Massage: Get in touch with its many benefits
A soothing massage can help you unwind, but that's not all. Explore the possible benefits of massage and what to expect. By Mayo Clinic Staff
Massage is no longer available only through luxury spas and upscale health clubs. Today, massage therapy is offered in businesses, clinics, hospitals and even airports. If you've never tried massage, learn about its possible health benefits and what to expect during a massage therapy session.
What is massage?
Massage is a general term for pressing, rubbing and manipulating your skin, muscles, tendons and ligaments. Massage therapists typically use their hands and fingers for massage, but may also use their forearms, elbows and even feet. Massage may range from light stroking to deep pressure.
There are many different types of massage, including these common types:
Benefits of massage
Massage is generally considered part of complementary and alternative medicine. It's increasingly being offered along with standard treatment for a wide range of medical conditions and situations.
Studies of the benefits of massage demonstrate that it is an effective treatment for reducing stress, pain and muscle tension.
While more research is needed to confirm the benefits of massage, some studies have found massage may also be helpful for:
Beyond the benefits for specific conditions or diseases, some people enjoy massage because it often involves caring, comfort, a sense of empowerment and creating deep connections with their massage therapist.
MRI Back Scans Do Not Predict if You Need Surgery
In most cases, the leg pain and most severe symptoms resolve in eight weeks, but we are not a patient society. Many of the people who have sciatica symptoms go on to have back surgery that may or may not solve the problem. Despite changes in technology and fancy titanium screws, plates and cages, the overall results of surgery have not significantly improved over the last few decades. This over-prescription of surgery is a huge problem.
MRI Scans of the Back
The introduction of MRI scans in the 1980s resulted in elegant pictures of the lumbar spine and graphic demonstrations of the deterioration that happens to our spines as we age. It is one thing to look in the mirror each morning and see the wrinkles that slowly form at edges of your eyes and mouth. It is another thing to have your doctor suddenly show you a picture of your spine with its bony growths, deteriorated disks and endangered nerve roots.
When throbbing back and leg pain attack your brain's pain centers, it is easy to say, "I will do anything to get rid of this pain. Where is the surgeon?" But, a recent study in the New England Journal of Medicine looks at whether an MRI scan can predict whether you need surgery or whether you are better off taking your time and following an extended course of conservative treatment. Having an MRI of your lumbar spine performed may be quick and painless, but it can lead to unneeded surgeries, complications, poor outcomes and chronic pain. The 15-20 percent of people who have recurrent episodes of sciatica will have even more MRI scans and repeatedly face the decision of whether to have surgery.
Researchers at multiple centers recruited 283 patients with persistent symptoms of sciatica (symptoms that had lasted 6-12 weeks) and randomized them in a study comparing early surgery versus prolonged conservative therapy. All of the patients had a herniated disk on their MRI scans, and scans were performed at the beginning of the study and one year later. The question was whether there is an association between what we see on the MRI scan and the eventual clinical outcome. Did the pain go away, and was the patient happy with the outcome?
Herniated Disks Can Disappear!
At one year, 84 percent of all the patients had a favorable outcome whether they had surgery or conservative treatment. Previous studies had reported that those who have surgery may get better faster, but at one year there is no difference. The disk pressing on the nerve root is thought to cause the pain down the leg, and it disappeared on the MRI scan in 82 percent of people having surgery. But, it also disappeared in 60 percent of those who had conservative therapy.
This shows that herniated disks get smaller and disappear even without surgery! The study also looked at those patients who still had a disk herniation on their MRI scan at one year, and once again there was no significant difference. Eighty-five percent of those with a disk herniation on their MRI scan at one year still had a favorable outcome, as compared to 83 percent with no disk herniation.
Of course, it is not so simple as to just assume that something is pressing on the nerve and causing the pain. How many times have you heard someone say that they had a "slipped disk" that their chiropractor put back in place? It sounds good, but it doesn't work that way. It may be inflammation, a chemical reaction or some other process that causes the pain. The truth is that the source of a person's low back and leg pain is frequently illusive.
The bottom line: When trying to decide who should have surgery, a herniated disk or nerve root compression on a MRI scan does not predict a better outcome. This study even looked at those situations where a piece of disk has broken off (an extrusion) and there was no difference. It is difficult to correlate a patient's symptoms with the findings on their MRI scan.
5 Guidelines to Follow
If a MRI scan does not distinguish between a favorable and unfavorable outcome, how should a doctor and patient make the decision on whether to have surgery? Here are the five guidelines that have served me well over the years.
1. You have persistent pain that you can no longer tolerate, and it is unresponsive to medications, physical therapy and a prolonged period of conservative therapy. Give it time.
2. The planned surgery correlates with the anatomic location of your symptoms. For example, your back hurts, so you think that means you should have surgery on your back. Far too many times I have seen patients have surgery on an area that is unrelated to the location of their complaints. Surgery that is performed for low back pain without leg pain is fraught with difficulties.
