How Does It Work?
There are numerous theories about how massage therapy may affect the body. The “gate control theory” suggests that massage may provide stimulation that helps to block pain signals sent to the brain, while other theories explain how massage might stimulate the release of certain chemicals in the body, such as serotonin, endorphins, and oxytocin, or cause beneficial mechanical changes in the body such as improved circulation.
Other theories emphasize the role of positive expectations, choice, and placebo effects. The “neuromatrix theory of pain” suggests that the experience of pain is a multidimensional outcome resulting from cumulative subjective and interactive outcomes and imparted by a conditioned neurosignature that reflects both genetic and conditional stimuli where massage therapy may be helpful because of the massage therapist is an interactor rather than an operator. (Whoa!)
What does this mean? While theories still need better testing to understand just how massage therapy may be beneficial to our health, it may be that our choices and subjective experiences may have an important role.
Therapist Quick Reference
Amyotrophic Lateral Slerosis (with caution, and under doctors supervision)
Anemia is a decrease in number of red blood cells (RBCs) or less than the normal quantity of hemoglobin in the blood. However, it can include decreased oxygen-binding ability of each hemoglobin molecule due to deformity or lack in numerical development as in some other types of hemoglobin deficiency.
Ankylosing spondylitis, previously known as Bekhterev’s disease, Bekhterev syndrome, and Marie-Strümpell disease is a chronic inflammatory disease of the axial skeleton with variable involvement of peripheral joints and nonarticular structures. AS is a form of spondyloarthritis, a chronic, inflammatory arthritis and autoimmune disease. It mainly affects joints in the spine and the sacroiliac joint in the pelvis, and can cause eventual fusion of the spine. It is a member of the group of the spondyloarthropathies with a strong genetic predisposition. Complete fusion results in a complete rigidity of the spine, a condition known as “bamboo spine”.
Anxiety refers both to an emotional state, as well as a personality trait 1. Generalized anxiety disorder (GAD) has a wide array of psychological and physical symptoms 12. Although prescription drugs can help, they often have undesirable side effects; many people experiencing symptoms of anxiety do not seek medical attention, turning instead to alternatives 3.
Recent research shows a good level of support that massage therapy is a safe and effective treatment for reducing state and general anxiety, both independently, as well as a condition arising with a comorbid condition 5(p.18) 2.
References1 Spielberger CD, Gorsuch RL, Lushene RE. Manual for the state-trait anxiety inventory (self-evaluation questionnaire). 1970; Palo Alto, CA: Consulting Psychologists Press.
2 National Center for Complementary and Alternative Medicine. “Anxiety.” <http://nccam.nih.gov/health/anxiety>. Last Modified January 16, 2012; Accessed August 14, 2012. 3 Cassileth, B., and A. Vickers. 2004. “Massage therapy for symptom control: Outcome study at a major cancer center.” J Pain Symptom Manage 28(3): 244-49; Diego, Manuel A., Field, Tiffany, Hernandez-Reif, Maria, Shaw, Kimberly, Friedman, Lawrence, and Gail Ironson. “HIV adolescents show improved immune function following massage therapy.” International Journal of Neuroscience 106(1-2): 35-45.Field, T., Ironson, G., Scafidi, F., and T. Nawrocki. 1996. “Massage therapy reduces anxiety and enhances EEG pattern of alertness and math computations.” Int J Neurosci 86(1-4): 205-17; Field, Tiffany, Peck, Michael, Krugman, Scott, Tuchel, Tammy, Schanberg, Saul, Kuhn, Cynthia, and Iris Burmin. 1998. Journal of Burn Care & Rehabilitation 19(3); Field, Tiffany M., Sunshine, William, Hernandez-Reif, Maria, Quintino, Olga, Schanberg, Saul, Kuhn, Cynthia, and Iris Burman. 1997. “Massage therapy effects on depression and somatic symptoms in chronic fatigue syndrome.”; Moraska, Albert, and Clint Chandler. 2009. “Changes in Psychological Parameters in Patients with Tension-type Headache Following Massage Therapy: A Pilot Study.” J Man Manip Ther 17(2): 86-94; Sunshine, William, Field, Tiffany M., Quintino, Olga, Fierro, Karen, Kuhn, Cynthia, Burman, Iris, and Saul Schanberg. 1996. “Fibromyalgia Benefits From Massage Therapy and Transcutaneous Electrical Stimulation.” Journal of Clinical Rheumatology 2(1): 18-22.
