MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

Multiple sclerosis (MS) causes a range of different symptoms. Patients with MS have looked for alternative therapies to control their MS progress and treat their symptoms. Non-invasive therapeutic approaches such as massage can have benefits to mitigate some of these symptoms. However, there is no rigorous review of massage effectiveness for patients suffering from MS.

The present systematic review was aimed at examining the effectiveness of different massage approaches on common MS symptoms, including fatigue, pain, anxiety, depression, and spasticity.

A total of 12 studies met the inclusion criteria. The authors rated 5 studies as being of fair and 7 studies of good methodological quality. Fatigue was improved by different massage styles, such as reflexology, nonspecific therapeutic massage, and Swedish massage. Pain, anxiety, and depression were effectively improved by reflexology techniques. Spasticity was reduced by Swedish massage and reflexology techniques.

The authors concluded that different massage approaches effectively improved MS symptoms such as fatigue, pain, anxiety, depression, and spasticity.

Clinical trials of massage therapy face formidable obstacles including:

  • difficulties in obtaining funding,
  • difficulties in finding expert researchers who are interested in the subject,
  • difficulties to control for placebo effects,
  • difficulties in blinding patients,
  • impossibility of blinding therapists,
  • confusion about the plethora of different massage techniques.

Thus, the evidence is often less convincing than one would hope. This, however, does not mean that massage therapy does not have considerable potential for a range of indications. One could easily argue that this situation is similar to spinal manipulation. Yet, there are at least three important differences:

  • massage therapy is not as heavily burdened with frequent adverse effects and potentially life-threatening complications,
  • massage therapy has a rational basis,
  • the existing evidence is more uniformly encouraging.

Consequently, massage therapy (particularly, classic or Swedish massage) is more readily being accepted even in the absence of solid evidence. In fact, in some countries, e.g. Germany and Austria, massage therapy is considered to be a conventional treatment.

12 Responses to Massage therapy for multiple sclerosis?

  • EE: massage therapy is not as heavily burdened with frequent adverse effects and potentially life-threatening complications,

    “ And yet, reviewing the literature again in 2013, Ernst and Posadzki found at least 18 reported examples of “moderately severe” reactions to normal massage, especially of the neck.4”

    https://www.painscience.com/articles/massage-therapy-side-effects.php

    Does massage therapy profession have an adverse event reporting system?

  • Reflexology should not be considered as ‘massage’.
    It is a completely different technique and should be in a category of its own.

  • How might any manual therapy intervention be capable of overcoming biological homeostasis that, had it not been of sufficient significance to limit fluctuations in the internal milieu, would have resulted in failure of the species? This entire line of argumentation is such an enormous, childish waste of time. Anyone claiming they can, with their hands (or other appendages), steer the function within another organism and do so to positively influence, beyond placebo, the natural course of a condition should be kicked out of healthcare, stripped of licensure. Say it feels good, fine, otherwise, Nurse Ratched is waiting to give you your sponge bath.

    • ???? The review was looking at the efficacy of massage for relieving some of the secondary symptoms of MS (pain, depression, etc), not for treating MS itself (which would indeed be nonsense on stilts if that was what was being claimed, which it wasn’t).

      Under different circumstances folks here might find subtle irony in a therapy that treats only the symptoms, not the disease itself; however, MS is a horrible disease for which we’ve yet to find a cure and the massage treatment in question lies at the pragmatic (feels good, relieves tension), not quacky (energy healing), end of the scale, so let’s not go there this time.

      The main takeaway from this review seems to be that it’s really hard to study massage therapy’s effectiveness scientifically, but I think that’s a given (the physical nature of the intervention makes it is virtually impossible to single-blind, never mind double-blind). However, I would suggest if a nice relaxing [non-quackery] massage makes MS sufferers report feeling better about their lives for a little while†, then that is “good enough” to suggest it as something they might wish to try out; no medical claims involved.

      † i.e. The A vs A+B problem doesn’t really apply when the only thing being quantified is “Do you feel better afterwards?” As long as participants’ response isn’t “Now I feel worse”, you’re golden.

      • You’ve completely missed the point. If you wish to bicker, find another tennis partner. I will stick to my original point, which is that manual therapies based on the assumption that input can reliably, predictably and effectively influence output based on a biomechanical (or any other premise) is QUACKERY. I have no qualms about deriving a pleasurably experience from massage, only that claiming anything other than pleasure, or transient, minimal at best, symptom amelioration is bs. Likewise to the entire armada contained under the umbrella term, “manual therapy”. This entire direction of argument is driven by cultish-thinking, ego-aggrandizement and little else of clinical utility.

        Placebo.

        • The argument you offer here, that the technique cannot easily be demonstrated to be causative, is exactly the same as every other technique in manual therapy. Having someone offer *touch* that is caring, safe is commonly described as useful, and if those disciplines that engage in such professional activities were to focus on that, then the entire industry of rehab would be a better place, until it collapsed under a pile of hubris.

          If state-sponsored professions are to be sanctioned to charge money, then this issue must be suuported by an ethical dimension that at present is dubious. So, sure, if folks feel good after a massage, fine. But does having MS matter? Again, the logical fallacies embedded in this cultish industry should be exposed to the bright light of scrutiny. A weekend workshop in massage and a healthy dose of empathy provides all that is required, not an entitlement of exchange of money..

          Placebo is not an insult, just truth.

        • “You’ve completely missed the point.”

          Very probably. Your point was clear as mud. The only bit of the review that intersected quackery was using some reflexology massage studies (since reflexology itself is bunk), but my impression was that it was looking at the efficacy of the massage component—as in massages makes people feel good—not the “OMG magical touching cures dis-eases” nonsense. From a messaging perspective it would be better, obviously, if it avoided the reflexology studies entirely (it seems to have evaded chiro and reiki) so as not to offer succor to quacks, but, eh; you work with the data you got, I suppose.

          If you can point to where the study suggested massage therapies can treat anything beyond the secondary symptoms of MS we’d expect them to treat—sore muscles, low mood—you’d have a point about placebo effect. (I just skimmed the abstract with a lay eye.) But it appears a fairly decent (if rare) demonstration of knowing how to stay in its lane, so I don’t think you do. Prof Ernst would appear to concur, mentioning out only that the evidence is not as high quality as would be ideal (though may be as good as is realistically achievable), whereas if the study had a serious problem you know he’d rip it first.

          Perhaps mainstream medicine should do more to incorporate massage therapy, along with “nice cup of tea and a chat” therapy and other “soft” treatments, and so extract it from AltMed’s hands entirely. One less “gateway” for them to sneak their rubbish in through (diets being the most popular one).

          • You have still missed the point. You are bickering.

            I never said that the study claimed to treat MS. Where did I say that? The sense I get from your argument is that you are not really that comfortable with critical appraisal of research, and instead your ego is getting in the way of how you are constructing whatever you are trying to get at.

            The issue is that the evidence to support ANY AND EVERY CONTENTION that massage offers more than a subjective feeling of transient duration, as it tends to for most people who get massage, is simply lacking because the methodological quality of research cannot be relied upon to offer more. That the study was looking at ppl afflicted with MS is secondary, at least insofar as aiming to treat the condition. The same could be said for those unafflicted with MS who get massage in that massage of any kind has not been demonstrated using high quality research, to do much. It feels good. Yes it does.

            Your ranting ego adds nothing to your argument. You just sound like an angry person who is looking to unload. Otherwise, you make no sense in discussing research, this paper, or any other.

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