Pain is the hallmark of sickle cell disease (SCD). Patients having this illness suffer from both recurrent attacks of acute painful episodes and chronic pain syndromes. The latter include avascular necrosis of the major joints and the spine, especially in the adult population. As a result, affected patients complain of chronic low back pain and hip pain that is associated with limited range of motion of the affected joints. Affected individuals become dependent on the use of opioid analgesics on a chronic basis. There are anecdotes that non-pharmacologic techniques such as massage, acupuncture and relaxation techniques are effective in ameliorating chronic pain and in decreasing the consumption of opioid analgesics. In this study, we wish to describe our experience in the utilization of a deep tissue/deep pressure massage therapy technique including neuro-muscular trigger point therapy with accupressure in patients with SCD.

Our objective; To evaluate whether a series regime of eight 1/2 hour clinic setting deep tissue/deep pressure neuromuscular massage treatments would be effective in reducing pain and dependency on opioid analgesics.

The hypothesis; A series of eight Bodhise Neuromuscular MassageTherapy (BNMT) treatments at a rate of two per week would result in reduced pain intensity and tension levels and increased relaxation and an increase in daily living activities. BNMT massage identifies soft tissue abnormalities and at the same time manipulates the soft tissue to normalize its function. Five SCD participants with chronic low back pain symptomatology with objective diagnostic findings of contractures of para spinal musculature, constriction and hypersensitivity in the skin in local and referred areas, increased pressure in the lumbar vertebral joints associated with the muscles and the palpation of trigger points.(TP). Outcome measures were pulse rate (beats per minute), pain and tension measured in 1 to 10 pain index response scale, relaxation (yes/no), the Profile of Mood States(POMS), and Assessment of Daily Living (ADL) were measured before and after each session..

Results revealed a significant main effect in each patient. The post-treatment pain, tension, POMS and ADL Scores were significantly lower or improved than pre-treatment scores. The patients reported a sense of relaxation, with pain and tension relief and an increase in their activities of daily living that persisted for up to a day or longer post massage. Concomitant with these results was a decrease in the use of opioid analgesics.

Conclusion: The provision of a deep tissue/ deep pressure specialized neuromuscular massage regimen for SCD patients resulted in significant reductions in pain and tension levels and an improvement in mood and daily living activities compared to pretreatment levels. The outcome of the study warrants the need for further study and evaluation on the need for neuromuscular massage therapy techniques in SCD.