Asthma is the common chronic inflammatory disease of the airways characterized by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm. Symptoms include wheezing, coughing, chest tightness, and shortness of breath. Asthma is clinically classified according to the frequency of symptoms, forced expiratory volume in 1 second (FEV1), and peak expiratory flow rate. Asthma may also be classified as atopic (extrinsic) or non-atopic (intrinsic).
Bell’s palsy is a form of facial paralysis resulting from a dysfunction of the cranial nerve VII (the facial nerve) that results in the inability to control facial muscles on the affected side. Several conditions can cause facial paralysis, e.g., brain tumor, stroke, and Lyme disease. However, if no specific cause can be identified, the condition is known as Bell’s palsy. Named after Scottish anatomist Charles Bell, who first described it, Bell’s palsy is the most common acute mononeuropathy (disease involving only one nerve) and is the most common cause of acute facial nerve paralysis.
Carpal Tunnel Syndrome
Carpal tunnel syndrome (CTS) is an entrapment median neuropathy, causing paresthesia, pain, numbness, and other symptoms in the distribution of the median nerve due to its compression at the wrist in the carpal tunnel. The pathophysiology is not completely understood but can be considered compression of the median nerve traveling through the carpal tunnel. The National Center for Biotechnology Information and highly cited older literature say the most common cause of CTS is typing. More recent research by Lozano-Calderón has cited genetics as a larger factor than use, and has encouraged caution in ascribing causality.
Cerebral palsy (CP) is an umbrella term encompassing a group of non-progressive, non-contagious motor conditions that cause physical disability in human development, chiefly in the various areas of body movement. Cerebral refers to the cerebrum, which is the affected area of the brain (although the disorder most likely involves connections between the cortex and other parts of the brain such as the cerebellum), and palsy refers to disorder of movement. Furthermore, “paralytic disorders” are not cerebral palsy – the condition of quadriplegia, therefore, should not be confused with spastic quadriplegia, nor tardive dyskinesia with dyskinetic cerebral palsy, nor diplegia with spastic diplegia, and so on. Cerebral palsy’s nature as an umbrella term means it is defined mostly via several different subtypes, especially the type featuring spasticity, and also mixtures of those subtypes. Cerebral palsy is caused by damage to the motor control centers of the developing brain and can occur during pregnancy, during childbirth or after birth up to about age three. Resulting limits in movement and posture cause activity limitation and are often accompanied by disturbances of sensation, depth perception and other sight-based perceptual problems, communication ability; impairments can also be found in cognition, and epilepsy is found in about one-third of cases. CP, no matter what the type, is often accompanied by secondary musculoskeletal problems that arise as a result of the underlying etiology.
Chondromalacia patellae (also known as CMP) is a term that goes back eighty years. It originally meant “soft cartilage under the knee cap”, a presumed cause of pain at the front and especially inner side of the knee. This condition often affects young, otherwise healthy individuals. Chondromalacia is due to an irritation of the undersurface of the kneecap. The undersurface of the kneecap, or patella, is covered with a layer of smooth cartilage. This cartilage normally glides effortlessly across the knee during bending of the joint. However, in some individuals, the kneecap tends to rub against one side of the knee joint, and the cartilage surface becomes irritated, and knee pain is the result.
Chorea (or choreia, occasionally) is an abnormal involuntary movement disorder, one of a group of neurological disorders called dyskinesias. The term chorea is derived from the Greek word χορεία (dance; see choreia), as the quick movements of the feet or hands are comparable to dancing. The term hemichorea refers to chorea of one side of the body, such as chorea of one arm but not both (comparable to hemiballismus).
Chronic Fatigue Syndrome
Chronic Fatigue Syndrome (CFS) is the most common name used to designate a significantly debilitating medical disorder or group of disorders generally defined by persistent fatigue accompanied by other specific symptoms for a minimum of six months, not due to ongoing exertion, not substantially relieved by rest, nor caused by other medical conditions. The disorder may also be referred to as myalgic encephalomyelitis (ME), post-viral fatigue syndrome (PVFS), chronic fatigue immune dysfunction syndrome (CFIDS), or several other terms. Biological, genetic, infectious and psychological mechanisms have been proposed for the development and persistence of symptoms but the etiology of CFS is not understood and may have multiple causes.
A muscle contracture is a permanent shortening of a muscle or joint. It is usually in response to prolonged hypertonic spasticity in a concentrated muscle area, such as is seen in the tightest muscles of people with conditions like spastic cerebral palsy. Contractures are essentially muscles or tendons that have remained too tight for too long, thus becoming shorter. Once they occur they cannot be stretched or exercised away; they must be released with orthopedic surgery or Osteopathic Manipulative Technique the application of osteopathic manipulative medicine. Most of the physical therapy, occupational therapy, and other exercise regimens targeted towards people with spasticity focuses on trying to prevent contractures from happening in the first place. Contractures can also be due to ischemia, as in Volkmann’s contracture. Excessive matrix metalloproteinase and myofibroblast accumulation in the wound margins can result in contracture.
