The Claim: Lying on Your Left Side Eases Heartburn

21291064_s
Source: The New York Times, By ANAHAD O’CONNOR
Date: October 25, 2010THE FACTS For people with chronic heartburn, restful sleep is no easy feat. Fall asleep in the wrong position, and acid slips into the esophagus, a recipe for agita and insomnia.

Doctors recommend sleeping on an incline, which allows gravity to keep the stomach’s contents where they belong. But sleeping on your side can also make a difference — so long as you choose the correct side. Several studies have found that sleeping on the right side aggravates heartburn; sleeping on the left tends to calm it.

The reason is not entirely clear. One hypothesis holds that right-side sleeping relaxes the lower esophageal sphincter, between the stomach and the esophagus. Another holds that left-side sleeping keeps the junction between stomach and esophagus above the level of gastric acid.

In a study in The Journal of Clinical Gastroenterology, scientists recruited a group of healthy subjects and fed them high-fat meals on different days to induce heartburn. Immediately after the meals, the subjects spent four hours lying on one side or the other as devices measured their esophageal acidity. Ultimately, the researchers found that “the total amount of reflux time was significantly greater” when the subjects lay on their right side.

“In addition,” they wrote, “average overall acid clearance was significantly prolonged with right side down.”

In another study, this one in The American Journal of Gastroenterology, scientists fed a group of chronic heartburn patients a high-fat dinner and a bedtime snack, then measured reflux as they slept. The right-side sleepers had greater acid levels and longer “esophageal acid clearance.” Other studies have had similar results.

THE BOTTOM LINE Lying on your right side seems to aggravate heartburn.

Can’t get comfortable lying on your side? Well you can now with the Mumanu Pillow. Buy yours today for the most comfortable night’s sleep.

Mumanu pillow range

Doctors Increasingly Ignore Evidence In Treating Back Pain

10108848_s
Source: Alcorn Public Radio, by The Editor
Date: July 30, 2013The misery of low back pain often drives people to the doctor to seek relief. But doctors are doing a pretty miserable job of treating back pain, a study finds.

Physicians are increasingly prescribing expensive scans, narcotic painkillers and other treatments that don’t help in most cases, and can make things a lot worse. Since 1 in 10 of all primary care visits are for low back pain, this is no small matter.

What does help? Some ibuprofen or other over-the-counter painkiller, and maybe some physical therapy. That’s the evidence-based protocol. With that regimen, most people’s back pain goes away within three months. [Or much faster with a Mumanu Pillow]

But when researchers at Beth Israel Deaconess Medical Center in Boston looked at records of 23,918 doctor visits for simple back pain between 1999 and 2010, they found that doctors have actually been getting worse at prescribing scientifically based treatments.

Doctors were recommending NSAID pain relievers and acetaminophen less often. Instead, they were increasingly prescribing prescription opioids like OxyContin, with use rising from 19 percent of cases to 29 percent. Over-the-counter painkiller use declined from 37 percent to 25 percent. Other studies have found that opioids help only slightly with acute back pain and are worthless for treating chronic back pain.

“That’s a big public health issue,” says Dr. John Mafi, chief medical resident and a fellow at Beth Israel Deaconess. Mafi was the lead author of the study, which was published online in JAMA Internal Medicine. In the 1990s doctors were criticized for ignoring patients’ pain, Mafi says. Some of that criticism was valid, but doctors have overreacted. “What magic bullet better than a very powerful pain medication?”

About 43 percent of patients taking opioids for chronic back pain also had other substance abuse disorders, the researchers found. In 2008, almost 15,000 people died from overdoses of prescription opioids, and abuse has surged among women. Opioids may be necessary in some cases, Mafi says, but “they’re certainly not first-line.”

Doctors were also quick to whip out the prescription pad and call for CT and MRI scans for people with lower back pain, the study found. The number of people getting scans rose from 7 to 11 percent. Though those scans won’t hurt the patient, in most cases they don’t find anything wrong. And they are expensive, costing $1,000 or more.

