• Massage Therapy

    Forms of Massage

    HCA image for massage therapy Along with herbal treatment, touch-based therapy is easily one of the most ancient forms of medical care. We instinctively stroke and rub areas of our body that hurt. Massage therapy develops this instinct into a professional treatment. There are many schools of massage. In most cases, massage therapists combine several techniques, but there are purists who stick to one method. The one of the most common techniques is Swedish massage, which combines long strokes and gentle kneading movements that primarily affect surface muscle tissues. Deep-tissue massage utilizes greater pressure to reach deeper levels of muscles. Shiatsu or acupressure massage also use deep pressure, but they do so according to the principles of acupuncture theory. This can differ markedly from those of Western-oriented massage therapies. Neuromuscular massage applies strong pressure to tender spots, technically known as trigger points.

    How Strong Is the Scientific Evidence for Massage Therapy?

    Although there is some evidence that massage may be helpful for various medical purposes, in general, the evidence is not strong. There are several reasons for this, but the main obstacle is that it is difficult to truly determine the effectiveness of a hands-on therapy like massage.
    Because of this obstacle, all studies of massage fall short. Many researchers have designed studies that compare massage to no treatment. However, studies of this type cannot provide reliable evidence about the effect of a treatment. If a benefit is seen, there is no way to determine whether it was caused by massage specifically, or just attention generally. (Attention alone will almost always produce some reported benefit.) More meaningful trials used some sort of placebo treatment for the control group, referred to as “sham” massage. However, using a placebo treatment that is very different in form from the treatment under study is less than ideal.
    Still other studies have simply involved giving people massages and seeing whether they improved. These trials are particularly meaningless. It is well-known that if a treatment of any kind is given, participants will think they have observed an improvement, regardless of whether or not the treatment does anything on its own. This is known as the placebo effect.
    Given these cautions, below is a summary of what is known about the effects of massage. The best evidence regards low back pain.

    Massage for Low Back Pain

    Although more studies are needed, it does appear that massage may offer benefits for low back pain. For example, in a review of 13 randomized trials, researchers concluded that massage offered benefits, especially when paired with exercise and education, in people with low back pain that is not due to a specific injury or condition. And in some of those participants with chronic pain, the effects lasted up to a year. Another study involving 401 people also with nonspecific back pain were randomized to receive two different types of massage (structural or relaxation) or usual care. The people in the massage groups experienced an improvement in their ability to function and had fewer symptoms, which lasted at least six months.

    Other Potential Uses of Massage

    There is some evidence to support the use of massage for a range of conditions, such as:

    How to Choose a Massage Therapist

    As with all medical therapies, it is best to choose a practitioner who is licensed in your state. Most US states do require massage therapists to be licensed. Organizations like the American Massage Therapy Association provide searchable databases to find a massage therapist in your area.
    Massage, like other hands-on therapies, involves personal talents that go beyond specific training, certification, or license. Some people are simply gifted with their hands. Furthermore, a technique that works for one person may not work for another. For these reasons, some trial and error is often necessary to find the best massage therapist for you.

    Safety Issues

    Although massage is generally safe, it can sometimes exacerbate pain temporarily, even when properly performed. In addition, if massage is performed too forcefully on fragile people, bone fractures and other internal injuries are possible. However, licensed massage therapists have been trained in ways to avoid causing these problems.

    RESOURCES

    American Massage Therapy Association http://www.amtamassage.org

    Massage Therapy Foundation http://www.massagetherapyfoundation.org/

    CANADIAN RESOURCES

    Health Canada http://www.hc-sc.gc.ca/index%5Fe.html/

    Massage Therapy http://www.massage.ca/

    References

    Birk TJ, McGrady A, MacArthur RD, et al. The effects of massage therapy alone and in combination with other complementary therapies on immune system measures and quality of life in human immunodeficiency virus. J Altern Complement Med . 2000;6:405-414.

    Brattberg G. Connective tissue massage in the treatment of fibromyalgia. Eur J Pain . 1999;3:235-244.

    Brosseau L, Casimiro L, Milne S, et al. Deep transverse friction massage for treating tendinitis. Cochrane Database Syst Rev . 2002;(1):CD003528.

    Chang MY, Wang SY, Chen CH. Effects of massage on pain and anxiety during labour: a randomized controlled trial in Taiwan. J Adv Nurs . 2002;38:68-73.

    Cherkin DC, Eisenberg D, Sherman KJ, et al. Randomized trial comparing traditional Chinese medical acupuncture, therapeutic massage, and self-care education for chronic low back pain. Arch Intern Med . 2001;161:1081–1088.

    Cherkin DC, Sherman KJ, Kahn J, et al. A comparison of the effects of 2 types of massage and usual care on chronic low back pain: a randomized, controlled trial. Ann Intern Med. 2011;155(1):1-9.

    Diego MA, Field T, Hernandez-Reif M, et al. HIV adolescents show improved immune function following massage therapy. Int J Neurosci . 2001;106:35-45.

    Diego MA, Field T, Hernandez-Reif M, et al. Spinal cord patients benefit from massage therapy. Int J Neurosci . 2002;112:133-142.

