Massage therapy is the movement and stimulation of body tissues by a therapist, such as the manipulation of muscle in Swedish massage or of joints, bones and tendons in chiropractic massage and osteopathy. Most healing traditions use massage. And most PHAs who use massage find it relieves stress and decreases anxiety. Massage may also benefit the immune system.

Swedish Massage

Swedish massage is the form of massage most commonly available in Canada. It aims to stimulate blood circulation and loosen knotted muscles. The kneading, stroking, pressing and stretching can help joints move better and provide relief from pain, stress and fatigue. Swedish massage may also help the immune system work better through relaxation. Studies of the immune benefits associated with massage are mixed. One small study showed an increase in immune system cells with regular massage, while another demonstrated no immune improvements. Benefits have been most dramatically demonstrated in babies. A study of babies born to HIV-positive women determined that those given regular massages gained weight faster and scored better on tests of motor control and alertness. Massage may also help with peripheral neuropathy.

Massage therapists are registered in Ontario and British Columbia, where they must complete a two- to three-year course and pass an examination in order to call themselves registered massage therapists. An hour-long massage session costs $30 to $90. Some massage therapists are covered under the B.C. health plan. (Check that the therapist has opted into the plan.) Some extended health care plans cover massage therapy.

Shiatsu

Shiatsu is a form of Japanese massage that aims to balance the energies in your body. Some HIV-positive people use shiatsu to relieve stress and fatigue. This type of massage may also have immune benefits similar to those suggested for acupuncture, although this claim has not been studied. At least two styles of shiatsu massage are available in Canada, and practitioners may offer one or both. Masunaga shiatsu (or zen shiatsu) is closely related to other eastern Asian medical practices. It focuses on creating balance and harmony in the body by stimulating the flow of Chi or life energy (see section on traditional Chinese medicine) and is closely related to acupressure. The second style of shiatsu is Namikoshi shiatsu, also called original shiatsu. This style combines the Western medical sciences of anatomy and physiology with the Eastern traditions of Masunaga shiatsu. Namikoshi practitioners focus on the pressure points associated with the body's endocrine system, which is a network of glands that distribute hormones throughout the body.

Shiatsu is not regulated in any province, and there is no national organization for shiatsu therapists. Although there is talk of creating a professional organization with a more national scope, only British Columbia and Ontario have professional organizations of shiatsu practitioners.

Reflexology

Reflexology was practised in several ancient medical systems. It aims to influence the health of different parts of the body by applying pressure to "reflex" points on the feet and hands. Each reflex point is associated with a different part of the body. Applying pressure to these points affects the health of the corresponding area of the body. Reflexologists do not use lotions or oils as part of the massage. Nor do they diagnose specific illnesses. Reflexology is used to reduce stress and tension, improve circulation and eliminate toxins. Reflexologists also work on reflex points that may stimulate the immune system.

A session with a reflexologist lasts about 45 to 60 minutes and costs from $30 to $70. Reflexologists are not regulated in any province. To become a member of the Reflexology Association of Canada, practitioners must complete at least 30 hours of classroom training and 60 hours of practical training.

Trager

Developed by Milton Trager, this form of mind-body medicine uses physical movement to access the healing power of the mind. With Trager, the practitioner guides the patient through a series of gentle movements, which the patient experiences as effortless and freeing. Trager is used to release basic physical and mental patterns and to facilitate deep relaxation, increased physical mobility and mental clarity. It is designed to strengthen a person's autonomy and sense of self. No oils or lotions are used, and the client is dressed, usually in swimwear, briefs or other non-restrictive clothing. Practitioners also teach a series of movements called Mentastics (short for mental gymnastics.) People can do these movements on their own to complement the effects of the Trager session. A session with a Trager practitioner usually lasts 60 to 90 minutes and costs $45 to $100. A person must be registered with a national Trager Association to qualify as a practitioner. Training requires a minimum of six months and includes lectures on anatomy and physiology as well as Trager sessions, both given and received. To maintain their registration, practitioners must participate in a three-day training session every year for the first three years, followed by a session at least every third year. Trager practitioners are not regulated in any Canadian province.  

Note: Trager and Mentastics are registered trademarks of the Trager Institute.

Chiropractic and Osteopathic Manipulation

Chiropractors assist the body's natural ability to heal by focusing on the skeleton, particularly on the spine and the nerves that run through it. Chiropractors do not use drugs or surgery. By manipulating the spine, they can relieve stress as well as musculoskeletal disorders like headache and back pain. Most of the conditions treated by chiropractors are not associated with HIV, however, PHAs use chiropractors to treat symptoms such as headaches or insomnia. Although their main tool is spinal manipulation, chiropractors also use ultrasound and the application of heat and light. They frequently use X-rays to aid in diagnosis.

Osteopathic doctors use manual manipulation techniques similar to chiropractors but focus more on the body's soft tissues, the muscles and the ligaments. They may be helpful in treating headaches, joint and muscle pain or fatigue. Osteopathic doctors combine osteopathic techniques with conventional medicine and are licensed as physicians in the United States and Britain. In Canada, the practice of Osteopathy is much more restricted. Alberta and British Columbia allow Doctors of Osteopathy to be licensed as physicians but this is not the case in other provinces. Due to these restrictions, osteopathic practitioners are relatively rare in Canada.

Legislation regulates the practice of chiropractic manipulation in all 10 provinces and in the Yukon. In the Northwest Territories and Nunavut, chiropractors are unregulated. The Canadian Memorial Chiropractic College in Toronto is the only accredited school to train chiropractors in Canada. To be admitted to the four-year Doctor of Chiropractic program, students must have completed at least 15 full-credit university courses.

A five-year course at the Université du Québec à Trois-Rivières qualifies graduates to practise in Quebec. Students must have a diploma of collegial studies to be admitted. To be licensed, chiropractors must pass a national board exam and an examination in the province where they want to practise.

Chiropractic services are partially covered by the health-care plans of Alberta, British Columbia, Manitoba, Ontario and Saskatchewan, although user fees may apply. Most private health-care plans cover at least some chiropractic treatments. For those with no coverage, fees are usually $20 to $40 per visit with additional charges for extra services like X-rays.

The Canadian Chiropractic Association does not provide referrals to qualified practitioners, nor do most of the provincial organizations. The regulation of practitioners in most of Canada, however, ensures that those who are certified are qualified to practise. In the Northwest Territories and Nunavut, check the credentials of a chiropractor (with his or her written consent) by writing to the following organization:

Canadian Chiropractic Examining Board
Suite 103, 1144 - 29th Avenue NE
Calgary, Alberta T2E 7P1
www.cceb.ca
(403)230-5997