When it comes to massage pressure, there’s a full spectrum of “intensity”. Some people prefer less pressure, while others like more generous pressure. Quite often this is associated with their tolerance for, or their preference for sensation. Yet, it’s not quite that simple. Pain is never that simple.
This conversation will delve both into the research done in the field of pain science, and into hypotheses around why and how we have “delicious pain”. I’ll do my best to be clear when something is my own anecdote/hypothesis (unverified), so that you know what is theory and what has been tested. References for research are in-text! The first thing we need to delve into is the idea of individual sensitivity.
Tolerance for Sensation
I think we can all anecdotally agree that everyone has different sensitivities for sensation and pain. Where one person might be hurt by a particular amount of pressure in a massage (or any other type of stimulus), another person might be asking for more. A considerable number of factors likely influence this, including by not limited to past experiences (physical and emotional), present situation, sympathetic nervous system activation (stress), how much you move/how sedentary you are, trigger point presence, degree of trust in the person massaging you, and so forth.
“sensation junkies” vs. “softies”
I only use these terms out of ease of understanding – not to make anyone feel bad about their preference for pressure in a massage, or their pain tolerance in other situations. Everyone has their ideal pressure that they like to receive. Sometimes it’s a lot, and other times it’s not so much. Regardless of how much pressure you require to reach your ideal sensation, it’s highly likely we’re all experiencing a similar phenomenon when we are at or close to that point. When we’re getting the perfect amount of pressure for us, there’s this thing that we call (somewhat paradoxically) “delicious pain”.
Delicious Pain: That sensation that has a high degree of “intensity” to it, that makes it almost unpleasant, and yet there’s this simultaneous feeling that it’s somehow “good” or important for us to be pressing on that point. Almost like we want it to end and at the same time we can’t get enough. And when the pressure is gone from that point, you want it again because it feels so necessary – kind of like scratching an itch.
What Is It?
We don’t know exactly. Straight up, pain science is complex and we have yet to clarify exactly what is happening to create this “delicious pain“. To create an hypothesis, let’s look at some component pieces of the phenomenon:
When does it happen?
Mostly we encounter these sensations when someone has landed on what we might commonly call a “knot”. More appropriately though we could call these ‘knots’ active trigger points (TrPs). Whilst massage is generally a pleasant sensation on the rest of the muscle, it gives this particular response when we press on TrPs.
What is a trigger point?
We address this more depth over here. Because TrP science is also largely unproven, we’re working through two linked hypotheses. To summarize the linked article, a TrP is a tightly contracted set of fibers within a muscle that creates a highly ischemic environment, allowing the build up of metabolic wastes. The chronic contraction, nerve irritation and waste build-up causes pain. This is happening on an incredibly small scale – as in, microscopic – yet it can cause significant amounts of discomfort/sensation.
Pressing On a Trigger point
We’ll discuss the usefulness of pressing on trigger points later. For now, the process of compressing a TrP is thought to either ‘squeeze’ the waste build-up into surrounding tissue through hydrostatic pressure, or release the waste build-up into surrounding tissue by causing the muscle fibers to relax from their contracted state. Either way, we’re releasing wastes into the tissue. This creates an environment that the body immediately / simultaneously responds to with a low-grade inflammatory response. ((that was an important piece…we’ll come back to this in a moment)).
When pressing on a TrP we also experience referred pain. This referred pain often ventures to organs or deeper muscle tissue. The theory behind this phenomenon is called “thalamic-convergence theory”. Essentially, the brain isn’t able to tell where the pain is coming from due to a convergence of nerve signals within and/or between adjacent nerve bundles (1).
Side Note: When someone is pressing on that spot that feels deliciously painful, we often want them to “stay right there”. There’s not only a desire to have that sensation happen, there’s an intrinsic call for the massage therapist to remain right where they are. Over time (3-5 minutes) we often notice a decreased sensitivity to repeated applications of pressure. This is also an important piece to add to the above note.
Pulling The Pieces Together:
I only say “my” theory because I don’t know if anyone else shares the same theory and to let you know that this has not been validated. Delicious pain is created by a variety of “Endorphins” being released in response to a confusingly high degree of pain signals being delivered to the brain.
What are endorphins?
They are “feel good” hormones produced in the body (both centrally and peripherally) in response to pain. They are designed to mask pain, and are rather additive in nature. Endorphins are opioids (you might be more familiar with the term ‘opiates’). Their addictive nature is evident in the fact that there has been an opiate epidemic since before the 1900’s. That’s when it’s injected and often synthetic. When we produce it ourselves, it’s still addictive, but our body releases it in small doses. A “runners’ high” and being addicted to running is another example of pain being masked and it being addictive in nature.
Summary and Scientific support:
Endorphins are released in response to neuropathic, inflammatory and visceral (organ) pain (2, 3, 4). When we press on Trigger Points, we are initiating all of these mechanisms of Endorphin release (5, 6). The type and amount of endorphins released, relate to the type and degree of painful stimulus (7), and when we press on TrPs our brains perceive a disproportionately high degree of pain due to the volume and type of pain signals due to pain referral (referenced earlier). The reason we feel the “deliciousness” of this pain is because there’s actually very little injury or physical disturbance, yet there’s enough Endorphin response to help us manage a significant injury. So the competing pain signalling with a recognition of safety leads to a unique combination of sensations lending to the term “delicious pain”. Endorphins help us “mask” pain by causing antinociception or analgesia (8, 9). And that’s why it feels good! We also have to note that part of the reason we don’t want that sensation to end, part of the reason it’s so delicious, is because it’s addictive – and so are Endorpins (10).
When Is It Too Much?
Tissues can be overworked though, and so we need to know when to stop massaging. Thankfully, and as you may have noted, at a certain stage the “deliciousness” fades. I believe this happens when the tissue has become disrupted/aggravated to the point where pain signals are coming from fewer sources (less referral) and more intensely from one source. It’s not that the Endorphins run out, or are produced less. It’s that the brain more accurately identifies the pain and the increased tissue damage increases the pain signalling.
Is It Actually Any Good For Us?
We’re not quite done yet! All this on what “delicious pain” is, and we haven’t yet considered if it’s even good for us to be feeling it? The scientific evidence suggests that massaging these points works at helping restore tissue function and reducing pain (11). However, we know that not all urges of the body are beneficial for us even though they might feel great! For example, scratching a mosquito bite, feels similarly delicious, yet it’s actually better for us to leave them alone. What do you think? Is it beneficial for us to seek this delicious pain for the benefit of our health? I’d love to hear your experiences below in the comments.