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PaperclipPerfector  10mo ago (text post)   2433 thread views

Wellness Wednesday for July 5, 2023

The Wednesday Wellness threads are meant to encourage users to ask for and provide advice and motivation to improve their lives. It isn't intended as a 'containment thread' and any content which could go here could instead be posted in its own thread. You could post:

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Blackpill or whitepill me on massage. I don’t particularly like heavy (sports, I guess) massages, but a lot of people I know including my partner swear by them. Osteopaths Love Him (etc etc).

Is there any health-based reason to visit a masseuse or osteopath that amounts to more than it being a pleasurable experience for people who enjoy it?

Not sure about scientific studies, and I'm primarily motivated by the pleasurable experience. But I can say that regularly getting Thai massages helped me get my splits, in a way that years of self-stretching never did. That mobility also carries over into everyday life, e.g. I'm able to sit into a true squat without raising my heels. Something about it taught me how to relax more into the stretch, since I didn't have to use my own muscles to hold the stretch. I don't think it's particularly helpful for me now though, after I've developed the body sense to perform the stretch on my own.

I'd also note that Thai massage is riskier than regular massage: there's a lot of quackery out there, but Thai massage involves going into farther ranges of motion than other modalities which introduces more risk of that quackery injuring you.

This is a great article written by a really thorough pain researcher who goes through the positives and negatives. Keep in mind he's a physical therapist so somewhat biased, but I really do trust his research and methodologies. Here's the gist:

It has some plausible medical benefits, even if they are inconsistent and unproven. More importantly, the emotional value of touch and the effects on mood and mental health are so profound that patients really just cannot lose — good quality massage therapy is a worthwhile service for anyone who can afford it whether it “works” as a treatment or not.

So I'd say - no real physical benefits at all, but hey it makes you feel nice. Personally I just self massage with oils/tennis balls and stretch and I've been much better off. You also have to consider that bad massages can really mess you up, especially if you have chronic pain issues or if the person is inexperienced/dumb and uses too much force.

Thanks, this was very interesting.

I'd say probably the biggest benefit is cheaper access to a moderately trained medical professional. In the US, all but 5 states require about a year of training to become a licensed massage therapist culminating in a standardized test with a ~70% pass rate. For something like $70 an hour, you get pretty good combination of competency and attention per dollar compared to a doctor.

For whatever NIH's medical credibility is worth, their review(1) of (the reviews of) the literature finds massage is effective for short term treatment (2-3 days) of low back, neck and shoulder pain, osteoarthritis, and fibromyalgia generally halving or thirding severity of symptoms. Generally there hasn't been enough study of long term outcomes to reach statistical significance, and the short term data is middling quality. An RCT of dosage response(2) found no benefit from 30 minute sessions but a 3x reduction in pain from 60 minute sessions and quote:

Our findings also suggest that previously published studies of massage for neck pain may have not administered adequate doses. For example, the newest Cochrane review of massage for neck pain reported 9 trials of massage for subacute or chronic neck pain. Among the 7 trials with conceivably relevant designs, 4 trials included only a single session of a single massage technique applied for less than 5 minutes, 1 trial included only five 30-minute treatments over 2 weeks, 1 included five 45-minute treatments over 1 month, and the last was a series of weekly 60-minute massages. In addition, most trials lacked massage resembling conventional massage practice in the United States, where 60-minute treatments administered by licensed massage therapists are the norm, a wide range of massage techniques are used in a single session, and self-care recommendations are provided. This review notes that there is little information regarding optimal parameters for the massage, including the number of treatments per week and the length of each session.

From my understanding, a good 15 minutes at the start of a massage session is just preparing the flesh so it is workable. An hour session is going to have a lot more time to do actual work.

There is a plausible story that reduced pain allows for faster long term improvement by making it easier to follow through with physical therapy exercises (or literal exercises(3)). This requires some level of conscientiousness on the patient's part (and some lack of it on the provider's part, massage therapists in the US are not allowed to prescribe physical therapy), but seems plausible.

Regarding your (lack of) enjoyment of sports massage, it might be useful to think about what is happening as assisted stretching. Many of the deep pressure techniques are attempting to fool your nervous system into thinking the muscle is tighter than it really is, and thus relax it. Like normal stretching the feeling is an acquired taste, and those without it often "guard" by tightening all the nearby muscle groups making a frame to avoid injury and reject the outside force.

Footnotes

-I haven't interacted with any osteopaths, but from the looks of it they are an unlicensed profession and thus going to have a lot more variability.

-I'm pretty close with a licensed massage therapist so included is probably some second hand propaganda

(1)https://www.nccih.nih.gov/health/providers/digest/massage-therapy-for-health-science

(2)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3948757/

(3)https://today.uic.edu/massage-therapy-beneficial-after-injury-exercise/

When you say "thirding the severity of symptoms", do you mean reducing to 33%, or reducing by 33%?

Reducing scores on pain level questionnaires to 33%.

I'd say probably the biggest benefit is cheaper access to a moderately trained medical professional. In the US, all but 5 states require about a year of training to become a licensed massage therapist culminating in a standardized test with a ~70% pass rate. For something like $70 an hour, you get pretty good combination of competency and attention per dollar compared to a doctor.

If you're going to someone like that explicitly for medical advice, I can only implore you to consider seeking a teleconsultation with a doctor from the cheaper parts of the world, likely for far less money. After all, correct me if I'm wrong, but these professionals can't prescribe anything but OTC medicine, nor scans.

You'll get a far higher quality assessment for one.

I already give out free medical advice here, at least while the GMC isn't looking, I'm nice like that. For $70/h, I'd do that, and suck your dick too /s

OK, honestly consider this an open advertisement for my services, first three purchases buy an effort post for a topic of your choice.

No legal prescribing power, totally agree that it is absurdly expensive compared to foreign care, but some cost comparisons of how messed up US healthcare costs without insurance:

$15.00/min Primary care

$7.00/min US based telehealth

$1.15/min Massage therapist

$0.90/min India based telehealth

I've been to an osteopath, and it feels like quackery to me. She gave me some useful advice, but the manipulations themselves felt weird and didn't provide any relief.

A good masseuse is great, but I like heavy massages. It's like doing a good deep stretch, but you don't have to do anything yourself.

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