Patients are partly to blame for the rush to scan, Mafi says. “Patients are expecting very comprehensive evaluations,” he tells Shots. “There’s a sentiment perhaps if my doctor ordered an MRI for my back pain they really listened to me. It’s almost validating.”

And in an era when doctors are rated online by patients, “doctors have an incentive to make patients happy,” Mafi says.

Financial incentives for doctors may also be a factor. This study didn’t examine why doctors aren’t following clinical guidelines for treating back pain, but other studies have found that when doctors own imaging equipment, they are more likely to use it.

Doctors should be cut a little slack, a journal commentary accompanying this study says, because guidelines have been conflicted on back pain treatment until recently, and it takes 17 years, on average, for new treatment standards to be widely adopted. But creating checklist-type guidelines for doctors would help speed that process, the commentary says. So would requiring patients to pay more of the cost of expensive imaging, and providing payment incentives for doctors who do the right thing.

“For the majority of new-onset back pain [cases], it gets better within three months,” Mafi says. “Unfortunately, we don’t have fancy treatments that cure it.” Time, some ibuprofen and gentle exercise aren’t sexy. But they most often do the trick.

Copyright 2013 NPR. www.npr.org

Relieve your lower back and hip pains naturally, quickly and easily with the Mumanu pillow. This revolutionary, versatile self-inflating pillow works while you sleep, sit and exercise. Find out more

Mumanu Side Sleeper Pillow

Do You Have Sciatica Hip Pain?

Man suffering from sciatica
Source: Low Right Back Pain HQ
Photo from Boots.com
23rd May 2013The largest nerves found in the human body are the sciatic nerves. Measuring approximately the same size in diameter as a little finger, the nerves exit the spinal column in the lumbar region, travel behind the hip and continue down through the buttock and the back of each leg to the foot. The length and size of the nerve creates a host of symptoms unique to sciatica hip pain.

Sciatica Symptoms

Unlike common lumbar pain, sciatica hip pain typically begins toward the hip region and travels down the affected leg, sometimes down to the foot. Depending on the impingement, the pain varies from annoying to disabling. The sensation ranges from tingling or burning to a deep, sharp shooting pain. The painful sensation often originates or worsens with movement or position changes that include standing from a sitting position. Coughing, laughing, sneezing or having a bowel movement often also intensifies pain.

Some individuals also might experience pain in one region of the leg and numbness in another. Some may experience a weakening in the leg or foot accompanied by sciatica hip pain. The weakness may become so severe that mobility becomes difficult.

Sciatica Causes

The discomfort begins when the nerve sustains compression or irritation. The pain may begin suddenly after lifting a heavy object or moving quickly. Sciatica hip pain also begins when various physiological changes occur.

Herniated or slipped discs remain the most common contributing factor. The discs lie between each vertebra and consist of a tough exterior and a gel like interior. Approximately the shape and size of a common checker, the discs provide shock absorbing cushioning. If the outer covering of the disc ruptures, the gelatinous interior oozes through the disc and compresses the sciatic nerve.

Spinal stenosis often occurs during the normal aging process and involves a narrowing of the vertebral space that surrounds the spinal column. The excess bone applies direct pressure to the sciatic nerve. People suffering from spinal stenosis often experience bilateral sciatica or discomfort radiating toward both hips.
Other aging factors that contribute to the condition include osteoarthritis or fractures caused by osteoporosis.

Spondylolisthesis refers to the condition involving a vertebra shifting out of place and over the adjoining vertebra, which compresses the sciatic nerve.

Piriformis syndrome describes the circumstance when the sciatic nerve becomes pinched or trapped by the piriformis muscle of the buttock.

Though rare, blood clots, systemic infections or tumors might also create the condition.

Seek Medical Attention

Individuals suffering sciatica hip pain should seek medical intervention under the following circumstances:

* Symptoms persist longer than three days or become progressively worse.
* Anyone younger than 20 or older than 55 experiencing sciatica for the first time.
* If currently diagnosed with cancer or have a history of cancer.
* If recently experiencing severe weight loss, unexplained chills or fever accompanied by back pain.
* Have a diagnosis of HIV positive.
* Use IV drugs.
* Experience difficulty bending forward for more than one or two weeks.
* Unexplained and increasing leg weakness.
* Inability to feel sensation or move the legs or feet.
* Unbearable pain not relieved by OTC medications or other first aid treatments.
* The pain occurs after a traumatic injury.
* Experience numbness in the genital region, lose bladder or bowel control.

