Other Proposed Uses
- Attention Deficit Disorder (ADD)
- Cancer Treatment Support
- Cystic Fibrosis
- HIV Support
- Iliotibial Band Pain
- Interstitial Cystitis
- Juvenile Rheumatoid Arthritis
- Migraine Headaches
- Neck Pain
- Neonatal Sepsis (Life-threatening Infection in Premature Infants)
- Premenstrual Syndrome (PMS)
- Pregnancy Support
- Quitting Smoking
- Recovery from Severe Burns
- Spinal Cord Injury
Along with herbal treatment , touch-based therapy is undoubtedly 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 is no doubt that massage relieves pain and induces relaxation at least temporarily; besides that, it feels good! Whether it offers any lasting benefits, however, remains unclear.
Forms of Massage
There are many schools of massage. In most cases, massage therapists combine several techniques, although there are also purists who stick to one method. The most common technique 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. This may be called the “hurts-good-and-feels-great-after” approach. Shiatsu or acupressure massage also uses deep pressure, but according to the principles of acupuncture theory. (Acupuncture is so similar to acupressure that we have elected to discuss studies of acupressure in the acupuncture article rather than here.) Neuromuscular massage (such as the St. John Method of Neuromuscular Therapy) applies strong pressure to tender spots, technically known as trigger points.
Several other techniques are best described as relatives of massage. Rolfing® Structural Integration aims to affect not muscles, but the connective tissue (fascia) surrounding muscles and everything else in the body. This highly organized technique aims to permanently improve the body’s structure. Reflexology is a form of foot massage based on the theory that the whole body is reflected in the foot.
How Does Massage Work?
There are many theories about how massage might work, but none have been proved true. Little doubt exists that massage temporarily increases blood circulation in the massaged area, but it is not clear that this makes any lasting difference. Some massage therapists and massage therapy schools promote the notion that massage breaks up calcium deposits in the muscle, but there is no objective substantiation for this claim.
A completely different explanation is that massage promotes healing in a more general way, by reducing stress and inducing relaxation. Massage also satisfies the basic human need to be touched.
What Is Massage Therapy Used For?
Massage is most commonly used to relieve muscular tension and promote relaxation. It is also said to be helpful as an aid to the treatment of various conditions, including attention deficit disorder (ADD) , asthma , autism , bedsores, bulimia , cystic fibrosis, diabetes , eczema , fibromyalgia , HIV , iliotibial band pain , juvenile rheumatoid arthritis, low back pain , lymphedema , neck pain , premenstrual syndrome (PMS) , pregnancy , severe burns, and spinal cord injury .
What Is the Scientific Evidence for Massage Therapy?
Only one form of study can truly prove that a treatment is effective: the double-blind, placebo-controlled trial . (For more information on why such studies are so crucial, see Why Does This Database Rely on Double-blind Studies? ) However, it isn’t possible to fit massage into a study design of this type. What could researchers use for placebo massage? And how could they make sure that both participants and practitioners would be kept in the dark regarding who was receiving real massage and who was receiving fake massage? The fact is, they can’t.
Because of these problems, all studies of massage fall short of optimum design. Many have compared massage to no treatment. However, studies of this type cannot provide reliable evidence about the efficacy 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 fake treatment for the control group, such as phony laser acupuncture. However, using a placebo treatment that is very different in form from the treatment under study is less than ideal. One study (discussed below) compared real reflexology against fake reflexology. However, it is quite likely that the reflexologists at least unconsciously conveyed more enthusiasm and optimism when performing the real therapy than the fake therapy; this, too, could affect the outcome. It has been suggested that the only way to get around this last problem would be to compare the effectiveness of trained practitioners against actors trained only enough to provide a simulation of treatment; however, such studies have not been reported.
Still other studies have simply involved giving people massages and seeing whether they improved. These trials are particularly meaningless; it has been long since proven that both participants and examining physicians will at least think that they observe improvement in people given a treatment, whether or not the treatment does anything on its own.
Finally, other trials have compared massage to competing therapies, such as acupuncture or relaxation therapy . Unfortunately, when you compare unproven therapies to each other, the results cannot possibly prove that any of the tested treatments are effective.
Given these caveats, the following is a summary of what science knows about the effects of massage.
Low Back Pain
Preliminary controlled trials of varying quality suggest that massage may provide benefit in a number of conditions, including the following:
- Anorexia nervosa8
- Asthma in children 9
- Cystic fibrosis 12
- Iliotibial band pain (a form of tendonitis that can cause knee or hip pain) 20
- Juvenile rheumatoid arthritis 21
- Migraine headaches22,39
- Pregnancy and childbirth 23-25,54
- Quitting smoking26
- Burn recovery 27
- Spinal cord injury 28
How to Choose a Massage Therapist
As with all medical therapies, it is best to choose a licensed practitioner. Where licensure is not available, your best bet is to seek a referral from a qualified and knowledgeable medical practitioner. However, most US states license massage therapists.
Note that massage, like other hands-on therapies, involves personal talents that go beyond specific training, certification, or licensure: Some people are simply gifted with their hands. Furthermore, what 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.
- Reviewer: EBSCO CAM Review Board
- Review Date: 08/2012 -
- Update Date: 03/26/2013 -