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Massage for Polyneuropathy
CAN MASSAGEs HELP WITH POLYNEUROPATHY?
If you have pain, you automatically tend to massage the affected areas. This can also be useful for polyneuropathy. Unfortunately, massaging does not heal damaged nerves. However, massaging can often still help to reduce the pain as it can help to reduce the other causes of pain.
NERVE AND MUSCLE PAIN TOGETHER INTENSIFY THE OVERALL PAIN
In many cases, pain from the muscles is added to the pain caused by the damaged nerves from polyneuropathy. This is called 'myofascial pain' syndrome and it is the most common cause of pain in the musculoskeletal system.
It causes small cramps at certain points in the muscle fibres that cannot heal themselves on their own. These mini-cramps disturb the work of the muscles and nerves. They can cause an incredible amount of pain and can even lead to joint blockages.
MUSCLE PAIN IS VERY COMMON IN POLYNEUROAPTHY
If you suffer from polyneuropathy, these problems in the muscles are very common. This is because the disease means the interplay between nerves and muscles no longer functions as it does in healthy people. The movement patterns change and often it is necessary to use relieving postures or unnatural movements. This places additional strain on the already weakened muscles.
MUSCLE AND NERVE PAIN ARE PRACTICALLY INDISTINGUISHABLE
As a result, more and more such cramps occur. This adds to the pain that polyneuropathy already causes, in addition to the pain from the muscles.
Furthermore, it is practically impossible to tell what exactly causes the pain - the damaged nerves due to polyneuropathy or the muscle cramps.
MUSCLE PROBLEMS IN POLYNEUROPATHY ARE OFTEN OVERLOOKED
In most cases, this connection is unfortunately also ignored. As soon as you have been diagnosed with "polyneuropathy", nobody looks at other options.
However, the only way to find out whether a massage really helps is to massage the muscles. As I said, there is no clear, reliable diagnosis but you have nothing to lose because there are no negative side effects to be expected. This means that you should just try the massage and see if it brings any relief.
By MASSAGing the MUSCLE,we CAN REDUCE PAIN FROM POLYNEUROPATHY
If you treat the muscle cramps, you will often see improvements in the pain. I have even had several patients where the pain disappeared completely after treating the muscles. In these cases, the cause of the pain was not polyneuropathy, but muscle spasms. In many cases, the pain can be limited to smaller areas. In some patients, I have observed that after treatment of the muscles only the toes hurt and not the whole foot.
In general, the chances of reducing the pain by massage in polyneuropathy are greater the closer the pain is to the centre of the body. If, for example, the calves or the heel aches, the chances of success are greater than if the pain is located in the typical areas in the tips of the toes.
HOW DOES THIS WORK IN PRACTICE?
The aim of massaging in polyneuropathy is to create so-called myofascial trigger points, here called 'trigger points' for the sake of simplicity.
These points are the centre of muscle cramps. They are pea-sized nodules that are very sensitive to pain and can also cause radiating pain. This means that if there is such a trigger point in the calf muscles, it can cause pain in the foot. As a result, you often have to look for the cause of the pain in a completely different place than where you think the pain is.
A MASSAGE, even for people with a HIGH SENSITIVITY to touch
This is a huge advantage in polyneuropathy. Many people have such severe pain and are so sensitive to touch due to polyneuropathy that direct massage of the painful areas is not possible.
For example, many of my patients' toes are so painful that they can hardly be touched.
However, if you know that the cause of the pain (the trigger point) is often in the lower leg, a treatment option suddenly opens up that is completely unproblematic for the patient.
Finding just the right places
These spots are usually in the same places and also cause pain in predictable areas. That is why it is relatively easy to find these spots with little experience.
You can easily tell if you have found the right spot by pressing on the muscles. You will often find places where pressure causes pain. This is a sign that you have found a muscle cramp because a relaxed muscle does not hurt when you press on it.
THE RIGHT LEVEL OF PRESSURE IS CRUCIAL IN THE MASSAGE OF POLYNEUROPATHY
You now continue searching with your fingertips and try to find the most painful spot. Then massage it with slow but firm pressure, whereby a slight pain should be felt. N.B. This should only be so strong that it just feels good. It should therefore be a pain that feels good. If you press harder on the muscle and cause a strong pain, the muscle will react with a defensive tension and you will achieve more tension than relaxation.
IT IS BEST TO LEARN HOW TO PERFORM THE MASSAGE FOR POLYNEUROPATHY YOURSELF
In my own practice I use osteopathic methods to treat the aching muscles. This is usually almost painless for the patient and the muscles respond very well. However, the trigger points, and therefore the pain, often come back, because the polyneuropathy and thus the core of the problem remains. That is why it makes sense for patients to learn to help themselves with the appropriate massage.
HOW THE MASSAGE WORKS
During this massage you should first try to find the trigger point as precisely as possible. The trigger point is located at the point in the muscle that hurts most when pressure is applied. Once you have found this point, press one or two centimetres into the muscle next to it and then move your finger over the painful area until you reach pain-free tissue again.
Always perform this movement in one direction only with pressure and then move the fingers without pressure to the starting position and start again.
The skin is moved along with the movement. This means that the fingers do NOT glide over the skin, but always stick to the same spot in the skin. After all, the massage should not work on the skin, but in the depth of the muscles. It is therefore not necessary to use massage oil.
DO NOT OVERDO IT
This process is repeated 10-20 times. Afterwards, the trigger point should be left alone for a while to prevent painful over-stimulation. You should massage again at the earliest after one hour.
After the massage it is useful to move the muscle lightly and stretch it slightly.
The CAUSE AND EFFECT OF the PAIN ARE NOT ALWAYS THE SAME
If for example, the toes hurt, it is particularly useful to massage the muscles that move the toes (Musculus Flexor Digitorum Longus and Musculus Flexor Hallucis Longus). These are very often overlooked because they are located far from the toes in the calf. However, the pain that problems cause there is felt in the toes.
MASSAGING THE SOLES OF THE FEET CAN REDUCE PAIN
It is also often helpful to massage the soles of your feet if you have pain in your feet. Hard balls such as tennis balls or even harder rubber balls (flummis) are suitable for this. You then place your foot on the ball and roll over the painful areas, then return to the starting point without pressure and start again. Again, it is very important not to apply too much pressure. You should feel a slight pain, but the massage should be pleasant.
Incidentally, hedgehog balls are not suitable for such a massage. Because of their shape, these balls only press into the skin with the individual spikes. This improves the blood circulation in the skin, but does not have any effect on the deep muscle layers.
IF YOU KNOW THE RIGHT PLACES THE MASSAGE FOR POLYNEUROPATHY IS VERY EASY
As you can see, the art of this form of massage is to find out where exactly the cause of pain lies. This is not so easy because the feet and lower legs have a large number of muscles. For example, each toe alone has two flexor and two extensor muscles (flexor digitorum brevis, flexor digitorum longus, extensor digitorum brevis and extensor digitorum longus).
ASK FOR ADVICE
This complexity should not deter you from trying the massage. I am currently working on a booklet that will serve as a guide to self-treatment. Until then, feel free to call me for advice on your personal treatment.
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For en extended German version of this article click here:
bitzer-sporttherapie.de/massage-bei-polyneuropathie/