MD, PhD, FMedSci, FSB, FRCP, FRCPEd

Since weeks I have been searching for new (2013) studies which actually report POSITIVE results. I like good news as much as the next man but, in my line of business, it seems awfully hard to come by. Therefore I am all the more delighted to present these two new articles to my readers.

The first study is a randomized trial with patients suffering from metastatic cancer who received one of three interventions: massage therapy, no-touch intervention or usual care. Primary outcomes were pain, anxiety, and alertness; secondary outcomes were quality of life and sleep. The mean number of massage therapy sessions per patient was 2.8.

The results show significant improvement in the quality of life of the patients who received massage therapy after 1-week follow-up which was not observed in either of the other groups. Unfortunately, the difference was not sustained at 1 month. There were also trends towards improvement in pain and sleep of the patients after massage. No serious adverse events were noted.

The authors conclude that “providing therapeutic massage improves the quality of life at the end of life for patients and may be associated with further beneficial effects, such as improvement in pain and sleep quality. Larger randomized controlled trials are needed to substantiate these findings“.

The second study examined the effectiveness of a back massage for improving sleep quality in 60 postpartum women suffering from poor sleep. They were  randomized to either the intervention or the control group. Participants in both groups received the same care except for the back massages. The intervention group received one 20-minutes back massage at the same time each evening for 5 consecutive days by a certified massage therapist. The outcome measure was the Pittsburgh Sleep Quality Index (PSQI). The results showed that the changes in mean PSQI were significantly lower in the intervention group than in controls indicating a positive effect of massage on sleep quality.

The authors’ conclusions were clear: “an intervention involving back massage in the postnatal period significantly improved the quality of sleep.

Where I was trained (Germany), massage is not deemed to be an alternative but an entirely mainstream treatment. Despite this fact, there is precious little evidence to demonstrate that it is effective. Our own research has found encouraging evidence for a range of conditions, including autism, cancer palliation, constipation, DOMS and back pain. In addition, we have shown that massage is not entirely free of risks but that its potential for harm is very low (some might say that this was never in question but it is good to have a bit more solid evidence).

The new studies are, of course, not without flaws; this can hardly be expected in an area where logistical, financial and methodological problems abound. The fact that there are many different approaches to massage does not make things easier either. The new evidence is nevertheless encouraging and seems to suggest that massage has relaxing effects which are clinically relevant. In my view, massage is a therapy worth considering for more rigorous research.

15 Responses to Massage therapy: finally some POSITIVE evidence !

  • OK, preliminary trials show promise. The next step is to improve the methodology of either trial with more numbers and better measurement of primary outcomes.

    Unfortunately, I expect that chiropractors will quote these as positive proof for their own scam and that any repeats will be on low numbers for yet another primary outcome/condition. But I’d be happy to be wrong on my prognostications.

  • Massage is self-care, not medical care. If somebody wants a massage, go ahead. But do not label it as ‘therapy’ and do not send the bill to health insurance. A lot of people feel better after a visit to the hairdresser. But we cannot call this hair-therapy and cannot send the bill to health insurance either.
    There are a lot of things that make people ‘feel better’ and improve quality of life. This should not be medicalized. It is self-care and belongs to the private choices of people.

    • Catherine de Jong said:

      A lot of people feel better after a visit to the hairdresser. But we cannot call this hair-therapy and cannot send the bill to health insurance either.

      I wouldn’t be too hasty: Laser Hair Therapy

    • i agree 100%. its like the studies involving prayer and positive thinking. whatever affects the nervous system in a positive way as far as improving the person’s outlook on life or their particular issue can be useful. I have had patients get more benefit from watching a funny uplifting movie that the therapy I gave that day.

    • I know it’s easy to say that massage just makes people “feel better” but this is WHY they feel better, which is medically proven and studied. I’m attaching an article for information. A leading Cardiologist at the Arkansas Heart Hospital had a team of nurses and massage therapist working together to improve the healing of patients after surgery. The results were very impressive. (I would have to search for the article if you would like proof of the findings.) Also, massage therapist work frequently with Oncologist for the treatment of cancer patients to improve lymphatic drainage. Sports injuries are effectively treated my massage therapist. Massage therapist also work with chiropractor’s to restore proper body alignment. The fact is, we are therapist who take our work seriously, even if all we do is make people “feel better”.

      massageandrehabilitationclinic.com
      Benefits & Effects of Massage
      Benefits & Effects of Massage

      In order to understand the benefits and effects of massage, it is important to consider how the body responds physiologically.

      Massage involves two types of responses:

      • mechanical responses as a result of pressure and movement as the soft tissues are manipulated
      • reflex responses in which the nerves respond to stimulation

      The Physiological Effects of Massage

      Effects on the Skeletal System

      • Massage can help increase joint mobility by reducing any thickening of the connective tissue and helping to release restrictions in the fascia.
      • It helps to free adhesions, break down scar tissue and decrease inflammation. As a result, it can help to restore range of motion to stiff joints.
      • Massage improves muscle tone and balance, reducing the physical stress placed on bones and joints.

