Massage Literacy; At Home and In The Media
As a Physical Therapist and Licensed Massage Therapist, I consider it my job to help everyone become more aware of the benefits of massage. While massage has been a staple of health and wellness in many cultures around the world, it is still viewed as a luxury here in the US.
Massage has been shown to be a safe and effective method of reducing pain, anxiety, and depression. It is safe, pleasant, and inexpensive when compared with chiropractic or standard medical care for pain.
Still, there is very little public awareness about massage, and ample myths and misconceptions. If you have any questions or concerns, I invite you to ask me anything in the space below:
Recent Massage Studies and Research
In July 2013, the Australian based AMT group summarized the research for the effectiveness of massages on various conditions. After looking this over, I have to say it is the best "State of Evidence" review I've ever seen. You can request additional information and read the whole detailed report here:
To paraphrase and summarize the major findings:
Managing stress and mood with a cancer diagnosis
The amount of evidence for positive effects using massage therapy as an aid to cancer patients has grown, including several new Level 1 and 2 studies published in the last few months. Massage is not a primary treatment for cancer, but it is effective in managing the associated distress and symptoms. It can improve patient mood after a cancer diagnosis, especially stress and depression.
Many systematic reviews support the efficacy of massage therapy in treating the side effects of cancer.
"The largest single study of massage and cancer was conducted at Memorial Sloan-Kettering Cancer Centre, where 1290 patients were treated with massage therapy over a three-year period."
Mechanical Pain, Low Back Pain
A significant body of evidence, including systematic reviews, supports the effectiveness of massage therapy in the treatment of Mechanical Pain and dysfunction.
Currently, five systematic reviews of massage and low back pain are available. Massage provides short-term improvement of sub-acute and chronic low back pain symptoms, and decreases disability immediately post treatment. Massage therapy works when combined with therapeutic exercise and education.
Currently, five systematic reviews of neck and shoulder pain are available, concluding that massage therapy provides short-term relief of mechanical neck pain. A 2013 meta-analysis and systematic review showed that massage therapy is an effective intervention that may provide immediate relief of neck and shoulder pain.
As previously mentioned on this blog, the amount of research for "Trigger Point" or "Neuromuscular" massage is fairly large. Active myofascial trigger points and various kinds of myofascial pain and dysfunction are well correlated, which provides evidence for the use of trigger point techniques. The Department of Physical Medicine and Rehabilitation at the Universidad Rey Juan Carlos has established a substantial body of work in this area, with a particular focus on headache, neck and shoulder pain.
There is a little evidence for using massage therapy to control the symptoms of fibromyalgia. A 2010 review revealed short-term benefits, with one single arm study reporting longer term effects.
A large body of empirical evidence supports the established effects of massage therapy for the following conditions and populations:
Reduced anxiety is a well-established effects of massage therapy with ample evidence crossing multiple presenting conditions and populations. A meta-analysis of 37 studies showed reductions in trait anxiety and depression as massage therapy’s largest effects. Some studies show massage therapy increases oxytocin levels, suggesting one possible mechanism of action.
A significant body of RCTs demonstrate the efficacy of massage in the management of pain before and after a surgery, as well as the associated anxiety and tension, and post-operative nausea.
A significant body of evidence supports the efficacy of massage throughout pregnancy, and particularly during labor. Massage improves the management of labor pain with few adverse side effects. Massage may have a role in reducing pain and improving women’s emotional experience of labor.
Massage of pre-term or low-weight infants improved daily weight gain by 5.1 grams and appeared to reduce the length of hospital stay by 4.5 days. There is evidence for benefits in connection with mother-infant interaction, sleeping and crying, and on hormones influencing stress levels.
There is evidence for the efficacy of pediatric massage for a range of conditions; however, significant reductions in state anxiety were identified as one of the strongest effects. A Meta analysis concluded that massage therapy may be a safe and cost-effective practice to improve weight gain and decrease the hospital stay of clinically stable preterm infants.
"A body of RCT evidence supports the efficacy of massage in treating a range of conditions associated with aging." Massage therapy may serve as an alternative or complement to other therapies for the management of behavioural, emotional and other conditions associated with dementia.
Systematic reviews show that massage therapy is effective in reducing soreness and enhancing recovery after strenuous exercise. A number of RCTs have also shown positive effects of massage on pain and recovery after strenuous exercise.
Headache and migraine
A systematic review found that massage therapy, physiotherapy, relaxation and chiropractic spinal manipulative therapy might be as effective as pharmaceuticals for prophylactic management of migraine. RCTs investigating headache and migraine also report positive results for massage.
RCTs support the efficacy of massage therapy in treating both osteo and rheumatoid arthritis. One recent RCT for osteoarthritis of the knee revealed massage significantly improved outcomes across a range of measurements compared to usual care. A study released in 2013 found that twice weekly, self-massage of the quadriceps muscle improved pain, stiffness, physical function and knee range of motion in adults with diagnosed knee osteoarthritis.
A number of studies report findings that massage therapy has a positive effect on immune function. A review found evidence to support the use of massage therapy to improve the quality of life of people living with AIDS/HIV. A 2013 clinical trial showed massage therapy to be effective in the treatment of depression in HIV patients.
Here is a list of the research cited in the original "State of Evidence":
Fellowes D, Barnes K, Wilkinson S. (2004). Aromatherapy and massage for symptom relief in patients with cancer. Cochrane Database Syst Rev. 2008;(2):CD002287.
Cassileth BR, Vickers AJ. (2004). Massage therapy for symptom control: Outcome study at a major cancer center. J Pain Symptom Manage, 28(3), 244-249.
Furlan AD, Imamura M, Dryden T, Irvin E. (2008). Massage for low-back pain. Cochrane Database Syst Rev. 2008 Oct 8;(4):CD001929.
