What Is Massage?
Massage predates recorded history. Now this ancient healing method is quickly becoming an increasingly popular complementary and integrative health (CIH) approach. Therapeutic massage is an effective treatment and can alleviate pain safely.
In 2012, 6.9% of Americans had experienced some form of massage during the past year. People who experience pain, use massage more than any other segment of the population.
A Canadian study reported that 56% of patients with nonspecific chronic back pain and 48% with arthritis or other musculoskeletal disorders had used it over the last 12 months. Aside from mind-body approaches and animal-assisted therapies, massage is currently one of the most widely available complementary approaches across all 50 states in the U.S. In 2015, 52 of 131 (40%) sites surveyed reported offering some form of massage therapy.
Massage therapist training and licensing standards vary greatly from state to state. There is also variability from school to school. Common certifications you will see after a therapist’s name include CMT (certified massage therapist) and LMT (licensed massage therapist). CAMT stands for certified acupressure massage therapist.
Types of Massage Therapy
Massage therapy refers to the systematic manipulation of soft tissue with the hands that positively affects and promotes healing, reduces stress, enhances muscle relaxation, improves local circulation, and creates a sense of well-being.
Types of massage therapy include the following:
I. Swedish massage (and any other similar school) involves stroking and kneading the body using various methods. 5 basic massage techniques include:
- Effleurage–stroking with various degrees of pressure. This is what most people think of when they think of a massage.
- Petrissage–a kneading motion, done with the fingers and thumbs in a circular pattern
- Tapotement–rhythmic, vigorous tapping or slapping done to stimulate deep tissues
- Friction–use of the palm, forearm, heel of the hand, or even the elbows to roll, ring, and compress tissue
- Vibration–using hands or a machine for creating pulsation or pulsating effects
II. Shiatsu is based on massaging over trigger points and pressure points. Therapists most commonly use the balls of their thumbs and follow points called tsubos. They press or hold these tsubos points which correlate with acupuncture points.
III. Neuromuscular massage involves applying pressure throughout the body, not just in areas that are sore. Pressure is usually much higher than in other forms of massage therapy. Neuromuscular therapy (or neuromuscular technique) involves a careful examination and manipulation of the soft tissues of a specific area of the body. Neuromuscular massage addresses chronic pain.
IV. Visceral massage involves the gentle manipulation of the visceral organs of the abdomen and pelvis. Mayan abdominal massage is an ancient healing method spanning many generations and serves as a perfect example.
How Massage Works
Massage may help you avoid chronic disease, because it may help reduce the effects of stress on the muscles, ease tension, and correct unhealthy postures. The movement of the fascia, which is the net of connective tissue surrounding the muscles and other tissues help facilitate massage therapy’s healing benefits.
The body may shift or adapt when the fascial network experiences injury or stress. This can have widespread health consequences. Massage therapy and other touch therapies may restore the fascial balance.
Even back in 2004, a meta-analysis of 37 studies found that a single massage therapy session led to the following:
- Reduced anxiety and depression (multiple sessions may provide some of the same benefits as psychotherapy)
- Lowered blood pressure
- Decreased heart rate
Studies show that single sessions may not immediately reduce pain, improve mood, or lower cortisol levels. However, many studies show how repeated sessions can reduce pain. See the findings.
When To Use It
Note the following:
- The best supporting evidence is for lower back pain, neck pain, shoulder pain, labor, and pain in multiple areas.
- There are weaker findings supporting potential benefits for TMK, fibromyalgia, cancer pain, and neck/shoulder pain.
It might be helpful to go into more detail as far as the research findings.
Pain
Pain is one of the main reasons people use massage as a treatment, and research favors it for many aspects of pain control and treatment.
Take a look at what some of the studies show.
General Pain Treatment
A 2016 review of 60 high-and 7 low-quality studies shows strong support for the recommendation of massage therapy as a pain management option, compared to no treatment. It also weakly recommended it for improving mood and health-care-related quality of life. A review of 26 trials found as a stand-alone treatment, it reduces pain and improves function in some musculoskeletal conditions (back pain, knee arthritis, shoulder pain), but did not show a clear benefit when compared to other active treatments. Another 2016 review of 16 studies found weak evidence of benefits for pain.
Back Pain Treatment
A 2015 Cochrane review of 25 trials did not find massage to be an effective low back pain treatment, though, in the short term, people reported benefits.
