Massage Therapy: The Biopsychosocial Framework
/My current goal is to promote the value of massage therapy by synthesizing and simplifying noteworthy finds and best available supporting evidence applicable to massage therapy.
Here I have put together a post defining massage therapy as well as an overview outlining potential responses to massage therapy
The Canadian Massage Therapy Alliance defines Massage Therapy as:
"The practice of massage therapy is the assessment of the Musculoskeletal system of the body and the treatment and prevention of physical dysfunction, injury and pain by manipulation, mobilization and other manual methods to develop, maintain, rehabilitate or augment physical function, relieve pain or promote health. Massage therapy is a clinically-oriented healthcare option that helps alleviate the Musculoskeletal disorders associated with everyday stress, physical manifestation of mental distress, muscular overuse and many persistent pain syndromes."
Massage Therapy: A Biopsychosocial Framework
A biopsychosocial framework helps put into context the interconnected and multidirectional interaction between: physiology, thoughts, emotions, behaviors, culture, and beliefs. In terms of clinical responses to massage therapy there are a couple of proposed mechanisms of action, including but not limited to:
• Neurodynamics - “A clinical concept that uses movement (1) to assess increased mechanosensitivity of the nervous system; and (2) to restore the altered homeostasis in and around the nervous system.” (Grieve's Modern Musculoskeletal Physiotherapy).
• Neuroplasticity - Touch can help sharpen the image of the self in our body maps.
• Contextually Aided Responses- The way we present ourselves and present our techniques is tied to clinical outcomes, the magnitude of a response may be influenced by mood, expectation, and conditioning.
• Neuromodulation - Massage has an affect on peripheral and central processes - input from large sensory neurons may prevent the spinal cord from amplifying nociceptive signaling.
• Social Touch - Nervous system regulated by touch helps modulate the activity of neural circuits important for maintaining resting state. This reduced physiological and behavioural reactivity to stressors results in improved mood/affect.
• Mechanotherapy - "Any intervention that introduces mechanical forces with the goal of altering molecular pathways and inducing a cellular response that enhances tissue growth, modeling, remodeling, or repair.” (Thompson et al. 2016).
More to Explore
Best, T. M., & Crawford, S. K. (2017). Massage and postexercise recovery: The science is emerging. British Journal of Sports Medicine.
https://www.ncbi.nlm.nih.gov/pubmed/27797730
Best, T.M., Gharaibeh, B., Huard, J. (2013). Stem cells, angiogenesis and muscle healing: a potential role in massage therapies? Br J Sports Med.
https://www.ncbi.nlm.nih.gov/pubmed/23197410
Bialosky, J.E., Beneciuk, J.M., Bishop, M.D., ... George, S.Z. (2018). Unraveling the Mechanisms of Manual Therapy: Modeling an Approach. J Orthop Sports Phys Ther.
https://www.ncbi.nlm.nih.gov/pubmed/29034802
Bialosky, J.E., Bishop, M.D., Penza, C.W. (2017). Placebo Mechanisms of Manual Therapy: A Sheep in Wolf's Clothing? J Orthop Sports Phys Ther.
https://www.ncbi.nlm.nih.gov/pubmed/28459190
Bishop, M. D., Torres-Cueco, R., Gay, C. ... Bialosky, J. E. (2015). What effect can manual therapy have on a patient's pain experience? Pain Management. (OPEN ACCESS)
https://www.ncbi.nlm.nih.gov/pubmed/26401979
Bove, G.M., Chapelle, S.L., Hanlon, K.E., Diamond, M.P., Mokler, D.J. (2017). Attenuation of postoperative adhesions using a modeled manual therapy. PLoS One. (OPEN ACCESS)
https://www.ncbi.nlm.nih.gov/pubmed/28574997/
Bove, G.M., Harris, M.Y., Zhao, H., Barbe, M.F. (2016). Manual therapy as an effective treatment for fibrosis in a rat model of upper extremity overuse injury. J Neurol Sci. (OPEN ACCESS)
https://www.ncbi.nlm.nih.gov/pubmed/26810536
Boudier-Revéret, M., Gilbert, K.K., Sobczak, S. (2017). Effect of neurodynamic mobilization on fluid dispersion in median nerve at the level of the carpal tunnel: A cadaveric study. Musculoskelet Sci Pract.
https://www.ncbi.nlm.nih.gov/pubmed/28734168
Chaitow, L. (2017). What's in a name: Myofascial Release or Myofascial Induction? J Bodyw Mov Ther. (OPEN ACCESS)
https://www.ncbi.nlm.nih.gov/pubmed/29037622
Chaitow, L. (2016). Dosage and manual therapies – Can we translate science into practice? Journal of Bodywork and Movement Therapies. (OPEN ACCESS)
https://www.ncbi.nlm.nih.gov/pubmed/27210835
Chaudhry, H., Bukiet, B., Ji, Z., Stecco, A., & Findley, T. (2014). Deformations Experienced in the Human Skin, Adipose Tissue, and Fascia in Osteopathic Manipulative Medicine. JAOA. (OPEN ACCESS)
https://www.ncbi.nlm.nih.gov/pubmed/25288713
Chen, L., Michalsen, A. (2017). Management of chronic pain using complementary and integrative medicine. BMJ.
