What physiologic effects of massage are useful in the treatment of back pain

• Tissue relaxation

• Increased local or regional blood flow

• Disruption or loosening of adhesions

• Reduction of edema by stimulating venous and lymphatic drainage

• Activation of a gate mechanism in the dorsal horn of the spinal core resulting in pain reduction

• Stimulation of sensory fibers to produce a state of reduced adrenocortical stress reactivity

• Centrally mediated effects (reflexology)

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