By Dr. Mercola
Neck pain is the third most common type of pain in the US, impacting up to 70 percent of people at some point during their lives.1 While the causes are varied – car accidents, poor posture, and even sleeping in the wrong position – the standard, go-to treatment offered by most physicians is medication, including anti-inflammatory drugs.
Unfortunately, many patients grow tired of treating their pain with drugs, not only because they may not relieve the pain in its entirety but also because they may cause side effects that are as bad as the pain itself – or worse.
Seeking more effective and safer alternatives, many turn to massage therapy for pain relief, with varying success.
New research has helped to explain why some people swear by massage for pain relief while others feel little difference. It turns out that, just as with medications, the dose matters when it comes to massage and may make the difference between pain relief… or not.
Longer, More Frequent Massage Sessions Work Best for Neck Pain Relief
Researchers from the Group Health Research Institute in Seattle set out to determine the optimal dose of massage for people with chronic neck pain. Study participants received 30-minute massages two or three times a week, or 60-minute massages one, two or three times weekly (with a comparison group that received no massages).
Compared with the no-massage group, those who got massages three times a week were nearly five times more likely to report a significant improvement in function and more than twice as likely to report a significant decrease in pain. The best pain-relief results were obtained by those who received 60-minute massages two or three times a week. One of the study's researchers told WebMD:2
"In the short term, 60 minutes of massage is better than 30, and you want to do multiple treatments a week for the first four weeks."
Dose Matters When Using Massage for Neck Pain
The featured study suggests that people who are not finding relief via massage therapy may not be getting the treatment in the proper dose. There are other variables that impact massage effectiveness as well, such as the technique used and the skill level of the massage therapist.
This may help explain why research on massage for pain relief often yields conflicting results. A review published in Cochrane Summaries, for instance, found that while massage appeared to offer little advantage over other treatments for neck pain, the quality of studies available was poor, making it difficult to accurately gauge effectiveness.3 The Cochrane researchers noted:
"Overall, the quality of the studies was poor and the number of participants in most trials was small. Most studies lacked a clear definition, description, or rationale for the massage technique used. Details on the credentials or experience of the person giving the massage were often missing.
There was such a range of massage techniques and comparison treatments in the studies that we could not combine the results to get an overall picture of the effectiveness of massage. Therefore, no firm conclusions could be drawn and the effectiveness of massage for improving neck pain and function remains unclear."
Massage Therapy for Pain: A Summary of the Research
That said, there is plenty of research in support of massage therapy. The featured study isn't the first to consider dose when it comes to massage therapy. In 2012, researchers compared 30-minute and 60-minute massage sessions conducted once or twice a week for pain due to osteoarthritis of the knee.4
Like the current study, those researchers found that 60 minutes appeared to be the "magic number," offering greater reductions in pain intensity than 30-minute sessions. However, they also concluded that just one 60-minute massage delivered once a week was the "optimal" dose when factoring in pain relief, convenience, and cost.
In 2008, separate research also found massage therapy to be effective for treating chronic neck pain, especially in the short term (pain relief and improvements in function were most significant after four weeks of massage therapy).5 Other research suggests massage therapy may help relieve many types of pain, including:
- Back pain
Why Are Some Hospitals Adding Massage Therapy to Their Standard Treatments?
While massage therapy is still considered "alternative" or "complementary," it's becoming much more widely accepted and utilized. Massage offers real health benefits, so much so that some conventional hospitals are making it a standard therapy for surgery patients, pregnant women, and others. Along with relieving pain, promoting relaxation, and improving your sense of well-being, getting a massage has been shown to:
- Reduce stress, anxiety, and depression, and ease insomnia
- Decrease symptoms of PMS
- Relax and soften injured and overused muscles, reducing spasms and cramping
- Provide arthritis relief by increasing joint flexibility
Massage affects your nervous system through nerve endings in your skin, stimulating the release of endorphins, which are natural "feel good" chemicals. Endorphins help induce relaxation and a sense of well-being, relieve pain, and reduce levels of stress chemicals such as cortisol and noradrenaline -- reversing the damaging effects of stress by slowing heart rate, respiration, and metabolism, and lowering raised blood pressure.
Stronger massage stimulates blood circulation to improve the supply of oxygen and nutrients to body tissues and helps your lymphatic system to flush away waste products. It eases tense and knotted muscles and stiff joints, improving mobility, and flexibility. Massage is said to increase activity of the vagus nerve, one of 10 cranial nerves, that affects the secretion of food-absorption hormones, heart rate, and respiration. It has proven to be an effective therapy for a variety of health conditions -- particularly stress-related tension. As reported by iVillage:6
"[A] … study from Thailand suggests that traditional Thai massage can decrease pain intensity, muscle tension and anxiety among people with shoulder pain. Meanwhile, research from the Touch Research Institute at the University of Miami in Florida found that when adults with hand pain had four weeks of massage therapy, they reported a lot less pain, anxiety and depression. Another study at the Touch Research Institute found that when pregnant women who were depressed received massages from their partners twice a week, they had much less leg and back pain and fewer symptoms of depression during the second half of their pregnancies."