Chronic obstructive pulmonary disease (COPD), also known as chronic obstructive lung disease (COLD), chronic obstructive airway disease (COAD), chronic airflow limitation (CAL) and chronic obstructive respiratory disease (CORD), is the occurrence of chronic bronchitis or emphysema, a pair of commonly co-existing diseases of the lungs in which the airways become narrowed. This leads to a limitation of the flow of air to and from the lungs, causing shortness of breath (dyspnea). In clinical practice, COPD is defined by its characteristically low airflow on lung function tests. In contrast to asthma, this limitation is poorly reversible and usually gets progressively worse over time. In England, an estimated 842,100 of 50 million people have a diagnosis of COPD. COPD is caused by noxious particles or gas, most commonly from tobacco smoking, which triggers an abnormal inflammatory response in the lung.
Overarching statement about depression and massage therapy
Recent research indicates massage therapy may be a safe and effective treatment to alleviate depression 1.
- Studies suggest massage therapy decreases reported depressive symptoms—as well as anxiety and stress levels 2.
- Individuals suffering from coinciding conditions—including, chronic pain, chronic fatigue, cancer, and HIV—report improvements in their depression with massage therapy 3.
- Massage therapy may help those experiencing posttraumatic stress disorder and pregnancy-related depression 4.
-  Coelho HF, Boddy K, Ernst E. Massage therapy for the treatment of depression: a systematic review. Int J Clin Pract. 2008;62(1):325-333; Ernst, E. The safety of massage therapy. Rheumatology. 2003; 42(9):1101-1106; Hou WH, Chiang PT, Hsu TY, Chiu SY, Yen YC. Treatment effects of massage therapy in depressed people: a meta-analysis. J Clin Psychiatry. 2010;71(7):894-901.
-  Moyer CA. Affective massage therapy. Int J Ther Massage Bodywork. 2008;(2):3-5; Moyer CA, Rounds J, Hannum JW. A meta-analysis of massage therapy research. Psychol Bull. 2004;130(1):3-18; Sherman KJ, Ludman EJ, Cook AJ, Hawkes RJ, Roy-Byrne PP, Bentley S, Brooks MZ, Cherkin DC. Effectiveness of therapeutic massage for general anxiety disorder: a randomized control study. Depress Anxiety. 2010;27(5):441-450.
-  Cassileth B, Vickers A. Massage therapy for symptom control: outcome study at a major cancer study. J Pain Symptom Manage. 2004;28(3): 244-249; Field T, Hernandez-Reif M, Diego M, Schanberg S, Kuhn C. Cortisol decreases and serotonin and dopamine increase following massage therapy. Int J Neurosci. 2002;115(10):1397-1413; Kutner JS, Smith MC, Corbin L, Hemphill L, Benton K, Mellis BK, Beaty B, Felton S, Yamashita TE, Bryant LL, Fairclough DL. Massage therapy versus simple touch to improve pain and mood in patients with advanced cancer: a randomized trial. Ann Intern Med. 2008;149(6):369-379; Sagar SM, Dryden T, Wong RK. Massage therapy for cancer patients: a reciprocal relationship between body and mind. Curr Oncol. 2007; 14(2):45-56; Tsao JC. Effectiveness of massage therapy for chronic, non-malignant pain: a review. Evid Based Complement Alternat Med. 2007;4(2):165-79.
-  Field et al. 2002.; O’Higgins M, St James Roberts I, Glover V. Postnatal depression and mother and infant outcomes after infant massage. J Affect Disord. 2008;109:189–192.
Diabetes Mellitus, often simply referred to as diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced. This high blood sugar produces the classical symptoms of polyuria (frequent urination), polydipsia (increased thirst) and polyphagia (increased hunger). The three main types of diabetes mellitus (DM) are: Type 1 DM results from the body’s failure to produce insulin, and presently requires the person to inject insulin. (Also referred to as insulin-dependent diabetes mellitus (IDDM) or “juvenile” diabetes) Type 2 DM results from insulin resistance, a condition in which cells fail to use insulin properly, sometimes combined with an absolute insulin deficiency. (Formerly referred to as noninsulin-dependent diabetes mellitus (NIDDM) or “adult-onset” diabetes) Gestational diabetes is when pregnant women, who have never had diabetes before, have a high blood glucose level during pregnancy. It may precede development of type 2 DM. Other forms of diabetes mellitus include congenital diabetes, which is due to genetic defects of insulin secretion, cystic fibrosis-related diabetes, steroid diabetes induced by high doses of glucocorticoids, and several forms of monogenic diabetes.