Home Treatment

Avoid positions that increase pain. Lie on your back with a Mumanu support pillow under the knees, or assume a side lying position with a Mumanu support pillow [under the top leg] to maintain hip alignment. However, remaining immobile for extended periods of time often exacerbates the condition. Take OTC anti-inflammatory medications per label instructions unless contraindicated if also taking prescription blood thinning medications. Apply an ice pack to the area. Alternate using ice packs with moist, warm heat. You may also check out these [stretches for sciatica]

Researchers Study the Cycle of Chronic Back Pain and Depression

7374822_s
Source: Nature World News.com by staff reporter
Apr 22, 2013Depression and chronic pain in the lower back often reinforce each other, according to a researcher from Australia. People with back pain are more likely to be depressed and people who are depressed can’t cope with pain.

The key in fighting this type of a pain-cycle is to stop it in its earliest stages. The study was conducted on a group of 300 patients who were receiving treatments for their back pain.

“The important thing is that doctors act quickly and do not wait for more severe symptoms to develop. Patients might not need anti-depressants; a variety of other treatments such as relaxation, biofeedback and cognitive behavioural therapy could help,” professor Markus Melloh from Western Australian Institute for Medical Research (WAIMR) said in a news release.

The study also included researchers from University of Berne in Switzerland. Researchers found that study participants who had symptoms of depression at the beginning of the treatment also had higher back pain scores after three weeks.

Also, participants who had back pain after three weeks were more likely to have signs of depression.

“Knowing about the reciprocal relationship between depression and back pain can make a real difference in the effectiveness of treatments for patients,” said Melloh.

The study is published in the journal Psychology Health & Medicine.

About 350 million people in the world suffer from depression, according to data from the World Health Organization.

Sleep Well, Live Well… Suffering from back pain? The Mumanu relieves lower back and hip pain while you sleep. www.mumanu.com

mumanu-show-poster-male.jpg

Recent Research Questions the Effectiveness of Back Surgery

8719766_s

Source: San Francisco Chronicle, Sturgeon Bay, WI (PRWEB) May 29, 2013

An estimated 38 to 50 billion dollars is spent yearly for the surgical treatment of lower back pain in the United States. While this is commonly accepted as the price to pay for this debilitating condition, Chiropractor and Naturopath Dr. J G Moellendorf examines two recent research studies and a neurosurgical university’s health policy questioning surgery’s effectiveness and cost.

Many victims of chronic low back pain turn to surgery when the muscle relaxers, anti-inflammatories, and pain killers fail. Considering the recent research, Sturgeon Bay, Wisconsin Chiropractor and Naturopath Dr. J G Moellendorf, DC, ND, LCP questions whether less costly alternatives to very expensive spinal surgeries might be a better solution.

A research team led by Dr. Benjamin J Keeney looked at workers compensation injuries in the state of Washington to determine if it could predict which work injuries would result in back surgeries. Their results were published in the May 15, 2013 issue of the journal Spine titled Early Predictors of Lumbar Spine Surgery After Occupational Back Injury: Results From a Prospective Study of Workers in Washington State. Out of 1,885 injured workers, 174 (9.2%) had low back surgery within 3 years of injury. The researchers discovered that if an injured worker was first seen by a surgeon, 42.7% would result in surgery, while if first seen by a Chiropractor, only 1.5% had surgery. The rate of an expensive surgery was reduced by 96.5%, just by the choice of the first doctor consulted.