Getting to the Bottom of Neck Pain
Massage is a worthwhile treatment option for neck pain – and I'll get to a few others shortly. But, ultimately, even if you use massage to relieve your pain, if you don't address the underlying causes it's eventually going to come right back. Most neck, back, and other muscle pains are related to imbalanced absorption of force throughout your body, created by working in unnatural positions for extended periods. When you teach your body to establish and repeat correct positioning, the pain often goes away. You must correct your foot, pelvis, torso, shoulder, and neck positions, as these are all required for good posture and balance. When these core areas are positioned improperly, you will likely develop pain first in those areas, with other areas soon to follow.
The Gokhale Method, described in the video above, addresses the root cause of most physical pain, which is typically caused by improper posture. The method teaches you to reclaim your primal posture, which is the way your body was designed to stand, sit and move. You can also try Foundation Training—an innovative method developed by Dr. Eric Goodman to treat his own chronic low back pain. The exercises are designed to help you strengthen your entire core and move the way nature intended.
5 Exercises to Banish Your Neck Pain
Once you've addressed any posture issues, you can try the five strength exercises that follow to help relieve neck pain. A study published in the journal Arthritis & Rheumatism showed that strength training targeting the neck and shoulder muscles is the most beneficial treatment for women with chronic neck muscle pain as opposed to a general fitness routine.7 Detailed explanations of how to perform each exercise are provided by the National Research Centre for the Working Environment:8
- Dumbbell shrug
Stand upright with the hand weights at the side of your body. In one even motion, lift your shoulders up towards your ears and lower them again slowly. At the same time, try to relax your jaw and neck.
- One-arm row
Stand with one knee on the bench and lean on the same-side hand on the front of the bench. With the free arm you pull the weight up towards your lower chest. When the weight touches your chest, lower it in a controlled motion.
- Upright row
Stand upright with your arms stretched and the hand weights in front of your body. Lift the weights in a straight line as close to your body as possible, until they reach the middle of your chest and your elbows point up and out. During the whole exercise, the hand weights should be placed lower than the elbows.
- Reverse fly
Lie down on a bench in a 45° forward bent angle with the hand weights hanging towards the floor. Lift the weights outward and upward until they are horizontal, and then lower the weights in one controlled motion. During the exercise, the elbows should be slightly bent.
- Lateral raise/shoulder abduction
Stand upright with the hand weights at the side of your body. Lift the weights outward and upward until they are horizontal, and then lower the weights in one controlled motion. During the exercise, the elbows should be slightly bent.
Additional Non-Drug Options for Treating Neck Pain
There are many other options for treating chronic pain than drugs. A variety of complementary and alternative medicine (CAM) treatments (including acupuncture, massage, spinal manipulation, and mobilization) were deemed to be significantly more efficacious than no treatment, placebo, physical therapy, or usual care (i.e. drugs) in reducing pain immediately or at short-term after treatment for those with neck or low-back pain.9 That said, if you have any type of chronic pain, the four steps I recommend doing first, include:
- Start taking a high-quality, animal-based omega-3 fat like krill oil. Omega-3 fats are precursors to mediators of inflammation called prostaglandins. (In fact, that is how anti-inflammatory painkillers work, they positively influence prostaglandins.) The omega-3 fats EPA and DHA contained in krill oil have been found in many animal and clinical studies to have anti-inflammatory properties, which are beneficial for pain relief.
- Reduce your intake of most processed foods as not only do they contain sugar and additives but most are loaded with oxidized omega-6 fats that upset your delicate omega-3:omega-6 ratio, which will contribute to inflammation, a key factor in most pain.
- Eliminate or radically reduce most grains (especially wheat) and sugars (especially fructose) from your diet. Avoiding grains and sugars will lower your insulin and leptin levels. Elevated insulin and leptin levels are one of the most profound stimulators of inflammatory prostaglandin production. That is why eliminating sugar and grains is so important to controlling your pain.
- Optimize your production of vitamin D by getting regular, appropriate sun exposure, which will work through a variety of different mechanisms to reduce your pain.
Once these factors are addressed, you can try these safe pain-relief techniques to help eliminate your pain without the need for prescription drugs:
- Emotional Freedom Technique (EFT): Few people want to be told that their pain is psychological or emotional in origin, but there's quite a bit of evidence that backs this up. Underlying emotional issues and unresolved trauma can have a massive influence on your health, particularly as it relates to physical pain. According to Dr. John Sarno, a psychiatrist who uses mind-body techniques to treat patients with severe low back pain, EFT has a greater than 80 percent success rate.
- Chiropractic adjustments: According to a study published in the Annals of Internal Medicine,10 and funded by the National Institutes of Health, patients with neck pain who used a chiropractor and/or exercise were more than twice as likely to be pain free in 12 weeks compared to those who took medication.
- Acupuncture: Researchers concluded that acupuncture has a definite effect in reducing chronic pain, such as back pain and headaches – more so than standard pain treatment.11
- Infrared laser therapy like K Laser can be profoundly effective and should be considered as an alternative before any surgical procedure for pain relief.