Dislocations in subacute stages.
Dupuytren’s Contracture (also known as morbus Dupuytren, Dupuytren’s disease or palmar fibromatosis) is a fixed flexion contracture of the hand where the fingers bend towards the palm and cannot be fully extended (straightened). It is an inherited proliferative connective tissue disorder which involves the palmar fascia of the hand. It is named after Baron Guillaume Dupuytren, the surgeon who described an operation to correct the affliction in the Lancet in 1831.
Fibromyalgia (FM or FMS) is a medical disorder characterized by chronic widespread pain and allodynia, a heightened and painful response to pressure. Fibromyalgia symptoms are not restricted to pain, leading to the use of the alternative term fibromyalgia syndrome for the condition. Other symptoms include debilitating fatigue, sleep disturbance, and joint stiffness. Some patients may also report difficulty with swallowing, bowel and bladder abnormalities, numbness and tingling, and cognitive dysfunction. Fibromyalgia is frequently comorbid with psychiatric conditions such as depression and anxiety and stress-related disorders such as posttraumatic stress disorder. Not all people with fibromyalgia experience all associated symptoms. Fibromyalgia is estimated to affect 2–4% of the population, with a female to male incidence ratio of approximately 9:1. The term “fibromyalgia” derives from new Latin, fibro-, meaning “fibrous tissues”, Greek myo-, “muscle”, and Greek algos-, “pain”; thus the term literally means “muscle and connective tissue pain”)
The joint capsule of the shoulder joint has ligaments that hold the shoulder bones to each other. When the capsule becomes inflamed, the shoulder bones are unable to move freely in the joint.
Guillain Barre Syndrome
Guillain–Barré syndrome (GBS), sometimes Landry’s paralysis or Guillain–Barré-Strohl syndrome, is an acute polyneuropathy, a disorder affecting the peripheral nervous system. Ascending paralysis, weakness beginning in the feet and hands and migrating towards the trunk, is the most typical symptom, and some subtypes cause change in sensation or pain as well as dysfunction of the autonomic nervous system. It can cause life-threatening complications, in particular if the breathing muscles are affected or if there is autonomic nervous system involvement. The disease is usually triggered by an infection.
HIV / AIDS
Acquired immune deficiency syndrome or acquired immunodeficiency syndrome (AIDS) is a disease of the human immune system caused by the human immunodeficiency virus (HIV). The illness interferes with the immune system, making people with AIDS much more likely to get infections, including opportunistic infections and tumors that do not affect people with working immune systems. This susceptibility gets worse as the disease continues.
Insomnia (or sleeplessness) is an individual’s report of sleeping difficulties. While the term is sometimes used in sleep literature to describe a disorder demonstrated by polysomnographic evidence of disturbed sleep, insomnia is often defined as a positive response to either of two questions: “Do you experience difficulty sleeping?” or “Do you have difficulty falling or staying asleep?”
Irritable Bowel Syndrome (IBS)
Irritable Bowel Syndrome (IBS, or spastic colon) is a symptom-based diagnosis characterized by chronic abdominal pain, discomfort, bloating, and alteration of bowel habits. As a functional bowel disorder, IBS has no known organic cause. Diarrhea or constipation may predominate, or they may alternate (classified as IBS-D, IBS-C or IBS-A, respectively). Historically a diagnosis of exclusion, a diagnosis of IBS can now be made on the basis of symptoms alone, in the absence of alarm features such as age of onset greater than 50 years, weight loss, gross hematochezia, systemic signs of infection or colitis, or family history of inflammatory bowel disease. Onset of IBS is more likely to occur after an infection (post-infectious, IBS-PI), a stressful life event, or onset of maturity.
Systemic Lupus Erythematosus, often abbreviated to SLE or lupus, is a systemic autoimmune disease (or autoimmune connective tissue disease) that can affect any part of the body. As occurs in other autoimmune diseases, the immune system attacks the body’s cells and tissue, resulting in inflammation and tissue damage. It is a Type III hypersensitivity reaction caused by antibody-immune complex formation. SLE most often harms the heart, joints, skin, lungs, blood vessels, liver, kidneys, and nervous system. The course of the disease is unpredictable, with periods of illness (called flares) alternating with remissions. The disease occurs nine times more often in women than in men, especially in women in child-bearing years ages 15 to 35, and is also more common in those of non-European descent. SLE is treatable using immunosuppression, mainly with cyclophosphamide, corticosteroids and other immunosuppressants; there is currently no cure. SLE can be fatal, although with recent medical advances, fatalities are becoming increasingly rare. Survival for people with SLE in the United States, Canada, and Europe has risen to approximately 95% at five years, 90% at 10 years, and 78% at 20 years, and now approaches that of matched controls without lupus.