Dr. Anne Froholdt’s research group at the Oslo (Norway) University Hospital followed chronic low back pain patients across a nine year period. Participants were randomly assigned to two groups. The first group had lumbar spinal fusion, while the second received cognitive training on doing daily activities without worrying about further injury, along with endurance and coordination exercises. Publishing their results in the December 2012 issue of the European Spine Journal, they found that during the nine years studied, of those who had spinal surgeries, one-third were operated on again. Of those in the non-surgery group, one-third opted to have surgery done. There were no notable differences in daily rated pain intensity, fear-avoidance beliefs, spinal muscle strength, and use of medication between the two groups. Both groups reported significantly less back and leg pain, less fear-avoidance beliefs, less emotional distress, and improved general function. Sixty-eight percent of those having surgery were out of work, while only forty-two percent of the non-surgery group were not working. Forty-four percent of the lumbar fusion group used medications for pain compared to seventeen percent in those who did not have surgery. Seventeen percent of those having surgery were dissatisfied with their results compared to only three percent among those who did not have surgery.

Dr. J G Moellendorf, DC, ND, LCP asks, “Why would we spend billions of dollars yearly on spinal surgery that has no better results than conservative therapies, while having increased disability rates and higher dissatisfaction with results?”

Realizing the high failure rate and heavy costs of back surgery, the University of Pittsburgh Medical Center (UPMC) health plan analyzed recent research for treating chronic low back pain. On January 1, 2012, UPMC implemented a comprehensive clinical initiative focused on the treatment of chronic low back pain. All lower back surgeries other than surgical emergencies require prior determination for surgical necessity. The policy states:

“To be considered for surgery, patients with chronic low back pain must have:

“This policy was developed using evidence-based literature and professional society guidelines, as well as the input of external medical professionals with expertise in the area”

8 Types of Low Back Pain that Mean You Should Visit Your Doctor

13655194_m
Source: advancingyourhealth.org by Susan Dreyer, MDOver 80% of the population will suffer from lower back pain at some point in their lives. Low back pain is a common complaint in medical offices and is a common issue causing many people to miss work and be unable to participate in daily life activities. Sometimes back pain is due to a pulled or strained muscle and many times will not require a trip to your doctor’s office. Other issues such as fractures, tumors and infections of the spine are very serious and need to be evaluated by a physician promptly.Patients should see a doctor immediately if they experience low back pain as a result of severe trauma. Patients should also make an appointment with a doctor if low back pain is accompanied by any of the following: fever, loss of bowel or bladder control, serious trauma, numbness, unplanned weight loss, personal history of cancer, back pain that persists more than 6 weeks, or severe night pain.

Fever and Back Pain
Fever combined with back pain can indicate an infection in your kidneys or back. A primary care physician can determine if you need antibiotics to eliminate the infection.

Loss of control of your bowel or bladder and Back Pain
If you have back pain along with new incontinence, you could have a serious back condition causing pressure on the nerves that requires immediate medical care.

Serious Trauma and Back Pain
Trauma such as a car accident or falling down a flight of stairs can cause a fracture in your back. Seek immediate care from your physician or the emergency department.

Numbness or Tingling in Leg and Back Pain
Numbness on tingling in your leg and back pain could indicate nerve irritation or nerve damage. You could have a herniated disc or spinal stenosis. A doctor can prescribe medications, treatments or even surgery to help relieve the pressure on the nerves.

Unexplained weight loss and Back Pain
If you lose a lot of weight without changing your diet or activity level and have back pain, a doctor should order imaging and blood work to check for cancers or hormonal disorders.

History of Cancer and New Back Pain
If you have had cancer, onset of back pain could be a sign that cancer has spread to you spine. You should visit your physician for further evaluation.

Back Pain at Night
Pain in your back that causes you to lose sleep should not be dismissed. This could be a sign of spinal tumors or even cancer.

Back pain that lasts more than 6 weeks
Any pain that lasts more than a month or two should be evaluated more fully.

If you experience significant trauma and back pain, an evaluation in the Emergency Department is indicated. In most other cases, your primary care physician can evaluate your condition and begin treatment. . If he or she is unable to help with your condition he can refer you to a spine specialist.

