Diabetes and Massage

Monday February 16, 2015

According to the Centers for Disease Control and Prevention, over 29.1 million people in the United States have diabetes. Of this number, a surprising 8.1 million do not know that they have diabetes.  The latest available statistics state that 37 % of people over the age of 20 have prediabetes.  This percentage represents another 86 million Americans. Massage Therapy can be an effective part of a diabetic treatment plan.

A critical component of effective diabetic care is exercise and increased physical activity. Poor circulation and the symptoms of neuropathy can sometimes make it difficult or even painful to make these necessary lifestyle changes.

Massage is a form of exercise!  The therapist’s manipulation and stretching of the muscles constitute passive exercise. Massage helps restore tone to flaccid muscles helping to prepare them for active exercise and partially compensating for lack of activity.

People age 60 or older with diabetes are 2–3 times more likely to report an inability to walk one-quarter of a mile, climb stairs, or do housework compared to people without diabetes.  Exercise may be limited in this population and others due to pain, loss of balance, or limited flexibility.  Massage therapy has been shown to reduce pain by releasing endorphins, the body’s natural pain killers. The stretches help increase muscle flexibility and joint Range of Motion which aids balance.

Massage therapy has been shown to reduce systolic and diastolic pressures, increase oxygen saturation, reduce heart rate, and improve arterial pressure and skin blood flow.  A combination of exercise and massage has been shown to improve arterial blood flow and ankle-brachial index in patients with Stage I or Stage IIA PAD (peripheral artery disease).

People with diabetes are twice as likely to suffer from depression and anxiety, which can complicate the management of diabetes. Massage therapy has been found to reduce depression and anxiety.  It increases dopamine, thereby improving mood and reducing the effects of stress. It releases a natural antidepressant and antianxiety hormone called oxytocin.

Insomnia is associated with a lack of serotonin.  Massage stimulates your body’s production of serotonin.  Serotonin is needed for our bodies to produce melatonin which influences the sleep stage of our circadian rhythm.  Insomnia also increases stress hormones in your body, which causes the body to store fat and makes it more difficult to lose weight. It also interferes with the body’s ability to use insulin effectively, and may be a risk factor for developing diabetes.Massage therapy lowers levels of the stress hormones cortisol, adrenalin and noradrenaline.

Diabetes may affect the musculoskeletal system in a variety of ways. The metabolic disturbances in diabetes result in changes in the connective tissue. Some clinical manifestations of connective tissue damage include, Limited Joint Mobility, Trigger finger, Carpal Tunnel Syndrome, Frozen shoulder, and stiff hand syndrome.  Massage will help to increase mobility and tissue elasticity addressing these conditions.  However, the effects of connective tissue damage become most clearly visible in the diabetic foot, where the interaction between vascular damage, neuropathy and limited joint mobility has dramatic consequences.  In fact, the National Diabetes Information Clearinghouse declares the most common reason for hospitalization of diabetics is foot-related complications.

Foot problems in diabetics, including nerve damage or peripheral neuropathy, usually begin with vascular disease.  It is believed that damaged circulation is the major cause of nerve damage that results in numbness or pain and burning sensations in the lower extremities of diabetics.  Once nerve damage progresses, it triggers loss of motor control and the abnormal gait that can result in ulcers, hospitalization or even amputations.

Massage increases the supply of oxygen and nutrients to the nerves.  It improves insulin absorption in the cells. Massage is known to increase circulation in the general population, but a recent study has shown that massage improves blood circulation in the lower limbs of type 2 diabetic patients and may be useful to slow the progression of PAD.  Foot massage can reduce neuropathy, ischemia, and swelling, as well as speed healing of wounds, and identify sores and calluses that, if left untreated, may lead to serious complications.

Hopefully, as diabetics understand and experience the benefits of massage therapy, the Medical Community will recommend that they can consider it a valuable part of their integrated health care program.

By: Michelle Taylor, BS, LMBT #6648