Multiple sclerosis (MS), also known as “disseminated sclerosis” or “encephalomyelitis disseminata”, is an inflammatory disease in which the fatty myelin sheaths around the axons of the brain and spinal cord are damaged, leading to demyelination and scarring as well as a broad spectrum of signs and symptoms. Disease onset usually occurs in young adults, and it is more common in women. It has a prevalence that ranges between 2 and 150 per 100,000. MS was first described in 1868 by Jean-Martin Charcot. MS affects the ability of nerve cells in the brain and spinal cord to communicate with each other effectively. Nerve cells communicate by sending electrical signals called action potentials down long fibers called axons, which are contained within an insulating substance called myelin. In MS, the body’s own immune system attacks and damages the myelin. When myelin is lost, the axons can no longer effectively conduct signals. The name multiple sclerosis refers to scars (scleroses—better known as plaques or lesions) particularly in the white matter of the brain and spinal cord, which is mainly composed of myelin. Although much is known about the mechanisms involved in the disease process, the cause remains unknown. Theories include genetics or infections. Different environmental risk factors have also been found. Almost any neurological symptom can appear with the disease, and often progresses to physical and cognitive disability. MS takes several forms, with new symptoms occurring either in discrete attacks (relapsing forms) or slowly accumulating over time (progressive forms). Between attacks, symptoms may go away completely, but permanent neurological problems often occur, especially as the disease advances. There is no known cure for multiple sclerosis. Treatments attempt to return function after an attack, prevent new attacks, and prevent disability. MS medications can have adverse effects or be poorly tolerated, and many patients pursue alternative treatments, despite the lack of supporting scientific study. The prognosis is difficult to predict; it depends on the subtype of the disease, the individual patient’s disease characteristics, the initial symptoms and the degree of disability the person experiences as time advances. Life expectancy of people with MS is 5 to 10 years lower than that of the unaffected population.
Osteoporosis (“porous bones”) is a disease of bones that leads to an increased risk of fracture. In osteoporosis the bone mineral density (BMD) is reduced, bone microarchitecture deteriorates, and the amount and variety of proteins in bone is altered. Osteoporosis is defined by the World Health Organization (WHO) as a bone mineral density that is 2.5 standard deviations or more below the mean peak bone mass (average of young, healthy adults) as measured by DXA; the term “established osteoporosis” includes the presence of a fragility fracture. The disease may be classified as primary type 1, primary type 2, or secondary. The form of osteoporosis most common in women after menopause is referred to as primary type 1 or postmenopausal osteoporosis. Primary type 2 osteoporosis or senile osteoporosis occurs after age 75 and is seen in both females and males at a ratio of 2:1. Finally, secondary osteoporosis may arise at any age and affect men and women equally. This form of osteoporosis results from chronic predisposing medical problems or disease, or prolonged use of medications such as glucocorticoids, when the disease is called steroid- or glucocorticoid-induced osteoporosis (SIOP or GIOP).
Parkinson’s Ddisease (also known as Parkinson disease, Parkinson’s, idiopathic parkinsonism, primary parkinsonism, PD, or paralysis agitans) is a degenerative disorder of the central nervous system. The motor symptoms of Parkinson’s disease result from the death of dopamine-generating cells in the substantia nigra, a region of the midbrain; the cause of this cell death is unknown. Early in the course of the disease, the most obvious symptoms are movement-related; these include shaking, rigidity, slowness of movement and difficulty with walking and gait. Later, cognitive and behavioural problems may arise, with dementia commonly occurring in the advanced stages of the disease. Other symptoms include sensory, sleep and emotional problems. PD is more common in the elderly, with most cases occurring after the age of 50.
Flat feet (also called pes planus or fallen arches) is a formal reference to a medical condition in which the arch of the foot collapses, with the entire sole of the foot coming into complete or near-complete contact with the ground. In some individuals (an estimated 20–30% of the general population) the arch simply never develops in one foot (unilaterally) or both feet (bilaterally).