    Eliott MA, Taylor LP. "Shiatsu sympathectomy": ICA dissection associated with a shiatsu massager. Neurology . 2002;58:1302-1304.

    Field T, Henteleff T, Hernandez-Reif M, et al. Children with asthma have improved pulmonary functions after massage therapy. J Pediatr . 1998;132:854–858.

    Field T, Hernandez-Reif M, Hart S, et al. Pregnant women benefit from massage therapy. J Psychosom Obstet Gynaecol . 1999;20:31–38.

    Field T, Hernandez-Reif M, LaGreca A, et al. Massage therapy lowers blood glucose levels in children with Diabetes Mellitus. Diabetes Spectrum . 1997;10:237–239.

    Field T, Hernandez-Reif M, Seligman S, et al. Juvenile rheumatoid arthritis: benefits from massage therapy. J Pediatr Psychol . 1997;22:607–617.

    Field T, Hernandez-Reif M, Taylor S, et al. Labor pain is reduced by massage therapy. J Psychosom Obstet Gynaecol . 1997;18:286–291.

    Field T, Lasko D, Mundy P, et al. Brief report: autistic children's attentiveness and responsivity improve after touch therapy. J Autism Dev Disord . 1997;27:333–338.

    Field T, Morrow C, Valdeon C, et al. Massage reduces anxiety in child and adolescent psychiatric patients. Am Acad Child Adolesc Psychiatry . 1992;31:125–131.

    Field T, Peck M, Krugman S, et al. Burn injuries benefit from massage therapy. J Burn Care Rehabil . 1998;19:241–244.

    Field T, Schanberg S, Kuhn C, et al. Bulimic adolescents benefit from massage therapy. Adolescence . 1998;33:555–563.

    Field TM, Quintino O, Hernandez-Reif M, et al. Adolescents with attention deficit hyperactivity disorder benefit from massage therapy. Adolescence . 1998;33:103–108.

    Franke A, Gebauer S, Franke K, et al. Acupuncture massage vs Swedish massage and individual exercise vs group exercise in low back pain sufferers—a randomized controlled clinical trial in a 2 x 2 factorial design [in German; English abstract]. Forsch Komplementarmed Klass Naturheilkd . 2000;7:286–293.

    Furlan AD, Brosseau L, Imamura M, et al. Massage for low-back pain: a systematic review within the framework of the Cochrane Collaboration Back Review Group. Spine . 2002;27:1896–1910.

    Furlan AD, Imamura M, Dryden T, Irvin E. Massage for low-back pain. Cochrane Database Syst Rev. 2008;CD001929.

    Hart S, Field T, Hernandez-Reif M, et al. Anorexia nervosa symptoms are reduced by massage therapy. Eating Disorders: Journal of Treatment and Prevention . 2001;9:217–228.

    Hernandez-Reif M, Deiter J, Field T, et al. Migraine headaches are reduced by massage therapy. Int J Neurosci . 1998;96:1–11.

    Hernandez-Reif M, Feld T, Hart S. Smoking cravings are reduced by self-massage. Prev Med . 1999;28:28–32.

    Hernandez-Reif M, Field T, Krasnegor J, et al. Children with cystic fibrosis benefit from massage therapy. J Pediatr Psychol . 1999;24:175–181.

    Hernandez-Reif M, Martinez A, Field T, et al. Premenstrual symptoms are relieved by massage therapy. J Psychosom Obstet Gynaecol . 2000;21:9–15.

    Irnich D, Behrens N, Molzen H, et al. Randomised trial of acupuncture compared with conventional massage and sham laser acupuncture for treatment of chronic neck pain. BMJ . 2001;322:1–6.

    Ironson G, Field T, Scafidi F, et al. Massage therapy is associated with enhancement of the immune system's cytotoxic capacity. Int J Neurosci. 1996;84:205–217.

    Kutner JS, Smith MC, Corbin L, et al. Massage therapy versus simple touch to improve pain and mood in patients with advanced cancer: a randomized trial. Ann Intern Med. 2008;149:369-379.

    Offenbacher M, Stucki G. Physical therapy in the treatment of fibromyalgia. Scand J Rheumatol Suppl. 2000;113:78–85.

    Oleson T, Flocco W. Randomized controlled study of premenstrual symptoms treated with ear, hand, and foot reflexology. Obstet Gynecol . 1993;82:906–911.

    Preyde M. Effectiveness of massage therapy for subacute low-back pain: a randomized controlled trial. CMAJ . 2000;162:1815–1820.

    Schachner L, Field T, Hernandez-Reif M, et al. Atopic dermatitis symptoms decreased in children following massage therapy. Pediatr Dermatol . 1998;15:390–395.

    Smith WA. Fibromyalgia syndrome. Nurs Clin North Am . 1998;33:653–669.

    Sunshine W, Field T, Quintino O, et al. Fibromyalgia benefits from massage therapy and transcutaneous electrical stimulation. J Clin Rheumatol. 1996;2:18–22.

    Vickers A. Yes, but how do we know it's true? Knowledge claims in massage and aromatherapy. Complement Ther Nurs Midwifery . 1997;3:63–65.

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