3. If you have "progressive" weakness, this may suggest that the there is increasing pressure on the nerves that needs more immediate attention. Weakness, in and of itself, is not an absolute indication for surgery.
4. Many people have numbness, tingling or some loss of sensation in their leg. This does not automatically require surgery and frequently does not resolve with surgery. The key here is whether you have a progressive loss of sensation or a sudden change that needs immediate attention.
5. The rapid onset of bladder or bowel symptoms may be a neurological emergency that needs immediate surgery. If you have chronic back or leg symptoms and then develop problems urinating, this needs immediate attention.
The next time your are lying on your back, encased in a MRI machine making clanging and banging sounds from another world, keep in mind that the amazing pictures your doctor will show you of your back are only part of the story. Remember that there is no such thing as "good as new."
For more by Richard C. Senelick, M.D., click here.
Eating cruciferous vegetables may lower inflammation
Cruciferous vegetables include cabbage, broccoli, bok choy, Brussels sprouts, kale and cauliflower, and eating them is often encouraged as a way to lower risk for heart disease and cancer.
Based on their findings, the study authors say the health benefits of these vegetables may be at least partly a result of their anti-inflammatory effects.
"Our group and others have found that consumption of fruits and vegetables, particularly cruciferous vegetables, was associated with lower total mortality and cardiovascular disease mortality - however, the potential mechanisms behind this association are not well understood," Dr. Gong Yang told Reuters Health by email.
"Chronic inflammation is implicated in the pathogenesis of cardiovascular and other chronic diseases - we therefore examined whether cruciferous vegetable intake may relate to inflammation," he said.
In animal studies, high intake of cruciferous vegetables or certain key compounds within them has been found to lower inflammation, Yang's team writes in the Journal of the Academy of Nutrition and Dietetics.
To see whether that is the case in people too, Yang and colleagues analyzed signs of inflammation in the blood of 1,005 middle-aged Chinese women who filled out questionnaires about their diets as part of the Shanghai Women's Health Study.
The participants included in the new analysis were generally healthy, and had an average age of 58. Yang and his colleagues divided the women into five groups based on their daily intake of cruciferous vegetables.
The median intake of cruciferous vegetables was just under one cup per day, with women in the lowest fifth consuming about half that amount. The women in the top fifth of consumption took in about 1.5 cups of cruciferous vegetables every day.
The researchers then measured levels of signaling molecules involved in causing inflammation in the women's blood. Blood levels of three important inflammatory molecules - tumor necrosis factor-alpha (TNF-a), interleukin-1beta (IL-1b) and interleukin-6 (IL-6) were lowest among women with the highest intakes of cruciferous vegetables.
The women who consumed the most cruciferous vegetables had, on average, 13 percent less TNF-a, 18 percent less IL-1b, and 25 percent less IL-6 than women who ate the fewest.
The researchers found a similar inverse relationship between the inflammation markers and intake of all vegetables combined, but not when they looked strictly at non-cruciferous vegetables.
"Cruciferous vegetables may have health benefits through modulating inflammation," Yang said. "However, it is premature to make any dietary recommendation on the basis of this single observational study."
"It's an important message - we always hear people saying 'eat your vegetables,' but it's also important to know that these aren't just theoretically good - we know that they really do have important health effects," Dr. Neil Barnard told Reuters Health.
Barnard is president of the Physicians Committee for Responsible Medicine and an advocate of plant-based diets. Also an adjunct assistant professor of medicine at George Washington University, in the District of Columbia, Barnard was not involved in the new study.
Inflammation is thought to be part of a cycle that promotes heart disease, and heart disease in turn promotes more inflammation.
"Bottom line, if you're eating a lot of cruciferous vegetables your health is better, and specifically, inflammation markers are diminished," he said. "That means you're going to have a healthier heart and you're going to live longer."
Barnard added that cruciferous vegetables are good in other ways beyond reducing inflammation.
"They happen to be a source of a highly available calcium - the absorption of calcium from Brussels sprouts in something like 60 percent, whereas for milk it's only 30 percent," he said. "They also provide iron in a really good form, and provide a little protein."
Barnard offered a couple of practical tips for consumers. "I think it's a good idea to cook cruciferous vegetables rather than just have them raw because they're more digestible that way," he said. "Generally speaking, you can eat raw carrots and raw celery, but it's best to cook broccoli and cauliflower."
He also suggests eating more than one serving of vegetables at a meal. "Instead of thinking about just one little modest vegetable serving at a meal, why not have two?" he said. "And a really great combination is green and orange, so you might have broccoli and sweet potato or you could have Brussels sprouts with carrots or cauliflower with carrots, something like that, so that you're mixing the colors."
SOURCE: bit.ly/OUoCsL Journal of the Academy of Nutrition and Dietetics, online March 17, 2014.
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