UF Researchers Test Massage Therapy For Treatment Of Chronic Sickle Cell Pain

By Melanie Fridl Ross

GAINESVILLE, Fla.---University of Florida physicians hope the healing power of hands and a healthy dose of relaxation will help people who suffer from the debilitating pain associated with sickle cell disease. Researchers are testing weekly massage therapy and teaching relaxation techniques to help patients cope with chronic pain.

Sickle cell disease is an inherited disorder of hemoglobin, the oxygen-carrying molecule in red blood cells. It is especially prevalent among black Americans: About 1 in 600 has a form of the disease, which is characterized by sickle-shaped red blood cells that logjam in vessels. The clogged cells decrease blood flow to various organs, which can cause intense discomfort.

"Many physicians are concerned about the long-term use of medication to manage this sort of pain because it is chronic -- that's why alternative pain control methods are highly desirable," says Michael Robinson, a clinical psychologist at UF's College of Health Professions. "However, there is little data available on their effectiveness, even as nontraditional medical interventions gain popularity. This is an attempt to put two such approaches to a rigorous scientific test."

Sickle cell disease is noted for two types of pain. One is referred to as sickle cell crisis, characterized by sudden episodes of severe pain in the legs, arms or back that often require hospitalization and treatment with potent medications. The other type of pain occurs on a regular basis and consists of achiness that varies in intensity.

Participants 18 and older will be randomized to weekly hourlong sessions of massage therapy or relaxation therapy, which they will attend at the UF Shands Cancer Center. Researchers will record pain levels and function before and after the study. After six weeks, patients will be allowed to choose the treatment option they did not receive for another six weeks. A licensed massage therapist who also is trained in relaxation therapy will administer the treatments. People with sickle cell trait are not eligible to participate in the pilot study, which is funded by the American Massage Therapy Association Foundation.

Relaxation training consists of a series of exercises that gently tense and relax muscles in a specified sequence throughout the body. Patients learn the difference between tense and relaxed muscles, and then learn the ability to relax. Relaxation is defined by decreased muscle tension and respiration, lower blood pressure and heart rate, and increased blood flow.

"This is physiologic relaxation," said Robinson, "not the layperson's idea of 'I'll have a beer in front of the TV to relax.'

"We anticipate both treatments will be effective to some degree, but we hope to determine which is the most effective means of treating the chronic pain," he added. Dr. Richard Lottenberg, chief of the division of hematology and oncology at UF's College of Medicine, said the treatments are a logical choice because so much of sickle cell pain stems from the musculoskeletal system. "We feel it is important to address these patients' pain problems so that we can improve their ability to carry out their own lives, interact with their families and maintain employment.