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Pain Management

Pain and Referred Symptoms

Pain is most often the primary complaint for patients presenting in musculoskeletal practice, but there may be other symptoms that cause them to seek advice, such as stiffness, weakness, numbness and pins and needles. Pain and referred symptoms will form the basis of discussion to help provide clues for diagnosis.
The subject and study of pain is a vast topic, most of which is outside the scope of this website but there are other detailed sources widely available. The International Association for Study of Pain (IASP) produced a revised definition of pain in 2020 describing it as 'An unpleasant sensory and emotional experience associated with, or resembling that associated with actual or potential tissue damage'. This definition can be applied to acute and persistent (chronic) pain and to all painful conditions, regardless of their biological pain mechanism. There are three pain mechanisms within the context of movement system and psychosocial factors.
Nociceptive - Due to activation of nociceptors: inflammation, injury, mechanical and chemical irritant. Example - Ankle sprain, degenerative arthropathy, rheumatoid arthritis.
Nociplastic - Due to alteration in central pain processing within Central Nervous System (CNS): enhanced central excitability and/or diminished central inhibition.
Example - Persistent non-specific low back pain, fibromyalgia, migraine.
Neuropathic - Due to pathology or disease of the somatosensory system.
Example - Spinal nerve root compression, carpal tunnel syndrome, diabetic neuropathy.


Psychological and physical vicious cycle of pain. (Adapted from Vlaeyen and Linton, 2012) 

Movement and Stress

Human joints have to withstand considerable forces day to day from compression, shearing and tension. To do this they have evolved layers of tissues and mechanisms to protect against and dissipate the forces that daily activities generate. Movement and stress always result in mechanical deformation of tissues and structures in the body because tissues undergo an elastic deformation when they are stretched. This deformation allows the tissue to rebound to its original shape and length if it is stretched within its normal limits. If the tissue is stressed beyond its physical limitations of elastic phase, it will fail to return to its original structure and will be lengthened (called the plastic phase of deformation). Stressing the tissue beyond its maximum capacity will result in a tear of that tissue. Not undergoing a healthy deformation within the elastic phase because of lack of activity or immobilization will inhibit joints from regenerating optimally. The end result is tissue thickening, insufficient water in the tissue matrix, loss of tissue elasticity, collagen cross-bridging and shortening of tissue. There will be a loss of range of motion of joints and the patient will experience joint stiffness and difficulty in moving. Healthy movement through the joint tissue can aid tissue repair and recovery. Joint articulation is commonly used as a technique in manual therapy that has been shown to be effective at reducing musculoskeletal pain. Articulations are often used with the objective to increase the range of motion of the joint through stretching of fibrous tissue and by affecting the stretch reflex excitability. Manual therapy can aid mechanotherapy by enabling the patient to return to physical activity as quickly as possible and promoting healthy cellular homeostasis.   

Joint Pain

There are various possible causes of joint pain. It could be brought on by an injury or a longer lasting problem or condition. It's recommended that you see a doctor if the pain is frequent or persist. It can affect people of all ages and intensity can vary from person to person. Joint pain may be accompanied with swelling, stiffness, redness and/or limited range of movement. According to the NHS website common types of pain include; knee, shoulder, hip, foot (including ankles & toes), hands (including wrist & fingers), elbows and neck. Pain can be felt in more than one joint at the same time. Symptoms of joint pain can vary from each person depending on the underlying cause.
Sometimes the pain may go away without needing any treatment, but if treatment is needed, your GP may prescribe painkillers, antibiotics (if infection is suspected), make a referral to a physiotherapist or hospital for scans and specialist treatments (steroid injections or surgery).
Massage therapy can help the surrounding anatomy around the joints to function properly helping to alleviate pain and increase range of movement. Massage therapy should be avoided at the start of an acute injury such as a broken bone, sprain or fracture as this may exacerbate instead of alleviate pain.

Massage Therapy Treatments

Massage therapy is a safe and effective treatment for a variety of physical and mental ailments. Massage therapy can be applied along side other treatments as a complement, as well as a stand alone treatment. It can help to reduce stress, pain, and inflammation without the side effects of medications. Massage treatments can also help to improve sleep, circulation, flexibility, and overall well-being.

These are some of the disorders massage and soft tissue therapy treatments can help with, aiding in recovery and pain relief:​​

Stress and Anxiety

Neck Pain / Whiplash

Shoulder Pain / Frozen Shoulder

Upper & Lower Back Pain

Tension, Headaches & Migraine

Sciatica, Trapped & Pinched Nerves

Hip & Knee Pain

Stiff & Painful Joints

Repetitive Strains & Sprains


Tennis & Golfer's Elbow

Piriformis Syndrome

Plantar Fasciitis

Carpal Tunnel

Arthritic & Rheumatic Pain


Sports Injuries 

Injuries Caused At Home or Work

Muscle Imbalance & Postural Dysfunction


Massage therapy is a holistic approach to health and wellness, providing a variety of treatments to promote relaxation, reduce stress, and improve overall body functioning. It is essential to note that massage therapy is not a cure, but instead works to create harmony within the body so that it can help to heal itself (homeostasis). 

If you have underlying conditions, please seek advice from your GP before booking.

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