, like grapes, apples, pears , cherries and berries has been shown to be protective against many chronic diseases. Polyphenols are a component of plants that serve to protect them from ultraviolet radiation or infections. They are considered natural antioxidants and assist in both the treatment and prevention of cancer (1).

Adequate protein

A small amount of protein at each meal is essential for repair post surgery and treatment but also provides stable blood sugar. Ideally a palm size , palm width portion is sufficient. Wherever possible consider including plant based sources of protein , such as chickpeas, lentils and tempeh, nuts and seeds. Nuts and seeds make an ideal snack to include daily as they are a powerhouse of nutrition with the benefit of incorporating healthy fats as well as essential minerals like zinc.

Add Therapeutic Foods

There are many foods which really have therapeutic effects outside of superfoods from the Amazonian rain forest. These include options such as green tea , cruciferous vegetables, flaxseed and turmeric. Through a range of pathways they are beneficial as they can assist in modulating genes which affect cell expression, growth and proliferation. Therapeutic foods may be helpful in that they can assist in reducing inflammation and support the development of tumour suppressor genes

  1. Green tea which contains useful polyphenols that can act as anti-oxidants in the body. From a preventative aspect the dosage of the active ingredient would result in you consuming up to four cups of green tea a day, preferably organic.
  2. Cruciferous vegetables which contains natural sulforaphane shown to slow down tumour growth and block the genetic mutations that lead to cancer in the first place. At least one cup a day of raw cruciferous vegetables which includes broccoli, cauliflower, brussels sprouts, kale and cabbage.
  3. Flaxseed, which contains beneficial omega 3 fatty acids and contains compounds that
    may reduce the body’s production of oestrogen. 1-2 Tablespoons a day is
  4. Turmeric, the most potent natural anti-inflammatory food on the planet; it is also many times
    more antioxidative than vitamin E.

Exercise regularly

One intervention that has been shown to reduce the risk of breast cancer recurrence by up to 55% is brisk walking of up to 2.5 hours a week. Exercise has the advantage of reducing inflammation but also assisting in the management of stress levels. Walking 30 minutes a day five days a week is enough to see a significant benefit it just needs to be at a pace where you can talk but not sing ! (2)

Reduce alcohol

The recommendation for alcohol consumption for women are 1-2 drinks a day however even at these levels it has been shown to increase the risk of breast cancer by 30-50%. (3) The equivalent of one standard drink a day increases risk by about 5%. Alcohol reduces the ability of the body to detoxify hormones and so it is particularly concerning with hormone receptive cancers.

So which intervention is more useful for you and your particular circumstances ? Not sure if it is my bias as a nutritionist but sorting out diet tends to make a significant impact and usually improves your energy so that you can increase your physical activity as well.

If you need assistance implementing changes or just want to check in on your current diet and supplements Christine is available on Tuesdays and Wednesdays at Elemental Health at St Ives and you can make appointments on 02 8084 0081. You can also book an online consultation on Zoom.

(1) Quideau S., Deffieux D., Douat-Casassus C., Pouységu L. Plant polyphenols: Chemical properties, biological activities, and synthesis. Angew. Chem. Int. Ed. 2011;50:586–621. doi: 10.1002/anie.201000044.

(2) https://www.breastcancer.org/research-news/exercise-improves-survival-and-reduces-risk#:~:text=The%20researchers%20found%20that%20women,t%20meet%20the%20minimum%20guidelines

(3) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3832299/