| Medical Massage and Control of Arterial | | | | Treatment Method and Approach |
| Hypertension | | | | The main objective of this pilot study was to |
| A Pilot Study | | | | determine whether or not the elimination of |
| By Boris Prilutsky | | | | somatic abnormalities in the reflex zones would |
| The medical benefits of massage therapy in | | | | bring about an elimination of pain symptoms |
| cases of musculoskeletal abnormalities are gaining | | | | (neck, upper back and headaches), increased |
| acceptance from health practitioners. However, | | | | range of motion and hypertension reduction. This |
| another advance in cases of various inner organ | | | | hypothesis was first proposed in 1973 by |
| disorders, as of yet, is not recognized. In an | | | | Professor Alexander Dembo of Leningrad. |
| attempt to bridge the gap between the two | | | | Unfortunately, his work was never fully embraced |
| developments, I, with the cooperation of Victor | | | | in the United States, hence my decision to |
| Gura, M.D. (an associate clinical professor at the | | | | replicate the pilot study in this country. |
| UCLA School of Medicine), have conducted a pilot | | | | Six participants were involved: Two Caucasian |
| study using six subjects with diagnosed arterial | | | | females ages 34 and 54; three Caucasian males |
| hypertension. Ross Turchaninov, M.D. (medical | | | | ages 42, 60 and 65; and a 32-year-old African |
| massage practitioner) advised on the | | | | American male. |
| project’s protocol. | | | | All the research subjects were diagnosed with |
| Chain Reaction | | | | hypertension, combined with somatic abnormalities: |
| Medical massage therapy is a soft tissue | | | | Headaches, dizziness, pain and tension in the |
| mobilization method. Several factors explain its | | | | cervical and upper thoracic areas, referral of pain |
| physiological effects. Medical massage creates a | | | | to the upper extremities, and range of motion |
| mechanical acceleration of venous blood flow and | | | | restrictions in the cervical spine and shoulder joints. |
| lymphatic drainage, mechanical breakdown of | | | | Diagnostic evaluation of somatic components |
| pathological accumulation (e.g., soft tissue | | | | revealed abundant abnormalities in the skin, |
| calcifications), and passive exercise on soft | | | | connective tissue zones, skeletal muscles and the |
| tissues. By mobilizing the skin, connective tissue, | | | | periosteum in the neck, anterior, lateral and |
| muscle tissue and the periosteum, receptors | | | | posterior surfaces of the thoracic cage, as well as |
| located in these areas are stimulated, generating | | | | in the upper extremities. Each subject received a |
| afferent electrical impulses. These impulses reach | | | | treatment every other day for a total of 15 |
| the central nervous system, stimulating the body | | | | treatments, followed by a two-week interim, and |
| to react via beneficial reflex mechanisms. The end | | | | then an additional course of 15 treatments. |
| results are vasodilation (resulting in decreased | | | | Hemodynamic examinations — cardio work, |
| blood pressure and heart rate), increased arterial | | | | peripheral vascular resistance and blood pressure |
| blood supply to tissues, muscular tension release | | | | — were conducted prior to the start of |
| and other healthful reactions. | | | | treatments and upon their conclusion. |
| Explaining EH | | | | The protocol for each session included three |
| The control of increased arterial blood pressure in | | | | stages Ñ introduction, body of the work and |
| those with hypertension is an important medical | | | | conclusion. During the introduction stage of the |
| and social challenge. Hypertension is considered to | | | | session, treatment began by releasing tension in |
| be a major cause of heart attacks and strokes. | | | | the cervical and upper shoulder muscles using |
| An interesting fact, however, is that out of all | | | | medical massage techniques in the inhibitory |
| hypertension cases, only 10 percent of patients | | | | regimen, a process of minimizing disconnection. |
| have an established cause explaining their | | | | For example, every receptor has its own level of |
| condition. For example, narrowing of the aorta, | | | | adaptation, which means its capability to produce |
| adrenal tumors or glomerulonephritis produces | | | | electrical activities (also known as impulse or |
| hypertension secondarily. In 90 percent of | | | | action potential). To work in the inhibitory regime |
| patients, the cause of hypertension is unknown. In | | | | means to minimize disconnection and to keep a |
| such cases, the patient has “essential | | | | rhythm of 70Ð80 movements per minute while |
| hypertension” or EH. | | | | gradually increasing pressure. Receptors will |
| Modern conventional medicine recognizes an | | | | eventually not produce any more action potential, |
| imbalance between the sympathetic and | | | | but the flow of afferent neural impulses from the |
| parasympathetic divisions of the autonomic | | | | contact area of our hands will continue. The |
| nervous system as the initial trigger of EH. An | | | | motor and vasomotor centers include |