Dr. Susan Dreyer
About Susan Dreyer, MD
Dr. Dreyer is an Associate Professor in the departments of Orthopaedics and Physical Medicine & Rehabilitation at Emory University School of Medicine. Dr. Dreyer specializes in non-operative spine care and focuses on helping patients achieve their best functional level. She has taught many national and international courses on spine care and spinal injections for sciatica and other causes of back and neck problems. She is also active in several professional societies. Dr. Dreyer started practicing at Emory in 1992.

The most comfortable pregnancy sleeping position to relieve lower back & hip pain

Sleeping well is so important during pregnancy to have you feeling full of energy and refreshed for the day ahead. Most pregnant women get uncomfortable during the night and as a result find it difficult to sleep well.

TOP TIP: The pillow between the knees is an urban myth. It puts too much pressure on the bottom leg, the knee joint twists which then twists the hip joint and pulls on the lower back. Sleeping with the pillow in foetal position further pulls on the buttocks and lower back muscles and if not supported correctly makes your spine twist. The pillow between your knees also puts pressure on your bladder so more getting up in the night. You also reduce space for your baby which means more kicking.
The Mumanu pillow relieves these problems by keeping your hip, knee and foot at the same height. It’s self-inflating so you adjust it to fit you perfectly. This position allows you to fully relax, takes pressure off your bladder and gives your baby extra space to be comfortable.

The hormone Relaxin makes your joints loser during pregnancy so it’s even more important than normal to get correctly aligned and super comfortable.
Mumanu_Pillow_Relieves_lower_back_pain
To relieve that pulling, heavy feeling in your belly, place a contoured pregnancy belly wedge under your belly to gently lift and bring your pregnant bump up to a neutral position.
Mumanu pillow range
You can purchase the Original Mumanu Pregnancy Pillow and the Mumanu Memory Foam Contoured Pregnancy Belly Wedge by visiting www.mumanu.com

6 Tips for Avoiding Back Pain During Sex

6 Tips For Avoiding Back Pain During Sex
Source: YourTango, by Connie Merk, March 26, 2013For people with lower back pain, just the thought of sexual activity can induce fear instead of excitement. Sex is supposed to be pleasurable, but when it’s associated with physical pain, sexual activity stops. And when that happens, relationships suffer.

The most important advice I can give, not only as someone who is working with back pain patients all the time, but also as someone who suffered from back pain for many years, is to be open with your partner. Communication prevents tension and misunderstandings.

Your partner needs to understand that you haven’t lost your interest in him or her, but that you are afraid of aggravating your pain. Your partner needs to feel that you still love him. Otherwise, your condition could jeopardize your relationship.

Openness is key. Talk about what works for you and what doesn’t — for both of you. It is not just the position that matters. Having sex is more than a performing act. Lovemaking is about closeness, sharing, understanding, pleasure, fun, and orgasm.

There are plenty of ways people can find sexual fulfillment besides penetration. If you’ve never experimented with oral sex, sex toys, different positions, now is the time! Get creative and explore. You may find that your sex life suddenly becomes much more interesting and fun.

Here are some more useful tips:

1. Prepare well. For many people, sex is something that happens spontaneously, and thus they believe that any kind of planning makes it less valuable or less enjoyable. But nothing could be further from the truth.

When you are dealing with acute or chronic back pain, proper preparation for “the act” may be the only way to enjoy the experience. Nothing kills passion faster then a sudden onset of pain or the constant fear that the wrong movement will render you helpless on the bed.

Due to your constant pain, it may be difficult for you to relax and let go. Thus, trying to relax the affected muscles by taking a muscle relaxant or pain killer might help to prepare for the sexual encounter. Or, even better, have your partner join you in a warm bath or hot shower, or give you a gentle massage as part of your foreplay.

2. Try different positions. Plan exactly where to have sex and in what position in order to avoid pain. In the beginning, you might need to try out different positions until you find the right one for you and your partner, where you both can be comfortable.

Try preparing the room with cushions, towels and covers under the knees, head, or lower back for support. Remember, it is all about feeling relaxed so you can enjoy your lovemaking.

