Tuesday, August 11, 2009

Cortisol decreases and serotonin and dopamine increase following massage therapy

It is well known that the when stressed the levels of adrenalin and cortisol in the body rise to support a "fight or flight" response. It speeds up the heart rate, redirects blood flow to major muscle groups, slows down digestion and changes other autonomic nervous functions to assist the body in dealing with the threat whether real or perceived.

In the previous post we saw that scientists are now able to explain the mechanism that results in the stress response causing premature cellular aging as well as the development of disease processes. Studies indicated that the stress hormone cortisol suppresses immune cells' ability to activate their DNA-protein complexes called telomerase. According to the study the cells of persons under chronic stress have shorter telomeres. This compromises genetic stability and cellular life span.

Once the perceived threat is gone, however the stress response is replaced by the relaxation response. All body systems are designed to return to normal function. If however, the hormones remain elevated in the bloodstream for long periods of time, as in the case of chronic psychological stress, it wears down the immune system and could lead to premature aging and disease.

The answer seems to rest in controlling cortisol levels in the body and having a massage is one way of lowering stress hormones.

A number of studies have investigated the positive effects of massage therapy on elevated cortisol levels:

Cortisol decreases and serotonin and dopamine increase following massage therapy by Tiffany Field, M Hernandez-Reif, M Diego, S Schaneberg and C Kuhn in Int J Neurosci 2005 Oct;115(10):1397-413. Touch Research Institute, University of Miami School of Medicine, Miami, Florida 33101, USA. Abstract: In this article the positive effects of massage therapy on biochemistry are reviewed including decreased levels of cortisol and increased levels of serotonin and dopamine. The research reviewed includes studies on depression (including sex abuse and eating disorder studies), pain syndrome studies, research on auto-immune conditions (including asthma and chronic fatigue), immune studies (including HIV and breast cancer), and studies on the reduction of stress on the job, the stress of aging, and pregnancy stress. In studies in which cortisol was assayed either in saliva or in urine, significant decreases were noted in cortisol levels (averaging decreases 31%). In studies in which the activating neurotransmitters (serotonin and dopamine) were assayed in urine, an average increase of 28% was noted for serotonin and an average increase of 31% was noted for dopamine. These studies combined suggest the stress-alleviating effects (decreased cortisol) and the activating effects (increased serotonin and dopamine) of massage therapy on a variety of medical conditions and stressful experiences.

Effects of Massage in Acute and Critical Care by Richards, Kathy Culpepper RN, PhD; Gibson, Robin RN, MNSc; Overton-McCoy, Amy Leigh RN, BSN in AACN Clinical Issues: Advanced Practice in Acute & Critical Care: February 2000 - Volume 11 - Issue 1 - pp 77-96. Abstract: This is a discussion of the results of a systematic review of 22 articles examining the effect of massage on relaxation, comfort, and sleep. The most consistent effect of massage was reduction in anxiety. Eight of 10 original research studies reported that massage significantly decreased anxiety or perception of tension. Seven of 10 studies found that massage produced physiologic relaxation, as indicated by significant changes in the expected direction in one or more physiologic indicators. In the three studies in which the effect of massage on discomfort was investigated, it was found to be effective in reducing pain. In only three studies was the effect of massage on sleep examined. The methods for measuring sleep were unclear in two of the studies, and results were inconclusive in the other. Further research is needed to investigate the effect of massage on discomfort and promoting sleep.

In their article Massage & Stress: Understanding the Research which appeared in the International Journal of Therapeutic Massage & Bodywork: Research, Education, & Practice, an open access, peer-reviewed publication of the Massage Therapy Foundation, Dr Cynthia Piltch and Martha Brown Menard, PhD, discuss the need for massage therapists to understand the effect that stress has on their patients and how massage can help alleviate those effects.

Follow the link to read the full article.

Dr. Cynthia Piltch is a Certified Therapeutic Massage therapist and holds a Ph.D. in Health Policy, Boston University. Her dissertation looked at Work and Mental Distress: A Comparative Analysis of the Experience of Women and Men MPH in Health Planning and Administration University of Michigan. She teaches at the Cortiva Institute-Muscular Therapy Institute and is an adjunct faculty member at the Northeastern UniversitySchool of Nursing and Tufts Medical School.

Martha Brown Menard, PhD, CMT,has been in private practice since 1982 and teaching research literacy since 1997. She is the author of Making Sense of Research, and serves as Director of Research at Potomac Massage Training Institute in Washington,DC.

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