Piriformis Syndrome is a neuromuscular disorder that occurs when the sciatic nerve is compressed or otherwise irritated by the piriformis muscle causing pain, tingling and numbness in the buttocks and along the path of the sciatic nerve descending down the lower thigh and into the leg. Diagnosis is often difficult due to few validated and standardized diagnostic tests, but one of the most important criteria is to exclude sciatica resulting from compression/irriation of spinal nerve roots, as by a herniated disk. The syndrome may be due to anatomical variations in the muscle-nerve relationship, or from overuse or strain.
A painful inflammatory process of the plantar fascia, the connective tissue on the sole (bottom surface) of the foot. It is often caused by overuse of the plantar fascia or arch tendon of the foot. It is a very common condition and can be difficult to treat if not looked after properly.
Premenstrual Syndrome (PMS) (also called PMT or premenstrual tension) is a collection of physical and emotional symptoms related to a woman’s menstrual cycle. While most women of child-bearing age (up to 85%) report having experienced physical symptoms related to normal ovulatory function, such as bloating or breast tenderness, medical definitions of PMS are limited to a consistent pattern of emotional and physical symptoms occurring only during the luteal phase of the menstrual cycle that are of “sufficient severity to interfere with some aspects of life”. In particular, emotional symptoms must be present consistently to diagnose PMS. The specific emotional and physical symptoms attributable to PMS vary from woman to woman, but each individual woman’s pattern of symptoms is predictable, occurs consistently during the ten days prior to menses, and vanishes either shortly before or shortly after the start of menstrual flow.
Postoperative Situations (with doctor’s permission)
Postural Deviations are when you are not using proper body mechanics, and your resulting posture is poor.
Pregnancy is the fertilization and development of one or more offspring, known as an embryo or fetus, in a woman’s uterus. In a pregnancy, there can be multiple gestations, as in the case of twins or triplets. Childbirth usually occurs about 38 weeks after conception; in women who have a menstrual cycle length of four weeks, this is approximately 40 weeks from the start of the last normal menstrual period (LNMP). Human pregnancy is the most studied of all mammalian pregnancies.
Psoriasis is an autoimmune disease that appears on the skin. It occurs when the immune system mistakes the skin cells as a pathogen, and sends out faulty signals that speed up the growth cycle of skin cells. Psoriasis is not contagious. However, psoriasis has been linked to an increased risk of stroke, and treating high blood lipid levels may lead to improvement. There are five types of psoriasis: plaque, guttate, inverse, pustular and erythrodermic. The most common form, plaque psoriasis, is commonly seen as red and white hues of scaly patches appearing on the top first layer of the epidermis (skin). Some patients, though, have no dermatological symptoms. The name wikt:psoriasis is from Ancient Greek, meaning roughly “itching condition” (psora “itch” + -sis “action, condition”).
In medicine, Raynaud’s phenomenon is a vasospastic disorder causing discoloration of the fingers, toes, and occasionally other areas. This condition may also cause nails to become brittle with longitudinal ridges. Named after French physician Maurice Raynaud (1814–1881), the phenomenon is believed to be the result of vasospasms that decrease blood supply to the respective regions. Stress and cold are classic triggers of the phenomenon. It comprises both Raynaud’s disease (also known as “Primary Raynaud’s phenomenon”) where the phenomenon is idiopathic, and Raynaud’s syndrome (secondary Raynaud’s), where it is caused by some other instigating factor, most commonly connective tissue disorders such as Systemic lupus erythematosus. Measurement of hand-temperature gradients is one tool used to distinguish between the primary and secondary forms. In extreme cases, the secondary form can progress to necrosis or gangrene of the fingertips.
Reflex Sympathetic Dystrophy
Reflex Sympathetic Dystrophy (RSD) or Complex regional pain syndrome (CRPS), formerly Begum Syndrome, is a chronic progressive disease characterized by severe pain, swelling and changes in the skin. It often affects an arm or a leg and may spread to another part of the body and is associated with dysregulation of the autonomic nervous system resulting in multiple functional loss, impairment and disability. Though treatment is often unsatisfactory, early multimodal therapy can cause dramatic improvement or remission of the syndrome in some patients. The International Association for the Study of Pain has proposed dividing CRPS into two types based on the presence of nerve lesion following the injury. Type I, formerly known as reflex sympathetic dystrophy (RSD), Sudeck’s atrophy, reflex neurovascular dystrophy (RND) or algoneurodystrophy, does not have demonstrable nerve lesions. Type II, formerly known as causalgia, has evidence of obvious nerve damage.
