The Benefits of Massage for MS Clients

by Stu Chisholm, LMT

Some of the most significant benefits of massage therapy for MS sufferers appear to be reduced spasticity and pain, improved circulation and increased muscle and joint flexibility.  Massage also reduces stress, which is thought to be a pain trigger for MS clients as well.(2)  Lastly, a small 2016 study suggested that massage therapy is associated with an improved quality of life, along with decreased fatigue and pain. (3)

As chance would have it, several people with MS (Multiple Sclerosis) found their way to my massage table when I was a student at Irene’s.  It is a simple, yet maddeningly perplexing disease even for doctors and specialists!  Simply put, MS isn’t a disease of the muscles, but a disease of the nerve tissue caused by the immune system mistakenly attacking the myelin sheath (protective protein coat) that surrounds nerve fibers.  These results in inflammation, which can further damage the myelin sheath as well as the nerve cells themselves, and the cells that produce myelin.

If we think of nerve bundles as electric wires, sending electrical impulses from the brain to muscles, the myelin sheath is like the plastic coating on the wire, preventing it from “shorting out” when coming into contact with other wires.  Yet this is exactly the effect that MS produces; signals can be weak, sent elsewhere activating unintended muscles, or simply lost altogether.  For the most part, the muscles themselves remain unaffected.  (One important exception later.)  Our part as massage therapists, then, is to support those muscles and help alleviate the symptoms that MS presents.  The most typical are fatigue, numbness and tingling, muscle spasms, walking difficulties, pain, and bowel/bladder problems.  Many clients also experience emotional changes, including depression, anxiety, and mood swings. (1)

One common denominator among MS clients is pain.  Pain seems to occur for no apparent reason and is sometimes referred to as a “neuropathy,” although in MS clients this not necessarily a contraindication for massage as it can be for diabetic foot neuropathy.  In fact, massage is useful in any condition in which a reduction in swelling or mobilization of tissues leads to pain relief. (4)  Compression is the #1 tool in my arsenal for pain issues.  While deep tissue work can be of benefit in some instances, I find that firm, time-sustained pressure to be most effective.

Spasticity, especially in MS clients with impaired mobility (using canes, walkers or wheelchairs), is another aspect that massage can address.  When muscles aren’t allowed to do the one thing they’re created to do – move – they will begin to atrophy.  Spasticity, or the involuntary movement of muscles, is a muscle’s way of self-preservation; if the signal to move isn’t coming, it will move to try and save itself.  Massage can help to relax these muscles, and stretches and other range of motion exercises can help maintain some muscle tone and lessen the frequency and duration of spasms.

Speaking of spasms, a Myomassologist might be tempted to use muscle mechanics in order to try and relax a spastic muscle, but this often doesn’t work for MS clients because their muscles lack spindle cells, the primary muscle “sensor” that tells the brain how short or long a muscle maybe (that important difference I mentioned earlier). Creating false tension by pressing on the muscle belly won’t work the same.  Golgi tendon organs, however, remain present, so some muscle mechanics may be beneficial if a therapist can access both the origin and insertion of the spastic muscle.

Traditional therapies of applying heat or cold can be problematic for your MS client as well.  According to the National Multiple Sclerosis Society (5), hypersensitivity to hot and cold is frequent among MS clients.  In the past, the “hot bath” test was used as a diagnostic tool.  A person suspected of having MS was immersed in a hot tub of water.  The appearance (or worsening of) neuralgic symptoms was taken as evidence the person had MS.  Changes in weather can affect those with MS; their symptoms can worsen with hot, humid weather or when running a fever.  An elevated temperature further impairs the ability of a demyelinated nerve to conduct electrical impulses.  For these reasons, I tend to avoid using heating packs, hot towels or even topical heating ointments.  While cold can sometimes also be a problem, especially when it comes to worsening spasticity, I have often used pain-relieving products such as Biofreeze to reduce pain and spasticity in the extremities.

Finally, massage can increase blood flow through superficial veins by use of friction, and through deeper arteries and veins by use of petrissage.  Light stroking can also increase capillary dilation, all of which aids in overall circulation.

Contraindications for massage on MS clients are similar to all others: edema, osteoporosis, ulcers, recent injuries, and pregnancy all should be overseen by a physician.  While massage can be helpful for all of the reasons stated above, it has no effect on the course of MS.  A 1998 study investigated the effect of massage on people with MS on:

• Relief of anxiety and depression
• Improvement in mood, self-esteem and body image
• Increased ambulation and improved physical and social functioning

The self-report style study found that, after five weeks, physical and social activity had improved among clients receiving a massage.  Those clients also reported a decrease in depression.  There was only marginal improvement in grip strength and ambulation.

The bottom line, then, is that the MS client does better when incorporating massage.  A focused, mindful therapist can maximize those benefits by understanding the disease and the strengths and limitations of the various tools in their massage arsenal.

NOTES:
1. https;//multiplesclerosisnewstoday.com/multiple-sclerosis-overview/
2. https://health.usnews.com/health-care/patient-advice/articles/2017-09-01/the-benefits-of-therapeutic-massage-for-ms
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5142712/
4. https;//www.nationalmssociety.org/Treating-MS/Complementary-Alternative-Medicines/Massage-and-Body-Work
5. https;//www.nationalmssociety.org/Living-Well-With-MS/Diet-Exercise-Healthy-Behaviors/Heat-Temperature-Sensitivity

Irene’s Myomassology Institute is a nationally accredited massage therapy school located in Southfield, Michigan.  Scholarships and Financial Aid are available for qualified students to help them pay school tuition.  Our students graduate with a state license prepared for a successful career as a massage therapist.  Irene’s lifetime job placement services maintain an abundance of massage career opportunities for our alumni.  Irene’s student massage clinic provides affordable massage to the public with discounted prices for seniors and veterans. Irene’s massage supply store equips massage therapists with the necessities to manage a successful career.