The Biopsychosocial Model of Massage Therapy.
/
The Biopsychosocial Model of Massage Therapy
My current goal is to promote the value of massage therapy to medical professionals by synthesizing and simplifying noteworthy finds and best available supporting evidence applicable to massage therapy.
Some of the best supporting evidence comes from recent recommendations from The Canadian Medical Association (Busse et al. 2017), The American College of Physicians (Chou et al. 2017, Qaseem et al. 2017), The Ontario Protocol for Traffic Injury Management (OPTIMa) (Wong et al. 2017) and The Mayo Clinic (Nahin et al. 2016).
As part of an upcoming presentation I have put together a post outlining potential responses to massage therapy, here is a brief excerpt.
The Biopsychosocial Model of Massage Therapy
A biopsychosocial model of massage therapy helps put into context the interconnected and multidirectional interaction between: physiology, thoughts, emotions, behaviors, culture, and beliefs.
The biopsychosocial massage therapy has been shown to be a safe, non-pharmacological therapeutic intervention that is simple to carry out, economical, and has very few side effects. In terms of clinical responses to massage therapy there are a couple of proposed mechanisms of action, including but not limited to:
• Neurodynamics - “A clinical concept that uses movement (1) to assess increased mechanosensitivity of the nervous system; and (2) to restore the altered homeostasis in and around the nervous system.” Grieve's Modern Musculoskeletal Physiotherapy.
• Neuroplasticity - Touch can help sharpen the image of the self in our body maps (Pelletier et al. 2015)
• Contextually Aided Recovery - The way we present ourselves and present our techniques is tied to clinical outcomes, the magnitude of a response may be influenced by mood, expectation, and conditioning (Bialosky et al. 2017).
• Neuromodulation - Massage has an affect on peripheral and central processes - input from large sensory neurons may prevent the spinal cord from amplifying nociceptive signaling (Bishop et al. 2015, Vigotsky et al. 2015).
• Social Grooming - Nervous system regulated by touch (social grooming) helps modulate the activity of neural circuits important for maintaining resting state. This reduced physiological and behavioural reactivity to stressors results in improved mood/affect (Ellingsen et al. 2016, Walker et al. 2017).
• Mechanotherapy - "Any intervention that introduces mechanical forces with the goal of altering molecular pathways and inducing a cellular response that enhances tissue growth, modeling, remodeling, or repair.” (Thompson et al. 2016).
More to Explore
Related Links
• Myofascial Techniques
• Sports Massage
• Active Release Treatments
• Medical Acupuncture
• Cupping
• Taping
• IASTM
Massage Therapy: Injury Specific Treatments
As the body of knowledge to support the use of massage therapy continues to grow, understanding the basic science behind what we do and the guiding principles of adaptability enable us to apply this work to a number of conditions including, but not limited to:
• Sports Related Aches and Pain
• Shoulder Injuries
• Carpal Tunnel Syndrome
• Post-Operative Patients
• Compartment Syndrome
• Dupuytren's Disease
• Low Back Pain
• Neck Pain
• Post-Concussion Syndrome
• Temporal Mandibular Disorder (TMD)
• Scar Management
Research Links
Best, T. M., & Crawford, S. K. (2017). Massage and postexercise recovery: The science is emerging. British Journal of Sports Medicine.
https://www.ncbi.nlm.nih.gov/pubmed/27797730
Best, T.M., Gharaibeh, B., Huard, J. (2013). Stem cells, angiogenesis and muscle healing: a potential role in massage therapies? Br J Sports Med.
https://www.ncbi.nlm.nih.gov/pubmed/23197410
Bialosky, J.E., Bishop, M.D., Penza, C.W. (2017). Placebo Mechanisms of Manual Therapy: A Sheep in Wolf's Clothing? J Orthop Sports Phys Ther.
https://www.ncbi.nlm.nih.gov/pubmed/28459190
Bialosky, J. E., Bishop, M. D., Price, D. D., Robinson, M. E., & George, S. Z. (2009). The mechanisms of manual therapy in the treatment of musculoskeletal pain: A comprehensive model. Manual Therapy.
https://www.ncbi.nlm.nih.gov/pubmed/19027342
Bishop, M. D., Torres-Cueco, R., Gay, C. W., Lluch-Girbés, E., Beneciuk, J. M., & Bialosky, J. E. (2015). What effect can manual therapy have on a patient's pain experience? Pain Management.
https://www.ncbi.nlm.nih.gov/pubmed/26401979 (OPEN ACCESS)
Chaitow, L. (2016). Dosage and manual therapies – Can we translate science into practice? Journal of Bodywork and Movement Therapies.
https://www.ncbi.nlm.nih.gov/pubmed/27210835
Chaudhry, H., Bukiet, B., Ji, Z., Stecco, A., & Findley, T. (2014). Deformations Experienced in the Human Skin, Adipose Tissue, and Fascia in Osteopathic Manipulative Medicine. JAOA.
https://www.ncbi.nlm.nih.gov/pubmed/25288713
Chen, L., Michalsen, A. (2017). Management of chronic pain using complementary and integrative medicine. BMJ.