Scar tissue is dense fibrous connective tissue that forms over and/or around a healed wound or cut; scar tissue is the body’s way of repairing damaged tissues (and sometimes protecting surrounding tissues from foreign bodies). Scar tissue can form externally or internally. One example of excessive internal formation of scar tissue is a common complication that occurs in breast augmentation patients, known as capsular contracture. Keloids and hypertrophic scars are examples of excessive scar tissue formation, which happens externally.
Sciatica (sciatic neuritis) is a set of symptoms including pain that may be caused by general compression or irritation of one of five spinal nerve roots that give rise to each sciatic nerve, or by compression or irritation of the left or right or both sciatic nerves. The pain is felt in the lower back, buttock, or various parts of the leg and foot. In addition to pain, which is sometimes severe, there may be numbness, muscular weakness, pins and needles or tingling and difficulty in moving or controlling the leg. Typically, the symptoms are only felt on one side of the body. Pain can be severe in prolonged exposure to cold weather. Although sciatica is a relatively common form of low back pain and leg pain, the true meaning of the term is often misunderstood. Sciatica is a set of symptoms rather than a diagnosis for what is irritating the root of the nerve, causing the pain. This point is important, because treatment for sciatica or sciatic symptoms often differs, depending upon the underlying cause of the symptoms and pain levels.
Scleroderma is a chronic systemic autoimmune disease (primarily of the skin) characterized by fibrosis (or hardening), vascular alterations, and autoantibodies. There are two major forms: Limited systemic sclerosis/scleroderma involves cutaneous manifestations that mainly affect the hands, arms and face. It was previously called CREST syndrome in reference to the following complications: Calcinosis, Raynaud’s phenomenon, Esophageal dysfunction, Sclerodactyly, and Telangiectasias. Additionally, pulmonary arterial hypertension may occur in up to one-third of patients, and is the most serious complication for this form of scleroderma. Diffuse systemic sclerosis/scleroderma is rapidly progressing and affects a large area of the skin and one or more internal organs, frequently the kidneys, esophagus, heart and lungs. This form of scleroderma can be quite disabling. There are no treatments for scleroderma itself, but individual organ system complications are treated.
Medial tibial stress syndrome, tibial periostitis or shin splints is a common injury that affects athletes who engage in running sports or basic activities such as cross country, football, or hiking. This condition is characterized by pain in the lower part of the leg between the knee and the ankle. MTSS injuries are caused by repeated trauma to the connective muscle tissue surrounding the tibia. Ignoring this injury may result in a more serious condition such as a stress fracture of the bones.
Spasm (long term Spasm)
In medicine a spasm is a sudden, involuntary contraction of a muscle, a group of muscles, or a hollow organ, or a similarly sudden contraction of an orifice. It most commonly refers to a muscle cramp which is often accompanied by a sudden burst of pain, but is usually harmless and ceases after a few minutes. There is a variety of other causes of involuntary muscle contractions, which may be more serious, depending on the cause. The word “spasm” may also refer to a temporary burst of energy, activity, emotion, stress, or anxiety unrelated to, or as a consequence of, involuntary muscle activity.
Spinal Cord Injury
A spinal cord injury (SCI) refers to any injury to the spinal cord that is caused by trauma instead of disease. Depending on where the spinal cord and nerve roots are damaged, the symptoms can vary widely, from pain to paralysis to incontinence. Spinal cord injuries are described at various levels of “incomplete”, which can vary from having no effect on the patient to a “complete” injury which means a total loss of function. Treatment of spinal cord injuries starts with restraining the spine and controlling inflammation to prevent further damage. The actual treatment can vary widely depending on the location and extent of the injury. In many cases, spinal cord injuries require substantial physical therapy and rehabilitation, especially if the patient’s injury interferes with activities of daily life.
Spondylolisthesis is the anterior or posterior displacement of a vertebra or the vertebral column in relation to the vertebrae below. It was first described in 1782 by Belgian obstetrician, Dr. Herbinaux. He reported a bony prominence anterior to the sacrum that obstructed the vagina of a small number of patients. The term “spondylolisthesis” was coined in 1854, from the Greek σπονδυλος = “vertebra” and “ὁλισθος” = “slipperiness”, “a slip”. The variant “listhesis”, resulting from misdivision of this compound word, is sometimes applied in conjunction with scoliosis. These “slips” (aka “step-offs”) occur most commonly in the lumbar spine.