If it is the man who suffers from back pain, you may want to try lying on a firm surface and using pillows to support the knee and/or head. A small, rolled towel under the lower back may bring additional comfort. You could also sit on a chair with a back rest and have your partner straddle you.

If it is the woman who suffers from back pain, the missionary position with the legs bent toward the chest may be worth trying out. Sitting on the edge of a chair with your partner kneeling between your legs is also a position that works for many woman. Or, have your partner sit on a chair while you sit on his lap, facing away from him.

Finally, regardless of who suffers from back pain, a side-by-side position may be the best. Both partners should on their sides, she with her back to him. Then, he can enter from behind, which is normally a very comfortable position for both.

3. Don’t rush. Plan your sexual encounter with your partner so that you have all the time in the world. Enjoy what you are doing. Maybe you were never too much into foreplay. If so, now is your chance now to explore that part of lovemaking and get to know your partner in a new, sensual way.

Choose sensuality over sexuality as you may not be as vigorous as you once were.

4. Undress first. As I have said before, when dealing with back pain, thoughtful preparation goes a long way, and not just when it comes to your position. In the throes of passion, we are not necessarily paying attention to anything besides our sensations.

We definitely don’t pay attention to our bodies and how they move. Therefore, undress carefully. You don’t want to struggle to get your clothes off in an awkward position that may knock your back out.

5. Masturbation, oral sex and sex toys. If penetration is too painful for one of the partners, there are plenty of other ways to give your partner sexual pleasures. Oral sex, masturbation and dildos or vibrators are great ways to bring about sexual fulfillment and spice up your sex life.

The most important thing is to communicate openly about what you both like and don’t like, and to explore and experiment with new ways of giving and receiving pleasure.

6. Make sex fun. If you are up for it, why not bring some spice into your bedroom? Try playing doctor.

The more you are distracted from your back pain, the better. Sex raises the spirit and puts you in a better mood. Plus, having an orgasm also relaxes all the muscles in the body, and if your muscles are relaxed, your will feel less pain.

With a bit of preparation and fantasy, suffering from back pain does not mean that you are doomed to a life without sex. On the contrary. You could find that experimenting with longer foreplay, toys, positions and role-plays —things you would have never considered before — can actually spice up your sex life. Just be open with your partner, and have fun!

Mumanu, not just a sleeping pillow! This fabulous pillow is self-inflating so adjust the height to your own comfort. (This position is not recommended from 30 weeks pregnant.) Visit the website for more ways to use the Mumanu

mumanu-back-position-pregnancy

Bad sleep ‘dramatically’ alters body

Sleep
Reprinted from BBC News
By James Gallagher Health and science reporter, BBC News, 26 February 2013

A run of poor sleep can have a potentially profound effect on the internal workings of the human body, say UK researchers.

The activity of hundreds of genes was altered when people’s sleep was cut to less than six hours a day for a week.

Writing in the journal PNAS, the researchers said the results helped explain how poor sleep damaged health.

Heart disease, diabetes, obesity and poor brain function have all been linked to substandard sleep.

What missing hours in bed actually does to alter health, however, is unknown.

So researchers at the University of Surrey analysed the blood of 26 people after they had had plenty of sleep, up to 10 hours each night for a week, and compared the results with samples after a week of fewer than six hours a night.

More than 700 genes were altered by the shift. Each contains the instructions for building a protein, so those that became more active produced more proteins – changing the chemistry of the body.

Meanwhile the natural body clock was disturbed – some genes naturally wax and wane in activity through the day, but this effect was dulled by sleep deprivation.

Prof Colin Smith, from the University of Surrey, told the BBC: “There was quite a dramatic change in activity in many different kinds of genes.”

Areas such as the immune system and how the body responds to damage and stress were affected.

Prof Smith added: “Clearly sleep is critical to rebuilding the body and maintaining a functional state, all kinds of damage appear to occur – hinting at what may lead to ill health.

“If we can’t actually replenish and replace new cells, then that’s going to lead to degenerative diseases.”

He said many people may be even more sleep deprived in their daily lives than those in the study – suggesting these changes may be common.

