ABMP Comments Re: Draft Report on Pain Management Best Practices

TO: U.S. Department of Health and Human Services (HHS) Pain Management Best Practices Task Force

RE: ABMP Comments re: Draft Report on Pain Management Best Practices: Updates, Gaps, Inconsistencies, and Recommendations (HHS-OS-2018-0027)

Associated Bodywork & Massage Professionals (ABMP) provides continuing education, professional liability insurance, business resources, professional publications, and legislative and regulatory advocacy. ABMP represents more than 80,000 members nationwide.

We are responding to the “Draft Report on Pain Management Best Practices: Updates, Gaps, Inconsistencies, and Recommendations.” We appreciate that this report recognizes and promotes the use of massage therapy and bodywork treatments as effective pain treatment methods. Massage therapy and bodywork treatments are effective treatments for a range of health issues including pain management and treatment. The report significantly advances discussions about meaningful pain management. We believe systems of care that combine interventional techniques with restorative movement therapies and incorporate aspects of mind-body awareness have far-reaching benefits for individuals and society.

As the report states: “Massage therapy can be effective in reducing pain. There are a variety of types of massage therapy, including Swedish, shiatsu, and deep tissue (myofascial release). In Swedish massage, the therapist uses long strokes, kneading, and deep circular movements. Shiatsu massage uses the fingers, thumbs, and palm to apply pressure. Deep tissue massage focuses on myofascial trigger points, with attention on the deeper layers of tissues.”

We support the task force’s recommendations to “conduct further research to provide evidence-informed data” and reduce barriers to accessing restorative therapy modalities as part of a multidisciplinary approach to care.

The report further states:
“Massage and manipulative therapies including osteopathic and chiropractic treatments, are commonly used for pain management. Such interventions may be clinically effective for short-term relief and is best accomplished in conjunction with consultation with the primary care and pain management team... Other reviews recognize positive clinical effects on various pain conditions, including postoperative pain; headaches; and neck, back, and joint pain."

With regard to complementary and integrative health approaches, we support the recommendation to include massage and manipulative treatments as part of a holistic pain treatment plan. Practitioners of the various massage and bodywork modalities undergo extensive education, hands-on training, licensure and/or certification to ensure the methods are safe and effective.

Increasingly, various states recognize the pain-management benefits of massage therapy when they are addressing the opioid epidemic. A recent study by Healwell and MedStar Health Research Institute studied the benefits of massage therapy on pain, medication use, and patient satisfaction in a palliative setting in a teaching hospital. The pilot project found that patients experienced a 30% decrease in pain scores following a massage therapy session: “‘Hands-On’ Palliative Care: Integrating Massage Therapy for Palliative Care Patients in Pain,” Anne Kelemen, LIC SW; Hunter Groninger, MD; Lauren Cates, LMT; Mihri Mete, PhD; Gianna Shipp; Catherine A. Walker, PharmD, 2017. www.healwell.org/wp-content/uploads/Lathum-Poster.- FINAL.pdf. Many people seek massage therapy when they are experiencing pain—particularly low-back pain—to holistically manage their symptoms.

ABMP appreciates the report’s recognition of the importance and effectiveness of restorative therapy, complementary, and integrative health approaches in addressing the national pain management epidemic. Prioritizing nonpharmacologic treatment approaches embraces a holistic approach to pain management and we view this strategic approach as a positive and productive way forward.

Thank you for the opportunity to comment as well as the time and effort you’ve invested in this thorough, thoughtful document. Please contact me at laura@abmp.com or 303-679-7645 if you have any comments or questions.

Sincerely,

Laura B. Embleton
Government Relations Director