Cardiovascular diseases

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For this post I wanted to look at the evidence-base for the role of massage therapy on cardiovascular disease. I found an article for free viewing in the Journal for Advanced Nursing Practice (http://www.nursingcenter.com/prodev/cearticleprint.asp?CE_ID=719639) The article described the evidence-base regarding the benefits of massage: 1. Reduced anxiety 2. Pain blocking 3. Psychological benefits 4. Parasympathetic system trigger 5. And therefore an enhancing of conventional medical interventions. The article proceeded to discuss how massage was used in one pilot project at a large hospital in the Midwest with postcardiac surgery patients. The authors describe the type of intervention these patients receive (including opening the chest cavity and positioning the body in challenging ways for extended periods of time during the surgery). It was posited that the treatment of the body might be related to the very common complaint of musculoskeletal pain in the head, neck, shoulders, and arms. Apparently 20 minute massage therapy sessions were provided to patients to great anecdotal success. The article didn’t discuss a statistical evaluation of the pilot project. I was encouraged by the integration of massage therapy in clinical practice. The more that I read about anatomy and physiology, pathology, and the areas where massage has been shown to be beneficial, the more I get the idea that massage is an indirect intervention. What I mean by an indirect intervention is that the purpose of massage therapy is not to cure an underlying dysfunction in the body–massage therapy is not going to unclog a blocked artery. What massage therapy can do is intervene on soft tissue where the condition of that soft tissue is in a negative state. For instance, the article talks about a patient who complained of major neck and shoulder pain with numbness in an arm and hand which was not controlled by the standard pain management protocol. The massage therapist identified tension in the neck and shoulder and spent 20 minutes working out the tension. The next day the patient reported greater overall mobility as well as mobility of the head, neck, shoulder and arm, less pain overall, and was discharged a day early. Did massage therapy heal this person? No, massage therapy relieved the tension that was inhibiting the body’s healing response which, in combination with the medical interventions that the patient was receiving, allowed the body to heal itself. I guess that makes the purpose of massage therapy to improve local and systemic circulation such that the body’s natural healing processes can be most effective.

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