Dr Akhilesh Reddy, a specialist in the body clock at the University of Cambridge, said the study was “interesting”.

He said the key findings were the effects on inflammation and the immune system as it was possible to see a link between those effects and health problems such as diabetes.

The findings also tie into research attempting to do away with sleep, such as by finding a drug that could eliminate the effects of sleep deprivation.

Dr Reddy said: “We don’t know what the switch is that causes all these changes, but theoretically if you could switch it on or off, you might be able to get away without sleep.

“But my feeling is that sleep is fundamentally important to regenerating all cells.”

Easy Labour Massage for Pain Relief During Childbirth

17755400_l

Massage during labour can either be completely relaxing and help speed up the process, or completely irritating and make the whole event last longer. So how do you know if you’re doing it right?Labour massage is very different from the type of massage you would get on a therapy bed and rightly so. During labour a woman needs to relax and switch off her thinking, judgemental brain so her body can feel safe and open up. Massage, when done correctly, will stimulate the body’s natural feel good, relaxation and labour hormone, oxytocin. The keys to making labour massage effective are repetition, a slow steady speed, comfortable pressure and a confident masseuse.Repetition allows the thinking brain to tune out. There’s no thinking of ‘what are they going to do next’ or ‘go back to what you were doing’. If you’ve ever stroked a cat, you’ll know the effects of repetition and a slow and steady speed. Go too fast or keep changing what you’re doing and the cat will stay wide eyed and interested. Keeping a slow and steady pace just stroking down the back will have the cat purring and lying down in no time. Labouring women are the same… slow and steady repetition will have her relaxed very quickly, even through contractions.Labour massage should never be painful. The techniques used must be solely concentrating on relaxation and not trying to dig into tight muscles. If you’ve ever had a sports massage you’ll know what I mean. We tense and hold our breath when we feel pain. Tensing during labour will affect the whole body and make the pain more intense. So, labour massage needs to be inducing relaxation and pleasure to help the woman cope with strong contractions. She will be able to relax and go with her body far more easily if she is being supported in a relaxed and caring way.

Let’s look at a popular technique that I would not recommend; circling up each side of the spine. During a normal massage, this circling technique is lovely to relieve muscle tension but it makes the receiver think ‘ooh that’s a sore bit, I didn’t realise I was tense there… just a bit higher/lower/left a bit/ right a bit’. This is not the dialogue you want a labouring woman having with herself. The same is true for shoulders, hands and feet. What you’re after is repetitive, steady and comfortable techniques that don’t make her think about either helping you (lifting fingers up for you to massage the next one) or what you might do next.

And lastly, the masseuse needs to be confident in what they are doing so lots of practice before the big day is essential. The labouring woman may not want to be touched, or think she does and then change her mind. A confident masseuse will not take this personally. A masseuse who is fearful, stressed or worried will not give as soothing a massage as someone who is relaxed and confident. Having said that, massage is a great way to relax the masseuse too so it may benefit both.

Here are some good techniques I’ve had great results with during the births I’ve attended…

Effleurage
This is a very relaxing and soothing massage stoke. To do effleurage is to stroke up the back from the sacrum using the flats of your hands, around the top of the shoulders and then sweep back down the sides. If done slowly and with a positive pressure (not too hard, not too soft), the recipient will feel totally supported and soothed. Massage oil is needed for this technique unless the woman is sweaty as that will act as a lubricant.

Using oils during labour should be kept to the absolute minimum. Grape seed oil is my favourite as it has very little odour and is absorbed nicely. Sweet almond oil is too thick and greasy for labour massage, as is baby oil.

Stroking

Using one hand resting on the floor or bed (be careful not to put weight from this hand on the body) use your other hand to slowly stroke down the spine. Start from the base of the neck and keep a continuous stroke going down to the very base of the spine. This is a deeply relaxing technique that can greatly help to reduce blood pressure and anxiety. You may be wanted here for a long time!