| increase in sympathetic tone produces arteriolar | | | | pain-analyzing systems, responding in vasodilation |
| vasoconstriction with a subsequent increase in the | | | | and dispolarization of the neuron, causing a |
| peripheral vascular resistance. At the onset, these | | | | reduction of pain sensation and muscular |
| changes exhibit a transient character and the | | | | relaxation. This approach aimed at reducing the |
| body uses self-regulatory mechanisms to restore | | | | sympathetic tone and restoring balance between |
| the proper relationship between sympathetic and | | | | the sympathetic and parasympathetic divisions of |
| parasympathetic tones. This is why in earlier | | | | the autonomic nervous system. During the main |
| stages there are episodes of increased arterial | | | | stage of the treatment, work proceeded toward |
| blood pressure, without symptoms of | | | | cardiac reflex zones in the skin, connective tissue, |
| hypertension. With time and repeated episodes of | | | | skeletal muscles and periosteum according to the |
| hypertension attacks, the body resets special | | | | zone maps of physicians O. Glezer and V.A. |
| receptors, called baroreceptors, in the arterial | | | | Dalicho (see illustration at left and “The |
| circulation to the new level, and the elevation of | | | | Development of Modern Medical Massage” on |
| arterial blood pressure becomes sustained. As we | | | | page 68). Direct massage influence was generated |
| have found, a correctly formulated protocol of | | | | on the areas of the vertebral arteries. This |
| medical massage therapy may play a critical role | | | | bodywork included gentle pressure and circular |
| in controlling arterial blood pressure in some | | | | motions on the localization of the insertion of the |
| patients with EH. | | | | vertebral artery to the brain’s circulatory |
| The Physiology | | | | system. Taking the distance from the mastoid |
| First, let’s quickly review how medical | | | | process and C2 spinal process, the localization of |
| massage therapy affects the arterial blood | | | | this point will be one-third the distance from the |
| pressure in patients with EH. There are three | | | | mastoid process. By gently placing the finger |
| major mechanisms which massage practitioners | | | | there, the practitioner will be able to feel a pulse. |
| should use to help patients with hypertension: | | | | Gentle, circular motion causes vasodilation of the |
| Balance the sympathetic and parasympathetic | | | | vertebral artery, which originates from the |
| divisions of the autonomic nervous system, | | | | sub-clavian artery. Now we have the capability to |
| vasodilate the vertebral arteries and reduce | | | | influence if we massage the area where the |
| peripheral vascular resistance. These three | | | | anterior scalene muscles insert into the first rib. |
| mechanisms are intimately correlated, hence the | | | | For a practical demo please visit |
| need to discuss them together as parts of the | | | | Peripheral vascular resistance (in the skeletal |
| same process. | | | | muscle groups of the upper and lower |
| Vertebral arteries arise from the subclavian | | | | extremities) was reduced by using a combination |
| arteries. They ascend through the cervical | | | | of different kneading techniques especially |
| vertebrae and enter the skull where they unite to | | | | designed for this purpose. In the final stage of the |
| form the basilar artery, supplying the posterior | | | | session, post-isometric muscular relaxation of the |
| part of the brain. The vertebral arteries also give | | | | cervical musculature was applied. In cases of |
| off two important arterial branches that supply | | | | prolonged accumulation of pathological tonous in |
| the entire spinal cord: The anterior spinal artery | | | | muscles, muscle fibers could be constricted |
| and two posterior spinal arteries. The pathway of | | | | creating an energetic imbalance inside the muscle. |
| the vertebral arteries through the cervical | | | | Any movement overloads the constricted part of |
| vertebrae is quite complex. The transverse | | | | the muscle, meaning that the more exercise is |
| process of each cervical vertebra has a special | | | | performed, the more pathology is accumulated. |
| opening called the transverse foramen through | | | | At the time of isometric tension (30 seconds), |
| which the vertebral artery passes. Cervical | | | | muscles will stretch instead of shorten, helping |
| vertebrae are positioned on top of one another | | | | balance the tonous of muscles. After the 30 |
| such that these openings form a bony canal | | | | seconds, post-isometric stretching is performed, |
| through which the vertebral arteries ascend. | | | | which additionally contributes to this balancing. |
| The walls of vertebral arteries have their own | | | | Results and Discussion |
| sympathetic plexus innervation, regulating their | | | | It’s important to remember that this pilot |
| constriction and dilation. It follows that any | | | | study was conducted to determine if more |
| irritation to this plexus may result in their | | | | scientifically organized, double-blinded studies should |
