Therapeutic bodywork vs. low back pain

In this article, I want to cover how different forms of therapeutic bodywork can address your symptoms of low back pain. But first, we need to understand the slippery nature of this subject. There are many variables regarding low back pain and a good therapist will read the info in the soap notes, listen to the how and where of the injury and palpate before doing the treatment. Here is a short list of the variables.

  • Body type – tall, short, thin, obese, overly tight and dense connective tissue, loose connective tissue
  • How did it happen? Often, you won’t know a specific event that caused it. It can be an accumulative problem.
  • What is your history? Has it happened before? Do family members suffer from the same condition?
  • What about stress levels? Emotional state? The environment where you live and work?
  • Where it hurts and where the actual injury is, may be in different areas.

Swedish massage

This form of massage was brought to America by Per Henrik Ling, who developed Swedish massage and introduced it into the U.S. in 1858 as “The Swedish Movement Cure”. He created his system by combining his knowledge of gymnastics, and physiology and from Chinese, Egyptian, Greek, and Roman techniques.

Swedish massage is the most popular and familiar type of massage. Done with oil, on a massage table, the therapist will use long strokes, kneading, and tapotement techniques to provide a very relaxing and therapeutic massage. It will increase circulation (which supports the healing process), move you into para-sympathetic response (which means you are relaxed) and softens tense muscles.

Thai massage

Thai massage or Nuad Phaen Boran is approximately 2500 years old. It is thought to have been brought to Thailand by Shivago Komarpaj an Ayurvedic physician, who was a contemporary of Buddha. Because of its long-standing presence throughout history, it has been influenced by other cultural traditions, such as Ayurveda, the 5 Element Theory of Traditional Chinese Medicine, Burmese and the Lanna traditions of Northern Thailand.

Thai massage is just a small part of this greater body of work that is Thai Medicine. The basic premise of Thai Medicine is that, “As long as energy can move freely through the body, you have health.” To accomplish the goal of getting the energy or “Lum” to move, the therapist will use movement and palming techniques to first warm the tissue. Once the tissue is warmed up, the therapist uses their thumbs along the Sen lines (meridian lines in TCM) to open and unblock the channels where the energy flows. It is so very relaxing that clients will often fall asleep during the massage.

Sometimes it is referred to as “Thai Yoga”, because the therapist will assist the client into asanas, such as Cobra, Half-Yoke, Shoulder stands or Yoga Mudra. These additional movement pieces help to create flexibility, greater range of motion and a wonderful feeling of release. The energy in the body now has the freedom to flow in and out, vitalizing the tissues and creating energetic balance for the client.

When you arrive for your appointment, make sure you are wearing loose, comfortable clothing. Thai massage is done on a soft mat on the floor. You can expect to be worked on in supine, prone, side-lying or seated positions. The average massage is 1 1/2 to 2 hours long.

Osteopathic manipulation

The profession of Osteopathy was founded in 1874 by an American physician, with a mechanical background, named Andrew Taylor Still (1828-1917). He believed that everything necessary to sustain human life was already present within the human body. Still developed “hand’s on” methods to enhance the body’s innate ability to heal itself and improve the relationship between structure and function.

With an advanced understanding of the interrelationships between the body’s structure and function, and an understanding of how the body can be influenced by or can influence a human’s emotional or spiritual nature, the D.O. uses palpation and manipulation to provide patient specific care that promotes health and treats disease.

Osteopathic physicians believe that the body has innate self-healing mechanisms that are key to restoring well-being and maintaining health, and that the physician’s responsibility is to provide the proper supportive therapy or preventive measure to help the person return to health or to maintain health. Osteopathic physicians are trained that rational patient care is based on integration of these principles. The basic tenets of Osteopathy make this practice of medicine a distinctive form of patient-centered health care.

The 4 Tenets of Osteopathy are:

  1. The body is a unit; the person is a unit of body, mind, and spirit.
  2. The body is capable of self-regulation, self-healing, and health maintenance.
  3. Structure and function are reciprocally interrelated.
  4. Rational treatment is based upon an understanding of the basic principles of body unity, self-regulation, and the interrelationship of structure and function.

Osteopathic physicians understand that structure influences function, so they look for areas of the body where the structure may be changed and made more normal through manipulation in order to improve function to a particular body region. This improved function has a distinct influence on the rest of the body.

An Osteopathic physician will use a variety of methods in order to help restore the body’s unity and movement towards homeostasis. The D.O. might use myofascial release to lessen the effect of structural tightness caused by up-regulated nerves, strain-counterstrain technique to release muscles in spasm muscles, high velocity/low amplitude thrust techniques which often result in cavitation of the joint or a “popping” noise, muscle energy, which uses the gentle muscle contractions of the patient to relax and lengthen muscles and normalize joint function. Ligamentous Articular Strain Technique or L.A.S.T., is a method originally created by William G. Sutherland, founder of Cranial Osteopathy, as an indirect technique and has over the years evolved into a direct method as well. It is a principle based, mechanoreceptor specific manual therapy used to treat peripheral joint tissue injuries.

Therapeutic Bodywork

In my own opinion, Therapeutic Bodywork differs from traditional Swedish massage in that it breaks away from the effleurage/petrissage/tapotement techniques and offers more tools to effectively approach the client’s complaint. Oftentimes, it is a simple complaint of not being able to turn their head, headaches or a sharp pain in the left sacroiliac joint. In my practice, I would use a combination of techniques such as myofascial release, muscle energy, dialogue, strain/counterstrain, nerve deregulation techniques, L.A.S.T., cranial work, movement exercises and/or somatic education.

Working on a traumatized section of the body requires careful consideration of your approach. Sometimes, just laying your hand on the affected body part and dialoguing with the client will set things in motion. You will feel them relax, perhaps sigh, and then you know you can begin with a method that feels correct for the situation. An important point to remember is that the body has an innate ability to heal itself. Sometimes all we need to do is get something started and then step out of the way so that it can happen.

Pain is inevitable, suffering is optional

When we experience pain, it is our body’s way of telling us something is wrong. Taking the necessary steps to honestly care for yourself can be one of the most important things that you do in your life. Participating in the process of managing your own healthcare and not waiting until you are sick or hurt is empowering and cultivates an ability to become more sensitive to your own needs. You become stronger, more vital and less prone to illness.

The point of this article is to express that there are many ways that we can deal with low back pain. Whether you choose therapeutic bodywork or any of the mentioned modalities, they all have the potential of being beneficial. But, it is important to remember that we are all different, the clinicians all have different approaches and the injuries we experience and our belief systems are unique to ourselves. Be patient, if you do not respond well to one modality, be willing to explore and find one that is right for you. If you are local to Southern New England, check out my website “Rolf Bodyworks” and book an appointment. Best way to understand the differences in bodywork and massage is to experiment and try it out. Peace and be well.



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