Tuesday, June 29, 2010

M.D. Points to Stress Reduction, Not Drugs, for Disease Prevention



Once when I was supervising an offsite internship for the Massage Therapy Program, I overheard a fourth semester student explain apologetically that he was interested in providing “only relaxation massage”. I interjected that there was no reason to apologize, because a truly relaxing massage could be just as significant as more targeted types of massage such as sports massage or myofascial release. Research into the impact of stress on every level of health and healing continues to shed light on just how important reducing stress can be.

In the current issue of Alternative Therapies in Health and Medicine (May/June 2010, Vol 16, No.3) Mark A. Hyman, MD looks at some large drug trials that attempted to demonstrate that targeting risk factors with pharmacological agents would reduce the risk of chronic disease endpoints such as cardiovascular events, diabetes, and mortality. Although drugs aggressively target risk factor reduction—lowering glucose, blood pressure and lipids, for instance—the data from these trials indicate that these efforts consistently failed to show benefit in primary prevention.

“Lipids, glucose, and blood pressure were all effectively reduced in these trials,” Dr. Hyman writes. “But there was no reduction in morbidity and mortality in any of the trials reported, and there were significant side effects.” Dr. Hyman compares the risk factors of elevated blood pressure or cholesterol as “the smoke, not the fire” that creates chronic disease.

Although seventy-five percent of statin prescriptions are written for primary prevention at a cost of more than $20 billion per year, Dr. Hyman points out that, “While there is some evidence for benefits of statin therapy for those with existing disease, there is no good evidence for primary prevention.” He concludes that, “A dramatic paradigm shift is needed in the targets for primary prevention. The era of individual risk factor reduction must now be supplanted by treatment of the etiology of chronic disease through a systems or functional model of diagnosis and treatment.” Dr. Hyman suggests that underlying causes of conditions like cardiovascular disease most likely result from insulin resistance, inflammation, environmental toxins, and stress. He suggests that treatment should target these factors.

Measuring the stress response 
Hans Selye, MD, the physician who first wrote about the effects of stress from a medical perspective in 1950, would be very excited about the research going on today. Dr. Selye’s contribution to medicine was defining the general adaptation syndrome (G.A.S), a response which involves virtually every organ and chemical constituent of the human body. In doing so, he proposed a way to measure stress objectively in terms of physical and chemical changes in the body.

In his book The Stress of Life, Dr. Selye predicted that “The study of stress differs essentially from research with artificial drugs because it deals with the defensive mechanisms of our own body. The significance of this kind of research is not limited to fighting this or that disease. It has a bearing upon all diseases and indeed upon all human activities.”

Anticipating Dr. Hyman by more than half a century, Dr. Selye proposed that the cause of conditions such as cardiovascular disease and digestive disorders stem in part from failures in the stress-fighting mechanism of the body.

Strengthening the body’s adaptive response 
Integrative health care offers many ways for people to reduce perceptions of stress and reactions to stressors. Yoga, meditation, imagery, exercise, acupuncture and massage can all be part of alleviating stress. Most of these modalities are generalized responses, which naturally enhance the general adaptation response of the body. From Dr. Selye’s viewpoint, they would be a valuable part of the future of medicine, offering “a new type of treatment, whose essence is to combat disease by strengthening the body’s own defenses against stress.”

Alumni from our programs are among the pioneers bringing the benefits of massage therapy and acupuncture to people they see privately as well as in hospitals. Their efforts are being looked at in a new light, as researchers uncover more about the role they play in reducing stress and pain. Far from being apologetic about it, therapists who provide stress reduction while understanding its far-reaching effect will be excited about their future work. They may be at the heart of the emerging field of integrative care that has prevention at its core.

Barbara Goldschmidt, LMT
Sinews editor

For more information:
National Center for Complementary and Alternative Medicine (NCCAM)
Touch Research Institutes 
Tiffany Field, PhD. Touch Therapy. New York, NY: Churchill Livingstone, 2000.