Massage and Medicine

Massage in the context of pain

Massage and Medicine by Renata França

Creator of the massage which is the most desired by the famous, Renata interviews physicians and specialists for J.P. magazine, addressing the benefits of massage for people’s health.

DR. Alessandra Gorgulho

Neurosurgeon at Vila Nova Star, Onco Star and Rede D’Or São Luiz hospitals - Regional Council of Medicine [CRM-SP] Registry NO. 87325

1- Renata França: What led you to the universe of neurosurgery? Alessandra Gorgulho: From my early days in medical school, I always enjoyed neuroanatomy, neurophysiology. Studying the nervous system was very pleasant and interesting. And this was confirmed during the 5 and 6 years in school, when were actually able to work in the different specialties, more closely with hospitalized patients. Surgical pathologies really appealed to me. I also enjoy making more algorithmic decisions, like whether or not a patient needs intervention, comparing different surgery methods etc.

2- RF: What neurological disorders have been most affecting individuals these days? AG: Epidemiologically, cephalgia (or headache) and epilepsy. The most prevalent neurodegenerative diseases are Alzheimer’s Dementia and Parkinson’s Disease. Due to the enhancement of people’s life expectancy, neurodegenerative diseases have become more frequent and more widely known to the general public. This has led to a increased focus by the health agencies in terms of research.

3- RF: Do anxiety and depression contribute to an increase in neurological diseases? AG: They do not increase occurrence of neurological diseases directly, but the coexistence of anxious and depressive symptoms may cause some neurological symptoms to aggravate. Depression may be a consequence of Parkinson’s disease, difficult-to-control epilepsies, chronic neuropathic pain etc. In other cases, anxiety plays a major role in worsening motor neurological symptoms, such as essential tremor, dystonia and Tourette syndrome. Every chronic disease, of moderate to severe intensity, is associated with some degree of concomitant depression, secondary to the limitations imposed by the underlying disease.

A person with migraine concomitantly diagnosed with generalized anxiety or major depression, for example, will experience increased pain surges, of greater frequency and intensity, when psychiatric symptoms are unbalanced. Chronic pain leads to depressive symptoms and depressive mood lowers the threshold of pain tolerability, making the person more vulnerable to the perception of pain.

4- RF: Is the diagnosis of Alzheimer’s still a challenge for neuroscience? AG: Early diagnosis of Alzheimer’s is still complex. An established dementia condition associated with certain changes in complementary exams (MRI, PET-CT and CSF) is diagnosed with relative ease by specialists. A very early condition, with few symptoms, may be identical to a mild cognitive impairment or further types of dementia, other than Alzheimer’s. Over time and as symptoms evolves, the condition may be more safely established.

5- RF: You also focus your work on relieving the suffering of patients. Can massages help patients experiencing such conditions? AG: Patients with acute tension headaches and those with refractory chronic pain can benefit from massages, as it produces muscle relaxation and can gradually raise the painful threshold through exposure to tactile stimuli. Massages may also help in relaxing and improving people’s moods, and interfering with the perception of pain.

6- RF: Are massages recommended for patients in the postoperative period, for instance? AG: They may be recommended, as long as the surgical incision area is preserved. Early recover of the ability to walk after spinal surgery results in better long-term pain control. Very anxious patients may also benefit from such method to promote muscle relaxation and enhance humor.