Managing Chronic Pain With Deep Tissue Bodywork

by Celeste Cooper, RN Health Professional

The purpose of bodywork is to improve musculoskeletal function by targeting the source of our pain and dysfunction. Many types of myotherapies are available, but sometimes the restrictions that cause us unrelenting pain are buried deep in the musculoskeletal system. That’s when methods of deep tissue bodywork can help. But what are they?


Rolfing is a type of bodywork that targets the release of musculoskeletal restrictions. But, as Rolfing specialist Ann M. Matney told me in an interview, it’s more than that. Rolfing/Structural Integration is a separate lineage from other myofascial therapies, like myofascial release. It has its own schools and its own continuing education. This method of bodywork strategically lengthens shortened fascia and avoids lengthening fascia that is relatively long. This allows maximal balance at each joint. Postural and movement re-education is an integral part of therapy because it optimizes muscle memory for sitting, standing, and walking without pain. This is important for those of us with deep muscle dysfunction that affects coordinated movement.

Is it painful? Ann told me the notion that intense Rolfing yielded better results has been debunked for decades. When the practitioner has a patient-focused approach, structural integration should not be aggressive or painful.

Active Release Technique® (ART)

Developed by chiropractor Dr. P. Michael Leahy, Active Release Technique, like myofascial trigger point therapy, is a hands-on approach for treating muscles and releasing adhesions to tissues and nerves. However, unlike trigger point therapy, this technique also works on deep muscle layers. This is important to people like me who have piriformis syndrome.

Here’s an example of why I prefer ART for this type of pain. The piriformis muscle is small, buried deep under large muscles in our buttocks, yet mighty because of where it is located — namely, around the sciatic nerve. Ultrasound guided trigger point injections are not possible. My physical therapist, specially trained in ART, manually isolates deep muscles by placing my body in specific positions. Following his instructions, our coordinated movements allow access to deep muscles for compression, manipulation, and restoration of the muscle to its normal operational state. It can be painful, I have fibromyalgia, but the temporary discomfort for me is well worth the long-term pain relief and improved function.

Pfrimmer® deep muscle therapy (PDMT)

Like Rolfing or ART, Pfrimmer® is not a massage technique. Instead, it is specialized system of corrective treatment designed to aid in the restoration of damaged muscles and soft tissue. Using a specific series of well-designed movements and cross-fiber strokes, a trained therapist concentrates on all layers of muscle that have become depleted of their normal blood and lymphatic flow, restoring circulation and natural healing properties at the cellular level, according to founder Therese C. Pfrimmer.

Many believe that PDMT works well in addition to superficial muscle therapies and helps the source of many structural problems, and it has a synergistic relationship with chiropractic, osteopathic, and physical therapy care.

Visceral Manipulation (VM)

Dr. Jean-Pierre Barral is a French Diplomate of Osteopathy, a physical therapist and the founder of the Barral Institute. His clinical work led to his development of VM, focusing on the internal organs (viscera), their environment, and the potential influence on structural and physiological dysfunctions. The goal of VM is to help our organs work together. Visceral Manipulation is considered therapeutic for chronic pelvic pain, chronic spinal dysfunction, headaches and Migraine, carpal tunnel syndrome, peripheral joint pain, sciatica, chronic postoperative pain, and other health issues.

Regardless of the type of manual therapy you choose make sure your therapist is qualified to practice and understands your individual needs. Under the right circumstances, deep tissue bodywork can restore function and reduce or eliminate persistent pain. ART is my personal go-to therapy, but your condition may be different from mine. Always take the necessary precautions and discuss any type of manual therapy with your doctor first.

Celeste Cooper, RN
Meet Our Writer
Celeste Cooper, RN

Celeste Cooper, R.N., is a freelance writer focusing on chronic pain and fibromyalgia. She is lead author of Integrative therapies for Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain and the Broken Body, Wounded Spirit: Balancing the See-Saw of Chronic Pain book series. She enjoys her family, writing and advocating, photography, and nature. Connect with Celeste through Twitter @PainedInkSlayer.