Apr 27, 2003
I have been receiving general and reflexology massages twice per week for the last six weeks,as i am struggling with peripheral neuropathy and arthritis. As a result i am much less likely to reach for pain killers. Can you or your staff site clinical data or current research on the effects of massage and muscle/nerve problems due to HIV? I am a person living with HIV for over 15 years and I have not been able to maintain an exercise program for any great length of time due to joint and muscle pain. Thanks for your column over the years.
Response from Mr. Vergel
Yes , I found a few references on massage and HIV: 1-Massage therapy for the treatment of painful peripheral neuropathy in HIV+ individuals.Acosta AM, Chan RS, Jacobs J. Int Conf AIDS. 1998;12:849 (abstract no. 42376). New York Hospital, Cornell Medical Center, NY, USA.
ISSUE: HIV+ individuals may present with complaints of painful peripheral neuropathy which may not adequately respond to pharmacologic therapy. PROJECT: HIV+ individuals with painful peripheral neuropathy of the feet who had partial or no improvement in pain after pharmacologic therapy (i.e. narcotic analgesics, tricyclic antidepressants and/or serotonin reuptake inhibitors) were referred to occupational therapy (OT) for pain management and treatment from 09/11/95 to 10/24/96. OT treatment consisted of 8 sessions of massage therapy and instruction on a self performed home massage program. No changes in medications were made during the duration of the project. The Brief Pain Inventory (BPI) was used to measure quality and intensity of pain (scale: 1-10 points) prior to initiating OT massage therapy and after 8 treatment sessions. RESULTS: Seven HIV+ individuals (4 males; 3 females) with an age range of 28 to 49 years (mean 39.1) received 8 OT massage therapy treatments over an average of 58 days (range 25 to 126 days). Five patients reported improvement with a mean decrease in pain of 3.2 (range: 1 to 7). The mean CD4 count in the responder group was 183 (range 17-336). One female reported no response to therapy (CD4 = 114) and one male reported worsening pain (CD4 = 247). Both non-responders were diabetic. None of the responders had diabetes. LESSONS LEARNED: OT massage therapy decreased the intensity of painful peripheral neuropathy of the feet in 5 of 5 non-diabetic, HIV+ individuals who had previously had little or no response to pharmacologic therapy. Two diabetic HIV+ individuals did not report improvement. OT massage therapy may be beneficial in the treatment of painful peripheral neuropathy in some HIV+ individuals.
2- Clinical outcomes and patient perceptions of acupuncture and/or massage therapies in HIV-infected individuals. Henrickson M.AIDS Care. 2001 Dec;13(6):743-8.
"There were three treatment groups: acupuncture-only (n = 8), massage-only (n = 34) and acupuncture-and-massage (n = 21). Pre-treatment and post-treatment measures were compared within groups, and treatment and non-treatment group clinical outcomes were compared with each other. Using nonparametric statistical analysis, it was found that the means of the treatment groups' differences in pre- and post-CD4 counts showed improvement when compared with the non-treatment control group's pre- and post-CD4 counts. Treatment subjects were then interviewed and asked to rate their experiences of the therapies; the subjective experience was very positive"
3-HIV adolescents show improved immune function following massage therapy.
Diego MA, Field T, Hernandez-Reif M, Shaw K, Friedman L, Ironson G.Int J Neurosci. 2001 Jan;106(1-2):35-45. Touch Research Institutes, University of Miami School of Medicine, Miami, FL 33101.
HIV+adolescents (M CD4=466 mm3) recruited from a large urban university hospital's outpatient clinic were randomly assigned to receive massage therapy (n=12) or progressive muscle relaxation (n=12) two-times per week for 12 weeks. To assess treatment effects, participants were assessed for depression, anxiety and immune changes before and after treatment the 12 weeks treatment period. Adolescents who received massage therapy versus those who experienced relaxation therapy reported feeling less anxious and they were less depressed, and showed enhanced immune function by the end of the 12 week study. Immune changes included increased Natural Killer cell number (CD56) and CD56+CD3-. In addition, the HIV disease progression markers CD4/CD8 ratio and CD4 number showed an increase for the massage therapy group only.
4-Massage therapy is associated with enhancement of the immune system's cytotoxic capacity.
Ironson G, Field T, Scafidi F, Hashimoto M, Kumar M, Kumar A, Price A, Goncalves A, Burman I, Tetenman C, Patarca R, Fletcher MA.Int J Neurosci. 1996 Feb;84(1-4):205-17.
Touch Research Institute, University of Miami School of Medicine, Fl, USA.
Twenty-nine gay men (20 HIV+, 9 HIV-) received daily massages for one month. A subset of 11 of the HIV+ subjects served as a within subject control group (one month with and without massages). Major immune findings for the effects of the month of massage included a significant increase in Natural Killer Cell number, Natural Killer Cell Cytotoxicity, soluble CD8, and the cytotoxic subset of CD8 cells. There were no changes in HIV disease progression markers (CD4, CD4/CD8 ratio, Beta-2 microglobulin, neopterin). Major neuroendocrine findings, measured via 24 hour urines included a significant decrease in cortisol, and nonsignificant trends toward decrease of catecholamines. There were also significant decreases in anxiety and increases in relaxation which were significantly correlated with increases in NK cell number. Thus, there appears to be an increase in cytotoxic capacity associated with massage. Implications for HIV+ men as those with other illnesses, particularly cancer, are discussed.
Acupunture, B-12 shots, cod liver oil compresses, and other complemetary therapies are being used for neuropathy also.
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