| contraction. Even a minor facet joint subluxation, | | | | be designed. Thus, results were not statistically |
| which may not even be visible by radiographic | | | | examined due to the small group of subjects and |
| means, can produce an irritation slightly | | | | are to be treated anecdotally. However, these |
| compressing the vertebral arteries. This | | | | results are important in that they open the door |
| constriction may lead to a reduced blood supply | | | | for discussion within the profession and give |
| to the brain, which in turn will cause further | | | | massage practitioners important information to |
| vasoconstriction in an attempt to compensate for | | | | discuss with other health practitioners. |
| compromised circulation. The result is an inevitable | | | | At the end of the course of treatment, all |
| increase in blood pressure or EH. | | | | subjects reported the disappearance of their |
| Other mechanisms that may cause a decrease in | | | | somatic complaints. It was also evident, upon |
| blood flow through the vertebral arteries are | | | | palpatory examination, that clinical symptoms |
| cervical spondylosis, emotional stress and physical | | | | were eliminated from reflex zones in the skin, |
| overload of the neck and upper back muscles. As | | | | fascia, skeletal muscles and periosteum. As |
| a result of these, a hypertonus develops in the | | | | originally expected, the elimination of somatic |
| cervical muscles. In order to maintain proper | | | | abnormalities was accompanied by normalization |
| function, the brain’s daily perfusion has to be | | | | of blood pressure and restoration of proper |
| approximately 2,000 quarts of arterial blood. This | | | | hemodynamics in all participants. |
| rate is regulated by special vascular receptors in | | | | Potential Impact |
| the arterial structures of the brain. Even a minor | | | | The results of this pilot study provide the |
| reduction in the amount of blood circulation | | | | opportunity for the design of a larger |
| triggers compensatory reactions such as an | | | | double-blinded study that will be conducted under |
| increased heart rate, increased cardiac output and, | | | | the supervision and participation of Gura. At this |
| most importantly, an increased peripheral vascular | | | | point, volunteer subjects are being sought to |
| resistance. | | | | participate in this new study. Volunteers must |
| Peripheral vascular resistance is a major opposing | | | | have at least a six-month history of EH. The |
| force to the heart’s work. Every time the | | | | study will include those who are and are not |
| left ventricle ejects blood, the force of the | | | | already taking medications. Age and gender do |
| cardiac contraction has to overcome the | | | | not matter. Those enrolled will receive a complete |
| resistance of arterial vessels (especially on the | | | | physical examination, blood tests, hemodynamic |
| level of middle-sized arteries in skeletal muscles). | | | | reports and treatments at no cost. Researchers |
| Thus, an increased sympathetic tone triggers | | | | will also conduct diagnostic evaluations of somatic |
| arteriolar vasoconstriction, which increases | | | | abnormalities in the reflex zone areas of the |
| peripheral vascular resistance, resulting in the heart | | | | participants. |
| having to work harder to pump blood. | | | | The potential impact of further studies is evident. |
| The body has a protective mechanism designed | | | | More than 50 million Americans are suffering from |
| to safeguard the blood supply to the brain. If | | | | EH, according to the U.S. Academy of Cardiology. |
| circulation in the vertebral arteries decreases even | | | | Medications to control it have an array of side |
| slightly, peripheral vascular receptors report to the | | | | effects, including impotence in males. Add the |
| vasomotor center in the medulla oblongata and | | | | enormous costs endured by individuals and |
| the heart rate increases. At the same time, | | | | insurance companies to treat it, and it’s easy |
| motor (efferent) impulses are sent to the | | | | to see that massage, as performed in this pilot |
| vascular structures in the skeletal muscles to | | | | study, would be an inexpensive and welcome |
| constrict and decrease local arterial blood flow. | | | | course of therapy. Since 1973, this massage |
| This change allows for an extra amount of arterial | | | | method has been utilized in the former Soviet |
| blood to be available for the restoration of brain | | | | Union and proven to be very effective. If further |
| perfusion. The combination of an increased heart | | | | studies in this country prove that massage |
| rate and an increased peripheral vascular | | | | therapy helps not only to reduce blood pressure |
| resistance triggers hypertension. With a more | | | | but also to stabilize it, then the utilization of |
| persistent vasoconstriction of the vertebral | | | | massage in treating people with high blood |
| arteries, the arterial hypertension becomes more | | | | pressure will be recognized as a legitimate and |
| enduring, resulting in higher systolic and diastolic | | | | effective alternative. |
| blood pressure values. | | | | |