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Massage should not be done directly over bruises, inflamed or infected skin, skin rashes, unhealed or open wounds, tumors, abdominal hernia, fragile bones, or areas of recent fractures. Massage may cause bruising and rarely, hematoma (a localized collection of blood outside of blood cells), venous thromboembolism, and a condition known as spinal accessory neuropathy.
Before you can decide which massage style is best for you, you need to ask yourself a question. Do you simply want a massage for relaxation and stress control? Or do you need symptom relief or help with a certain health condition? Before booking a massage, let the therapist know what you're looking for and ask which style the therapist uses. Many use more than one style. Or the therapist may customize your massage, depending on your age, condition, or any special needs or goals you have.

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RCTs have a vital role in the assessment of efficacy in reflexology. However, they only address the effect of reflexology in which other pertinent issues are unexplored such as the mechanism of reflexology, psyche, and the experience of participants receiving reflexology. Nursing research has long used qualitative research to explore various health care phenomena. Similarly, qualitative approach can provide further understanding about the patient's perception and belief towards reflexology.4, 36 Qualitative research also assists in understanding the impact of the context and the process of reflexology intervention. A greater understanding of reflexology intervention has the potential to enhance the delivery of health care. Thus, it is argued that qualitative explorative methods combined with RCTs could potentially reveal the contributing factors of reflexology effect.

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In this particular study, published in Studies in Health Technology and Informatics, therapeutic massage included techniques of tapping and friction, while DTM used “oblique pressure and a combination of lengthening and cross-fiber strokes.” All sessions were 30 minutes long and preformed daily, and all participants did not receive any other treatments during the course of the study. After 10 days, participants treated with DTM reported significant improvements in pain (lower back pain in this case) compared to those treated with therapeutic massage, based on scores using the Modified Oswestry Low Back Pain Disability Index, Quebec Back Pain Disability Scale and Visual Analog Scales. (4)

The therapist may utilize some Swedish techniques to warm up the tissues (kneading, friction, percussion), softening the superficial layers so that he or she can access the deeper ones more easily. Then, with little or no lotion, the therapist utilizes the hard surfaces of their hands and arms — surfaces such as fingers, knuckles, forearms, and elbows — and employs a very slow, sustained type of stroke.

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Like massages, chiropractic care can be beneficial for lowering pain and improving recovery. It’s also been shown to lower stress, headaches and more. One way that chiropractors help treat pain is by lowering mechanical compression and irritation of spinal joints, which can send nerve signals throughout the body that increase inflammation and irritation.


No one really knows how a painful massage can also feel so good at the same time. This is a sensory phenomenon mostly beyond the reach of science — not entirely14 — all we can do is speculate. A main question is whether good pain is good because we expect relief to follow pain, or because positive and negative qualities are being produced simultaneously. My bet is on the latter.

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