Face Massage

During labour a woman’s jaw can become very tight and cause a lot of tension in the rest of her body. Some women may also screw up their faces creating a lot of tension around their eyes and cheeks and also in their scalp. A great way to relieve stress and tension is to gently stroke the labouring woman’s brow, stroking from her brow and through her hair. Using circular movements with the flat pads of your fingers on the temples (light pressure) can help with eyestrain and forehead tension. And likewise, circular moves all along the jaw, right up to near the ears will help the labouring mother’s jaw to loosen. This has a nock on effect to the whole body. If the forehead and jaw loosen, tension can also be released in the stomach and abdominals. Also, a loose mouth means a relaxed pelvic floor (and thus not trying to hold baby in).

Head Massage

Head massage is often deeply relaxing and can help relieve headaches. Practise this technique before the birth to find out what preferences your pregnant partner has. There are two slightly different techniques: rotate the skin of the scalp under the pads of your fingers (move the skin not your fingers), or using circular moves, rub your fingers all over the scalp helping to get the muscles loosened. The former is very relaxing, the latter can also be invigorating depending on how fast and deep you do it. It may be that an invigorating head massage will help a tired woman find the extra energy to birth her baby.

Hands & Feet

When experiencing pain and discomfort, it is a natural reaction to clench the hands and tighten the feet. It’s difficult to tense your hands and no other part of your body. The more you can release tension in the hands and feet, the more tension is relieved in all other areas of the body. Even stroking a hand as you hold it has great benefits. Never underestimate the power of holding someone’s hand, especially if you’re helping them to relax it.

Holding her hand with both your hands you can use the length of your thumbs to loosen up the tension. Using stretching movements outwards on the palm will help ease tension and remind your partner to relax. The slower the moves the more relaxation you will induce. Start from the middle with both thumbs, and move them apart.

For the feet, rubbing the heel of your hand down the sole of the foot (from the balls of the toes to the heel) while support the top of the foot with your free hand will be deeply relaxing and prevent any tickling or pain.

Neck & Shoulders

Massaging the shoulders allowing them to drop down is often much appreciated during labour (and any other time!). You can use as much pressure as is comfortable for your partner. Be careful not to pinch the shoulders causing pain (ask for feedback). And do not over work tight muscles, or dig into them. Ensuring you are using a comfortable pressure will create more relaxation. Remember you’re not trying to do a therapeutic or sports massage, you’re intending to help the birthing woman relax. Use circular movements with your thumbs across the top of the shoulders, your fingers dropping down the front of the body.

When massaging the neck, make sure the head is supported either with the other hand, or by having the birthing woman with her head on a pillow. Have your thumb sweep up one side of the neck and your fingers sweeping up the other side.

Abdominal Effleurage

Using your effleurage techniques, you can help to relieve tension in the abdominal muscles by very gently stroking a labouring woman’s belly. The uterine muscles are more than capable of squeezing out a baby without the need of the stomach muscles. In fact tensing the stomach muscles can inhibit and slow down labour. By using gentle upward strokes with the whole of your hand, or gentle circular moves up the belly with the pads of your fingers, you can help the abdominal muscles to relax. If the labour has been induced with an oxytocin drip, this technique may be very useful to help a woman’s uterus relax between contractions.

NB Remember not to poke or prod the belly. Gentle pressure is essential.

Lumbosacral Pressures

There are several techniques you can use to help ease back ache (different from back labour pains caused by a posterior baby) and uterine pains.

If sore spots are felt in the sacrum area (if you have been practising your relaxation techniques you will be more aware of locations of pains rather than all over pain), then you can use elbow, knuckle or thumb pressures to help relieve the tension. The pressure must be no more than pleasure pain and hold until the discomfort subsides (which may be a while so make sure you’re comfortable!). Do not press on the spine, but on the muscles around the buttocks and either side of the sacrum. I have found this a very supportive technique for women who have experienced slipped discs or any chronic or acute back pain.

NB the sacrum is part of the pelvis that moves outwards during labour to make more room for the baby. This can be quite painful. It’s important not to put pressure on the sacrum bones themselves during labour as they need to move out (and not be pushed back in). Working either side of the sacrum itself is an effective way to make this process more comfortable.