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PaperclipPerfector  1yr ago (text post)   2595 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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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

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