Spondylosis is a term referring to degenerative osteoarthritis of the joints between the centra of the spinal vertebrae and/or neural foraminae. If this condition occurs in the zygapophysial joints, it can be considered facet syndrome. If severe, it may cause pressure on nerve roots with subsequent sensory and/or motor disturbances, such as pain, paresthesia, or muscle weakness in the limbs. When the space between two adjacent vertebrae narrows, compression of a nerve root emerging from the spinal cord may result in radiculopathy (sensory and motor disturbances, such as severe pain in the neck, shoulder, arm, back, and/or leg, accompanied by muscle weakness). Less commonly, direct pressure on the spinal cord (typically in the cervical spine) may result in myelopathy, characterized by global weakness, gait dysfunction, loss of balance, and loss of bowel and/or bladder control. The patient may experience a phenomenon of shocks (paresthesia) in hands and legs because of nerve compression and lack of blood flow. If vertebrae of the neck are involved it is labelled cervical spondylosis. Lower back spondylosis is labeled lumbar spondylosis.
A sprain (possibly from Middle French espraindre, to squeeze) is an injury in a joint, caused by the ligament being stretched beyond its capacity. A muscular tear caused in the same manner is referred to as a strain. In cases where either ligament or muscle tissue is torn, immobilization and surgical repair may be necessary. Ligaments are tough, fibrous tissues that connect bones to other bones. Sprains can occur in any joint but are most common in the ankle and wrist.
A strain is an injury to a muscle or tendon in which the muscle fibres tear as a result of overstretching. A strain is also colloquially known as a pulled muscle. The equivalent injury to a ligament is a sprain.
Substance abuse, also known as drug abuse, refers to a maladaptive patterned use of a substance (drug) in which the user consumes the substance in amounts or with methods not condoned by medical professionals. Substance abuse/drug abuse is not limited to mood-altering or psycho-active drugs. Activity is also considered substance abuse when inappropriately used (as in steroids for performance enhancement in sports). Therefore, mood-altering and psychoactive substances are not the only drugs of abuse. Substance abuse often includes problems with impulse control and impulsivity.
Temporomandibular Joint Disorder (TMJD)
Temporomandibular Joint Disorder, TMJD (in the medical literature TMD), or TMJ syndrome, is an umbrella term covering acute or chronic pain, especially in the muscles of mastication and/or inflammation of the temporomandibular joint, which connects the mandible to the skull. The primary cause is muscular hyper- or parafunction, as in the case of bruxism, with secondary effects on the oral musculoskeletal system, like various types of displacement of the disc in the temporomandibular joint. The disorder and resultant dysfunction can result in significant pain, which is the most common TMD symptom, combined with impairment of function. Because the disorder transcends the boundaries between several health-care disciplines — in particular, dentistry and neurology — there are a variety of treatment approaches.
Tendinitis (informally also tendonitis), meaning inflammation of a tendon (the suffix -itis denotes diseases characterized by inflammation), is a type of tendinopathy often confused with the more common tendinosis, which has similar symptoms but requires different treatment. The term tendinitis should be reserved for tendon injuries that involve larger-scale acute injuries accompanied by inflammation. Generally tendinitis is referred to by the body part involved, such as Achilles tendinitis (affecting the Achilles tendon), or patellar tendinitis (jumper’s knee, affecting the patellar tendon).
A Tension Headache (renamed a tension-type headache by the International Headache Society in 1988) is the most common type of primary headache. The pain can radiate from the lower back of the head, the neck, eyes, or other muscle groups in the body. Tension-type headaches account for nearly 90% of all headaches. Approximately 3% of the population has chronic tension-type headaches.
Thoracic Outlet Syndrome
Thoracic Outlet Syndrome (TOS) is a syndrome involving compression at the superior thoracic outlet wherein excess pressure placed on a neurovascular bundle passing between the anterior scalene and middle scalene muscles. It can affect one or more of the brachial plexus (nerves that pass into the arm from the neck), the subclavian artery, and – rarely – the vein, which does not normally pass through the scalene hiatus (blood vessels as they pass between the chest and upper extremity. Rarely a Pancoast tumor (a rare form of lung cancer in the apex of the lung) may be the cause. TOS may occur due to a positional cause – for example, by abnormal compression from the clavicle (collarbone) and shoulder girdle on arm movement. There are also several static forms, caused by abnormalities, enlargement, or spasm of the various muscles surrounding the arteries, veins, and/or brachial plexus, a fixation of a first rib, or a cervical rib.
A Vascular Headache is an outdated term to describe certain types of headache which were thought to be related to blood vessel swelling and hyperemia as cause of the pain.
Whiplash is a non-medical term describing a range of injuries to the neck caused by or related to a sudden distortion of the neck associated with extension. The term “whiplash” is a colloquialism. “Cervical acceleration-deceleration” (CAD) describes the mechanism of the injury, while the term “whiplash associated disorders” (WAD) describes the injury sequelae and symptoms.