Brosseau L, Wells GA, Poitras S, Tugwell P, Casimiro L, Novikov M, Loew L, Sredic D, Clément S, Gravelle A, Kresic D, Hua K, Lakic A, Ménard G, Sabourin S, Bolduc MA, Ratté I, McEwan J, Furlan AD, Gross A, Dagenais S, Dryden T, Muckenheim R, Côté R, Paré V, Rouhani A, Léonard G, Finestone HM, Laferrière L, Haines-Wangda A, Russell-Doreleyers M, De Angelis G, Cohoon C. (2012). Ottawa Panel evidence-based clinical practice guidelines on therapeutic massage for low back pain. J Bodyw Mov Ther, 16(4), 424-455.
Patel KC, Gross A, Graham N, Goldsmith CH, Ezzo J, Morien A, Peloso PM. (2012). Massage for mechanical neck disorders. Cochrane Database Syst Rev. 2012 Sep 12;9:CD004871
Brosseau L, Wells GA, Tugwell P, Casimiro L, Novikov M, Loew L, Sredic D, Clément S, Gravelle A, Hua K, Kresic D, Lakic A, Ménard G, Côté P, Leblanc G, Sonier M, Cloutier A, McEwan J, Poitras S, Furlan A, Gross A, Dryden T, Muckenheim R, Côté R, Paré V, Rouhani A, Léonard G, Finestone HM, Laferrière L, Dagenais S, De Angelis G, Cohoon C. (2012). Ottawa Panel evidence-based clinical practice guidelines on therapeutic massage for neck pain. J Bodyw Mov Ther, 16(3), 300-325.
Kong LJ, Zhan, HS, Cheng YW, Yuan WA, Chen B, & Fang M. (2013). Massage therapy for neck and shoulder pain: A systematic review and meta-analysis [Electronic version]. Evid Based Complem & Altern Med.
See numerous studies by Alonso-Blanco C, Fernández-de-Las-Peñas C, de-la-Llave-Rincón AI, Zarco-Moreno P, Galán-Del-Río F and Svensson P.
Kalichman L. (2010). Massage therapy for fibromyalgia symptoms. Rheumatol Int. Jul;30(9):1151-7.
Moyer CA, Rounds J, Hannum JW. (2004). A meta-analysis of massage therapy research. Psychol Bull, 130(1), 3-18.
Lee A, Fan LT. (2009). Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting. Cochrane Database Syst Rev. 2009 Apr 15;(2):CD003281.
Jones L, Othman M, Dowswell T, Alfirevic Z, Gates S, Newburn M, Jordan S, Lavender T, Neilson JP. (2012). Pain management for women in labour: an overview of systematic reviews. Cochrane Database Syst Rev. 2012 Mar 14;3:CD009234.
Smith CA, Levett KM, Collins CT, Jones L. (2012). Massage, Reflexology and other manual methods for pain management in labour. Cochrane Database Syst Rev. 2012 Feb 15;2:CD009290.
Vickers A, Ohlsson A, Lacy JB, Horsley A. (2004). Massage for promoting growth and development of preterm and/or low birth-weight infants. Cochrane Database Syst Rev. 2004;(2):CD000390.
Underdown A, Barlow J, Chung V, Stewart-Brown S. (2006) Massage intervention for promoting mental and physical health in infants aged under six months. Cochrane Database Syst Rev. 2006 Oct 18;(4):CD005038.
Beider S, Moyer CA. (2007). Randomized controlled trials of pediatric massage: A review. Evid Based Complement Alternat Med, 4(1), 23-34.
Wang L, He JL, & Zhang XH. (2013). The efficacy of massage on preterm infants: A meta-analysis [Electronic version]. Am J Perinatol.
Viggo Hansen N, Jørgensen T, Ørtenblad L. (2006). Massage and touch for dementia. Cochrane Database Syst Rev. 2006 Oct 18;(4):CD004989.
Ernst E. (1998). Does post-exercise massage treatment reduce delayed onset muscle soreness? A systematic review. Br J Sports Med, 32(3), 212-214; and Best TM, Hunter R, Wilcox A, Haq F. (2008) Effectiveness of sports massage for recovery of skeletal muscle from strenuous exercise. Clin J Sport Med, 18(5), 446-460.
Chaibi A, Tuchin PJ, Russell MB. (2011). Manual therapiesfor migraine: A systematic review. J Headache Pain, 12(2), 127-133.
Perlman AI, Ali A, Njike VY, Hom D, Davidi A, Gould-Fogerite S, Milak C, Katz DL. (2012). Massage therapy for osteoarthritis of the knee: A randomized dose-finding trial. PLoS One, 7(2), e30248.
Perlman AI, Sabina A, Williams AL, Njike VY, Katz DL. (2006). Massage therapy for osteoarthritis of the knee: A randomized controlled trial. Arch Intern Med, 166(22), 2533-2538.
Atkins DV & Eichler DA. (2013). The effects of self-massage on osteoarthritis of the knee: A randomized controlled trial. Int J Ther Massage Bodywork, 6(1), 4-14.
Cambron JA, Dexheimer J, Coe P. (2006). Changes in blood pressure after various forms of therapeutic massage: A preliminary study. J Altern Complement Med, 12(1), 65-70.
Hillier SL, Louw Q, Morris L, Uwimana J, Statham S. (2010). Massage therapy for people with HIV/AIDS, Cochrane Database Syst Rev. 2010 Jan 20;(1):CD007502.
Poland RE, Gertsik L, Favreau JT, Smith SI, Mirocha JM, Rao U, & Daar ES. (2013). Open-label, randomized, parallel-group controlled clinical trial of massage for treatment of depression in HIV-infected subjects. J Altern Complement Med, 19(4), 334-340.