Why Massage Hurts But Feels Good - The Therapeutic Pain and Pleasure

The Pain and Pleasure of Massage

Massage is meant to help relieve muscle tension, soreness and pain in the body. Yet it's not uncommon for massage to hurt, especially when working on extremely tight, knotted areas of the muscles. This seeming contradiction can leave people confused - if massage is supposed to help with pain, why does it often hurt too?

There are a few key reasons why massage may cause some pain even as it provides therapeutic benefits. Understanding how massage works can help make sense of this phenomenon.

Breaking Down Muscle Knots

Muscle knots, also called trigger points, are areas of tight muscle fibers that form hard, tense nodules. These knots restrict circulation and pinch nerves, causing soreness, pain and limited mobility. Massage aims to locate these knots and break them down.

Massage therapists use techniques like deep tissue massage, compression, cross-fiber friction, assisted stretching and trigger point therapy to break up knotted muscles. This requires applying focused pressure that can hurt as it digs into tense tissues. It's much like digging out a splinter - it hurts as it's happening, but removing it brings relief.

Increasing Blood Flow

Lactic acid buildup in muscles contributes to soreness and stiffness. Massage helps increase circulation, bringing fresh oxygenated blood to muscle tissues while flushing out lactic acid, toxins and other metabolic waste. Various massage strokes like effleurage, petrissage and tapotement mechanically push blood through the vessels.

When blood floods into tissues that have been deprived, it can cause a pain response. Like pins and needles when a limb "wakes up", the rush of blood into restricted areas may sting or burn before tissues adapt. This discomfort is often a sign of therapeutic effects taking place.

Releasing Muscle Adhesions

Muscle adhesions form when fascia - connective tissues surrounding muscles - get stuck together. This limits mobility and range of motion. Massage techniques like skin rolling aim to separate adhered fascia and restore flexibility.

However, fascia offer resistance, so physically manipulating them creates tension and discomfort. Adhesions may snap or pull during massage as tissues regain mobility. Patients may feel some burning or twinging as adhesions release.

Relaxing Muscle Spasms

Muscles often spasm as a protective response to overexertion, injury or imbalance. Spasms cause muscles to involuntarily contract, creating pain and inflexibility. Massage can help relax and loosen spasming muscles.

Therapists use stretches and localized pressure to gently coax contracted tissues to let go. This may cause aches and soreness at first. But as muscles relax, normal length and mobility is restored, along with relief from spasm-related pain.

The Body's Response to Massage

Beyond the direct physical effects on muscles and connective tissues, massage also sets off cascading reactions in the body that play a role in both the pain and pleasure of massage.

The Pain Gate Theory

According to the pain gate theory, massage may provide pain relief by essentially "overloading" the nervous system. Nerves can only transmit a limited amount of signals at once. Massage may flood nerves with new signals about touch, pressure and massage strokes.

This influx may temporarily block ongoing pain signals from an injury or condition from reaching the brain. However, massage may also stimulate nerves to fire new pain signals as tissue damage is addressed. Overloading nerves may explain how massage both eases and causes pain.

The Stress Response

Massage signals the body to activate its relaxation response. As the parasympathetic nervous system kicks in, blood pressure lowers, breathing slows, muscles relax and feel-good hormones like serotonin and endorphins rise. This counters the strain of the sympathetic "fight or flight" state.

However, transitioning out of stressed mode may also trigger discomfort. Just as stress can manifest as physical pain, unwinding stress may also briefly intensify painful sensations before the body achieves equilibrium.

Inflammation

Massage's localized pressure and motions physically break up inflammation and scar tissue while boosting circulation. This reduces painful swelling and stiffness in injured or overworked areas.

But inflamed tissues are also extra sensitive. Pressing into swollen, tender areas often hurts. Pain signals the body to handle damaged tissue gently while healing occurs. Increased pressure may be necessary to drive out inflammation, but it won't feel good until tissues rebuild.

Maximizing Massage's Benefits

To help clients past the pain for the greatest therapeutic gains, massage therapists utilize various techniques and best practices, including:

Communication

Therapists check in with clients about comfort levels and make sure they aren't using more pressure than can be tolerated. Clients must also communicate clearly about what hurts, what feels good, and what's just right to steer the massage.

Mindfulness

Therapists help clients practice mindfulness to rise above pain signals coming from the body. Tuning into breathing, focusing away from discomfort and visualizing healthy tissues can modify the pain experience.

Slow Build Up

Starting gently and slowly increasing pressure over time allows the body to acclimate to new sensations. Rushing into deep work without building a foundation may backfire.

Layering Techniques

Blending lighter strokes, compression, holds and other moves provides variety to keep nerves from fixating on pain. Switching up stimulation helps tissues release in stages.

Aftercare Advice

Therapists recommend rest, hydration, light activity and heat or cold therapy after massage to help the body process inflammation and accelerated healing. Clients should avoid intense exercise and addictive painkillers.

Realistic Expectations

Clients must understand massage often initially hurts before it feels better as Change takes time. Lifelong tension doesn't disappear in one session. Patience through discomfort leads to progress.

The Takeaway

Aches during massage are common and even normal. Discomfort doesn't inherently indicate something is wrong or that massage has failed. On the contrary, some pain can signal therapeutic processes at work as muscles release and circulation increases.

Results are maximized when therapists customize pressure and activities to client tolerance and feedback. Clients must also breathe through discomfort, communicating openly and sticking with it as the body acclimates and unwinds. Understanding how massage provides hurt that heals can help save clients from throwing in the towel prematurely.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.