Neck Pain Treatment
A 2014 meta-analysis concluded that there is moderate evidence supporting that massage therapy improves neck pain, but not dysfunction (e.g. limited range of motion).
Post-surgical Pain Treatment
A 2016 review of 12 high-and 4 low-quality studies found enough data to weakly recommend massage for reducing pain and anxiety in patients undergoing surgical procedures. A 2017 review of 10 studies including 1,157 patients found it may alleviate post-operative pain, though the methodological quality of studies was low. Another review found it serves as a useful adjunct to medications for reducing post-cardiac surgery pain intensity.
Cancer Pain Treatment
A 2016 review of 16 studies offered weak recommendations for massage therapy, compared to an active comparator, for the treatment of pain, fatigue, and anxiety. A 2015 meta-analysis of 12 studies with 559 participants concluded, massage significantly reduces cancer pain compared to no massage or conventional care. Results show reflexology, including foot massage, exhibits a greater effect than aromatherapy or body massage. In contrast to these results, a Cochrane review concluded that overall, studies were too small to draw a conclusion.
Arthritis Treatment
A 2017 review found seven small trials involving 352 people which concluded there is low-to moderate-quality evidence supporting massage over non-active therapies for improving osteoarthritis or rheumatoid arthritis outcomes.
Fibromyalgia Treatment
A unique 2015 study looked at which types of massage therapy were most helpful in fibromyalgia. Many studies do not differentiate between types when compiling data. Studies show that myofascial release had large, positive effects on pain and medium effects on anxiety and depression. Studies also show that Shiatsu and connective tissue massage improved several outcomes, whereas Swedish massage did not. Another 2014 meta-analysis of nine trials involving 404 patients with fibromyalgia found that treatment with massage therapy for five weeks or longer led to immediate and lasting improvements in pain, depression, and anxiety.
Blood Pressure
A 2014 systematic review concluded that massage therapy combined with anti-hypertensives was more effective than the drugs alone for lowering blood pressure. Reduction of systolic pressure averaged about 7 points, and 3.6 points for diastolic pressures. However, the overall quality of the studies was poor. There are a number of theories surrounding how it affects blood pressure, including that it may decrease sympathetic nervous system activity and alter adrenal cortex activity.
Other Indications
Although there is not enough research available, massage therapy’s overall safety and broad availability make it a worthwhile approach. Natural Medicines, which summarizes research for given therapeutic approaches, rates it as Likely Effective for back pain and cancer-related pain and Possibly Effective for ADHD, fibromyalgia, labor pain, low birth weight, and stress. The verdict is still out for many other conditions, including alcoholism, asthma, carpal tunnel syndrome, dementia, diabetes, headache, multiple sclerosis, osteoarthritis, Parkinson’s, premenstrual dysphoric disorder, rheumatoid arthritis, and other types of pain.
A wide-ranging 2016 review concludes that massage therapy has beneficial effects on varying conditions including prenatal depression, preterm infants, full-term infants, autism, skin conditions, pain syndromes including arthritis and fibromyalgia, hypertension, autoimmune conditions including asthma and multiple sclerosis, immune conditions including HIV, and breast cancer and aging problems including Parkinson’s and dementia.
A 2018 review of 8 trials with 657 participants found that acupoint massage likely maintains cognitive function in older adults.
What To Watch Out For (Harms)
When done by a skilled therapist, massage therapy is quite safe. Contraindications to it, according to some therapists, include the following:
- Infectious or contagious skin conditions
- Acute inflammation (e.g., rheumatoid arthritis, appendicitis)
- Open skin wounds, burns, or other friable tissues
- Varicose veins and venous inflammation (thrombophlebitis)
- Sites of tumors or metastases. Even though it is unlikely that massaging an area with cancer would be any more likely to cause metastases to split off than exercise would, many practitioners recommend avoiding direct massage or cancerous areas
- Low bone density (for techniques that use high pressure)
- Coagulopathies where it might cause severe bruising
- Risk of recurrent bleeding at a recently injured or traumatized site
A good therapist should question and then avoid touching vulnerable places.
Appropriate draping is also essential.
3 Key Takeaways
There is more than one kind of body-based therapy.
Various types may be useful for a variety of reasons or patient issues.
If you help create Personal Health Plans (PHPs), it might help if you keep body-based therapies in mind.
Find an acupressurist and anyone else from the best aroma therapists to herborists.