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Managing Diabetic and Peripheral Neuropathy through Massage

It may start with a tingling sensation in the feet and hands.  Sometimes it can progress slowly, and if it goes undiagnosed and untreated it can become debilitating.  Neuropathy is a disorder of the peripheral nerves – the motor, sensory, and autonomic nerves that connect the spinal cord to muscles, skin, and internal organs that can be

affected causing [sometimes] excruciating pain and disability.  If diagnosed early, it can often be controlled through various techniques; one of those ways is through massage therapy.

Massage has been recommended as one of the complementary forms of medicine for more than a hundred years, and is one of the fastest growing complementary therapies used in the United States.  There are no clear studies done that examine the long term effects of massage on people with neuropathy or diabetes.  However, there have been studies done that create an atmosphere of the high-level benefits, not only for relaxation purposes, but also to the physiological side of medicine.  Can massage prove relief of neuropathy, whether it be diabetic related or peripheral?  Yes, in my opinion.  I have seen it first hand with my patients.  The long term effect is genuine; as well as the side benefits if done on a regular basis.

Using massage in the medical field is rising In recent years that percentage has been higher than in the past, and has shown to be the most statistically significant increase than any other complementary medicine (CM) modality.  Massage is among the CM therapies with the highest physician referral rate; and as well has been given a total thumbs up as the most beneficial and least likely to be harmful.  This is why it's important to make sure you go to a qualified therapist.  I have been doing diabetic massage for eight years with excellent results.  Neuromuscular therapy manipulates the deep soft tissues to improve circulation, release nerve entrapment, and deactivate trigger points.  This helps to stimulate circulation that is so critical in helping to battle neuropathy.  Lymphatic drainage lightly redirects subcutaneous lymph stasis or blockages into functional lymphatic channels; thus limiting the "stored" fluid in the body.  Many diabetics suffer from retaining fluid and this method can achieve greater relief of the neuropathy – releasing the pressure on the muscle tissue and skin.

The physiological effects of massage on neuropathy are many; it increases the blood flow, stimulates the muscles, and calms the nerve endings.  There have been several studies that have documented the effects to reduce muscle tension in both subjective and objective testing.  The stress-reducing benefits of massage have been tested and confirmed to show that people with diabetes show a marked improvement for the most part, and those with neuropathy have felt the benefits over time.  For my own personal observation, my sister has had diabetes since 1991 and is suffering from neuropathy in her feet and ankles.  She also suffers from retaining water in the muscle tissue and upon massaging her and doing lymph drainage; there is an immediate and marked improvement in her stance and her feeling.  She has conveyed that the pain level decreases and has at times lasted as long as 48 hours.  This may happen because massage induces the relaxation response; and for general diabetic relief, it controls the counter-regulatory stress hormones and permits the body to use insulin more effectively.  Researchers found that some diabetic patients receiving massage on a regular basis decreased their baseline HbA1c levels by as much as 1.2%.

More research is needed in order to fully understand and retain the benefits of massage on neuropathy patients.  By assessing outcomes used in neuropathy trials, it can be determined which optimal benefits are best achieved by what kind of massage treatment, (either effleurage or petrissage).  In one study done on HIV patients suffering from neuropathy, it was found that massage therapy decreased the intensity of painful peripheral neuropathy of the feet in five of five non-diabetics.

Patients suffering from neuropathy need to communicate to the therapist about their condition and the severity of their pain before beginning treatment.  For many, the gentle friction (petrissage) of massage can be hard, while the lighter touch (effleurage) massage may be just the thing to help calm the tingling of the nerves and cramping of the muscles.  For others, the full massage treatment of gentle friction and lymph drainage may be most beneficial.  It is also important for the patient to make sure the therapist is familiar with the disease and has had some training in doing other forms of conditional massage such as for fibromyalgia, cancer, or HIV.  In the end, it is always best to keep good lines of communication open with your therapist before, during, and after your massage.  The only way to assist in your complementary medicine and to find the path to better health is communication.

Nadja Knighte, Licensed Massage Therapist - nadja@2bwell.net