https://www.ncbi.nlm.nih.gov/pubmed/28438745
Crane, J., Ogborn, D., Cupido, C., Melov, S., Hubbard, A., Bourgeois, J., & Tarnopolsky, M. (2012). Massage Therapy Attenuates Inflammatory Signaling After Exercise-Induced Muscle Damage. Science Translational Medicine.
http://www.ncbi.nlm.nih.gov/pubmed/22301554
Dunn, S. L., & Olmedo, M. L. (2016). Mechanotransduction: Relevance to Physical Therapist Practice--Understanding Our Ability to Affect Genetic Expression Through Mechanical Forces. Physical Therapy.
http://www.ncbi.nlm.nih.gov/pubmed/26700270
Ellingsen, D., Leknes, S., Løseth, G., Wessberg, J., & Olausson, H. (2016). The Neurobiology Shaping Affective Touch: Expectation, Motivation, and Meaning in the Multisensory Context. Frontiers in Psychology.
https://www.ncbi.nlm.nih.gov/pubmed/26779092
Fryer, G. (2017). Integrating osteopathic approaches based on biopsychosocial therapeutic mechanisms. International Journal of Osteopathic Medicine.
http://www.sciencedirect.com/science/article/pii/S1746068917300317
Gilbert, K. K., James, C. R., Apte, G., Brown, C., Sizer, P. S., Brismée, J., & Smith, M. P. (2015). Effects of simulated neural mobilization on fluid movement in cadaveric peripheral nerve sections: Implications for the treatment of neuropathic pain and dysfunction. Journal of Manual & Manipulative Therapy.
http://www.ncbi.nlm.nih.gov/pubmed/26917940 (OPEN ACCESS)
Louw, A., Nijs, J., Puentedura, E. (2017). A clinical perspective on a pain neuroscience education approach to manual therapy. Journal of Manual & Manipulative Therapy.
http://www.tandfonline.com/doi/abs/10.1080/10669817.2017.1323699?journalCode=yjmt20
Mancini, F., Nash, T., Iannetti, G.D., Haggard, P. (2014). Pain relief by touch: a quantitative approach. Pain.
https://www.ncbi.nlm.nih.gov/pubmed/24361816
Mancini, F., Beaumont, A., Hu, L., Haggard, P., & Iannetti, G. D. (2015). Touch inhibits subcortical and cortical nociceptive responses. Pain.
https://www.ncbi.nlm.nih.gov/pubmed/26058037
Melzack, R. & Wall, P.D. (1965). Pain mechanisms: a new theory. Science.
http://www.ncbi.nlm.nih.gov/pubmed/5320816
Morikawa, Y., Takamoto, K., Nishimaru, H., Taguchi, T., Urakawa, S., Sakai, S., Ono, T., Nishijo, H. (2017). Compression at Myofascial Trigger Point on Chronic Neck Pain Provides Pain Relief through the Prefrontal Cortex and Autonomic Nervous System: A Pilot Study. Front Neurosci.
https://www.ncbi.nlm.nih.gov/pubmed/28442987 (OPEN ACCESS)
Newell, D., Lothe, L.R., Raven, T.J. (2017). Contextually Aided Recovery (CARe): a scientific theory for innate healing. Chiropr Man Therap.
https://www.ncbi.nlm.nih.gov/pubmed/28289539
Nummenmaa, L., Tuominen, L., Dunbar, R., ... Sams, M. (2016). Social touch modulates endogenous μ-opioid system activity in humans. Neuroimage.
https://www.ncbi.nlm.nih.gov/pubmed/27238727
Parravicini, G., Bergna, A., (2017). Biological effects of direct and indirect manipulation of the fascial system. Narrative review. Journal of Bodywork & Movement Therapies.
https://www.ncbi.nlm.nih.gov/pubmed/28532888
Pelletier, R., Higgins, J., Bourbonnais, D. (2015). Addressing Neuroplastic Changes in Distributed Areas of the Nervous System Associated With Chronic Musculoskeletal Disorders. Phys Ther.
https://www.ncbi.nlm.nih.gov/pubmed/25953594
Rabey, M., Hall, T., Hebron, C., Palsson, T.S., Christensen, S.W., Moloney, N. (2017). Reconceptualising manual therapy skills in contemporary practice. Musculoskeletal Science and Practice.
https://www.ncbi.nlm.nih.gov/pubmed/2828624
Thompson, W. R., Scott, A., Loghmani, M. T., Ward, S. R., & Warden, S. J. (2016). Understanding Mechanobiology: Physical Therapists as a Force in Mechanotherapy and Musculoskeletal Regenerative Rehabilitation. Physical Therapy.
https://www.ncbi.nlm.nih.gov/pubmed/26637643 (OPEN ACCESS)
Vigotsky, A. D., & Bruhns, R. P. (2015). The Role of Descending Modulation in Manual Therapy and Its Analgesic Implications: A Narrative Review. Pain Research and Treatment.
https://www.ncbi.nlm.nih.gov/pubmed/26788367 (OPEN ACCESS)
Walker, S.C., Trotter, P.D., Swaney, W.T., Marshall, A., Mcglone, F.P. (2017). C-tactile afferents: Cutaneous mediators of oxytocin release during affiliative tactile interactions? Neuropeptides.
https://www.ncbi.nlm.nih.gov/pubmed/28162847