      Effects on the Muscular System

      • Massage relieves muscular tightness, stiffness, spasms and restrictions in the muscle tissue.
      • It increases flexibility in the muscles due to muscular relaxation.
      • It increases blood circulation bringing more oxygen and nutrients into the muscle. This reduces muscle fatigue and soreness.
      • It promotes rapid removal of toxins and waste products from the muscle.

      Effects on the Cardiovascular System – Massage can:

      • improve circulation by mechanically assisting the venous flow of blood back to the heart
      • dilate blood vessels helping them to work more efficiently
      • produce an enhanced blood flow; delivery of fresh oxygen and nutrients to the tissues is improved and the removal of waste products, toxins and carbon dioxide is hastened via the venous system
      • help temporarily to decrease blood pressure, due to dilation of capillaries
      • decrease the heart rate due to relaxation

      • reduce ischemia (ischemia is a reduction in the flow of blood to body parts, often marked by pain and tissue dysfunction)

      Effects on the Lymphatic System – Massage helps to:

      • reduce oedema (excess fluid in the tissue) by increasing lymphatic drainage and the removal of waste from the system
      • regular massage may help to strengthen the immune system, due to the increase in white blood cells

      Effects on the Nervous System

      • Massage stimulates sensory receptors: this can either stimulate or soothe nerves depending on the techniques used.
      • It also stimulates the parasympathetic nervous system, helping promote relaxation and the reduction of stress.
      • Massage helps to reduce pain by the release of endorphins (endorphins are also known to elevate the mood).

      Effects on the Skin – Massage can bring about:

      • improved circulation to the skin, increased nutrition to the cells and encouraging cell regeneration
      • increased production of sweat from the sweat glands, helping to excrete urea and waste products through the skin
      • vaso-dilation of the surface capillaries helping to improve the skin’s colour
      • improved elasticity of the skin
      • increased sebum production, helping to improve the skin’s suppleness and resistance to infection.

      Effects On The Respiratory System

      • Massage deepens respiration and improves lung capacity by relaxing any tightness in the respiratory muscles.
      • It also slows down the rate of respiration due to the reduced stimulation of the sympathetic nervous system.

      Effects on the Digestive System – Massage can:

      • Increase peristalsis in the large intestine, helping to relieve constipation, colic and gas.
      • Promote the activity of the parasympathetic nervous system, which stimulates digestion.

      Effects on the Urinary System

      • Massage increases urinary output due to the increased circulation and lymph drainage from the tissues.

      The Psychological Effects of Massage –

      • Massage can help to: reduce stress and anxiety by relaxing both mind and body
      • create a feeling of well-being and enhanced self-esteem
      • promote positive body awareness and an improved body image through relaxation
      • ease emotional trauma through relaxation

    • Is physiotherapy medical care? Physiotherapy has its roots in massage. Massage therapy is a lot more than the fluff and bubble spa treatments in the beauty therapy industry that many people associate it with. If used with critical thinking and can effectively and successfully manage soft tissue injury and the resultant pain. Rather than managing symptoms (which many doctors excel at, with the assistance of a prescription pad) you identify and deal with the cause of the dysfunction. A one size fits all approach is rarely what people need. If a variety of modalities and techniques are used sensibly we see remarkable outcomes for clients in our industry. After personally having suffered horrific injuries, and living with those physical impairments as well as the emotional and psychological effect, massage therapy has been intergral in helping me overcome certain barriers including pain, range of motion and the quality of movement and functionality. I’ve since become a massage therapist myself and seen similar results in my clients. If it means that people can have a better quality of life, are more productive and can have better meaningful social interaction then why wouldn’t it be subsidised given the contrast in social cost?

      • @Dean Morris

        You said:

        Rather than managing symptoms (which many doctors excel at, with the assistance of a prescription pad) you [physios] identify and deal with the cause of the dysfunction.

        A prescription for an antimicrobial agent deals specifically with an infection.
        A prescription for a calcium channel blocker deals specifically with hypertension.
        A prescription for insulin deals specifically with hyperglycaemia.
        A prescription for a statin deals specifically with dyslipidaemia.
        A prescription for a proton pump inhibitor deals specifically with the consequences of gastric hyperacidity.
        A prescription for a hormone deals specifically with a hormone deficiency.

        I could go on, but I hope you just might rethink your sweeping opinion of physicians writing prescriptions merely to deal with symptoms, while your physiotherapy properly deals with the underlying cause of a dysfunction.

    • If infants are not touched they will die. How could you say that being touched in a healthy way as an adult is not therapeutic??? Your wrong for that.

      • If infants are not touched they will die.

        Huh?! In what circumstances does not touching an infant lead to death?

        How could you say that being touched in a healthy way as an adult is not therapeutic???

        Therapeutic for what precisely?

        • Therapeutic for what precisely?

          Touch therapies can be good for those who suffer from loneliness. Many types of quackery, e.g. reflexology, Bowen, craniosacral etc., rely heavily on the customer’s desire for human touch an loving care. You might call them “Petting practices” Nothing really wrong with that if it were honestly advertised without false claims of efficacy for ailments and disease.

  • the sample in these “studies” are not statistically significant. In future please list the name of the study and author so that readers can draw there own conclusions

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