Multiple sclerosis (MS) is the leading neurologic disease in young adults, affecting approximately 300,000 people in the United States. MS worsens throughout the affected person’s life, with periods of remission & exacerbation (also called relapses or flare-ups). With each exacerbation, additional areas of the nervous system are affected. Many people who have MS become incapacitated over a period of 20 to 30 years.
Multiple sclerosis is progressive demyelination of neurons of the brain, spinal cord, & cranial nerves, especially the optic nerve. The loss of myelin ultimately leads to scarring or sclerosis & plaque formation, which interferes with the transmission of nerve impulses (similar to an electrical wire stripped of its insulation). Cognitive dysfunction is highly common in MS & may appear early in the disease, including decrease in information processing speed, word finding, concentration, & attention.
Women are more affected than men (3 : 1), & it is more prevalent in Caucasians than in other ethnic groups. Onset is usually between the ages of 20 & 40. MS is believed to be an autoimmune disorder that has a genetic component; 15% of persons with MS have an affected relative. Environmental exposure to certain factors such as viruses, vitamin D deficiency, & smoking may also play a role in its development.
Common signs & symptoms of MS are loss of vision; paresthesia or sensations of numbness, burning, prickling, tingling, or itching; & neuropathy. The person experiences progressive muscle weakness that leads to loss of coordination, postural instability, & eventual paralysis. Muscle spasms, fatigue, vertigo, & tremors are frequent manifestations. Speech & hearing impairments may develop. Bladder & bowel dysfunction occur in severe cases or as a complication.
Treatment goals are to reduce the frequency of exacerbation, delay disease progression, decrease disability, & to manage symptoms. Symptoms are managed with non-pharmacological & pharmacological methods (rehabilitation, energy conservation techniques, muscle relaxants), as well as supportive therapies (physical, occupational, & massage therapy, speech therapy). Regular moderate exercise in the early stages of the disease helps maintain muscle tone. Relapses are treated with corticosteroids.
Massage Therapy and Multiple Sclerosis –
Massage reduced pain, improved dynamic balance, as well as walking speed in persons with MS (1). Pain reduction was greater when massage therapy was combined with exercise therapy (1). Self-applied abdominal massage lessened constipation in people with MS (2).
Massage also decreased anxiety & depression in persons with MS (3). Massage helped individuals manage stress & cope with the challenges associated with chronic disease (3, 4), perhaps through increased self-efficacy (5), improved self-esteem & body image (2), & through promoting positive mood & better psycho-emotional states (5).
Assess the client thoroughly at every visit because symptoms change from day to day. During periods of exacerbation, massage using light pressure can be performed. An example of light pressure is approximately a 3 on a 10-point pressure scale. In areas affected by neuropathy, use the same massage guidelines that are used for exacerbation periods (i.e., light pressure). Check in with your client regarding how the pressure is being received as you work.
Articles and Journals Referenced:
- Negahban H., Rezaie S., & Goharpey S. (2013). Massage therapy and exercise therapy in patients with multiple sclerosis: a randomized controlled pilot study. Clin Rehabil. 27(12):1126-36.
- McClurg D., Hagen S., Hawkins S., & Lowe-Strong A. (2011). Abdominal massage for the alleviation of constipation symptoms in people with multiple sclerosis: A randomized controlled feasibility study. Mult Scler. 17(2):223-33.
- Hernandez-Reif M., Field T., & Theakston H. (1998). Multiple sclerosis patients benefit from massage therapy. J Bodywork Mov Ther. 2:168–174.
- Schroeder B., Doig J., & Premkumar K. (2014). The effects of massage therapy on multiple sclerosis patients’ quality of life and leg function. Evid Based Complement Alternat Med. (4):640916.
- Finch P., & Bessonnette S. (2014). A pragmatic investigation into the effects of massage therapy on the self efficacy of multiple sclerosis clients. J Bodyw Mov Ther. 18(1):11-6.
Susan Salvo is a board certified massage therapist with 30+ years of experience. Susan is passionate about massage therapy and massage education. You can contact her at firstname.lastname@example.org.