https://www.ncbi.nlm.nih.gov/pubmed/28438745
Crane, J., Ogborn, D., Cupido, C., Melov, S., Hubbard, A., Bourgeois, J., & Tarnopolsky, M. (2012). Massage Therapy Attenuates Inflammatory Signaling After Exercise-Induced Muscle Damage. Science Translational Medicine.
http://www.ncbi.nlm.nih.gov/pubmed/22301554
Courtney, C.A., Fernández-de-Las-Peñas, C., Bond, S. (2017). Mechanisms of chronic pain - key considerations for appropriate physical therapy management. J Man Manip Ther.
https://www.ncbi.nlm.nih.gov/pubmed/28694674
Ellingsen, D., Leknes, S., Løseth, G., Wessberg, J., & Olausson, H. (2016). The Neurobiology Shaping Affective Touch: Expectation, Motivation, and Meaning in the Multisensory Context. Frontiers in Psychology. (OPEN ACCESS)
https://www.ncbi.nlm.nih.gov/pubmed/26779092
Fryer, G. (2017). Integrating osteopathic approaches based on biopsychosocial therapeutic mechanisms. Part 1: The mechanisms. International Journal of Osteopathic Medicine.
http://www.sciencedirect.com/science/article/pii/S1746068917300317
Fryer, G. (2017). Integrating osteopathic approaches based on biopsychosocial therapeutic mechanisms. Part 2: Clinical approach. International Journal of Osteopathic Medicine.
http://www.sciencedirect.com/science/article/pii/S1746068917300536
Gilbert, K. K., James, C. R., Apte, G., ... Smith, M. P. (2015). Effects of simulated neural mobilization on fluid movement in cadaveric peripheral nerve sections: Implications for the treatment of neuropathic pain and dysfunction. Journal of Manual & Manipulative Therapy. (OPEN ACCESS)
http://www.ncbi.nlm.nih.gov/pubmed/26917940
Habig, K., Schänzer, A., Schirner, W., ... Krämer, H.H. (2017). Low threshold unmyelinated mechanoafferents can modulate pain. BMC Neurol. (OPEN ACCESS)
https://www.ncbi.nlm.nih.gov/pubmed/28915853
Louw, A., Nijs, J., Puentedura, E. (2017). A clinical perspective on a pain neuroscience education approach to manual therapy. Journal of Manual & Manipulative Therapy.
https://www.ncbi.nlm.nih.gov/pubmed/28694679
Mancini, F., Nash, T., Iannetti, G.D., Haggard, P. (2014). Pain relief by touch: a quantitative approach. Pain. (OPEN ACCESS)
https://www.ncbi.nlm.nih.gov/pubmed/24361816
Mancini, F., Beaumont, A., Hu, L., Haggard, P., & Iannetti, G. D. (2015). Touch inhibits subcortical and cortical nociceptive responses. Pain. (OPEN ACCESS)
https://www.ncbi.nlm.nih.gov/pubmed/26058037
Melzack, R. & Wall, P.D. (1965). Pain mechanisms: a new theory. Science.
http://www.ncbi.nlm.nih.gov/pubmed/5320816
Miller, B.F., Hamilton, K.L., ... Butterfield, T.A., Dupont-Versteegden, E.E. (2018). Enhanced skeletal muscle regrowth and remodelling in massaged and contralateral non-massaged hind limb. J Physiol.
https://www.ncbi.nlm.nih.gov/pubmed/29090454
Morikawa, Y., Takamoto, K., Nishimaru, H., ... Nishijo, H. (2017). Compression at Myofascial Trigger Point on Chronic Neck Pain Provides Pain Relief through the Prefrontal Cortex and Autonomic Nervous System: A Pilot Study. Front Neurosci. (OPEN ACCESS)
https://www.ncbi.nlm.nih.gov/pubmed/28442987
Newell, D., Lothe, L.R., Raven, T.J. (2017). Contextually Aided Recovery (CARe): a scientific theory for innate healing. Chiropr Man Therap. (OPEN ACCESS)
https://www.ncbi.nlm.nih.gov/pubmed/28289539
Nummenmaa, L., Tuominen, L., Dunbar, R., ... Sams, M. (2016). Social touch modulates endogenous μ-opioid system activity in humans. Neuroimage.
https://www.ncbi.nlm.nih.gov/pubmed/27238727
Parravicini, G., Bergna, A., (2017). Biological effects of direct and indirect manipulation of the fascial system. Narrative review. Journal of Bodywork & Movement Therapies.
https://www.ncbi.nlm.nih.gov/pubmed/28532888
Pelletier, R., Bourbonnais, D., Higgins, J. (2017). Nociception, pain, neuroplasticity and the practice of Osteopathic Manipulative Medicine. Journal of Manual & Manipulative Therapy.
http://www.sciencedirect.com/science/article/pii/S1746068917300111
Pelletier, R., Higgins, J., Bourbonnais, D. (2015). Addressing Neuroplastic Changes in Distributed Areas of the Nervous System Associated With Chronic Musculoskeletal Disorders. Phys Ther.
https://www.ncbi.nlm.nih.gov/pubmed/25953594
Rabey, M., Hall, T., Hebron, C., Palsson, T.S., Christensen, S.W., Moloney, N. (2017). Reconceptualising manual therapy skills in contemporary practice. Musculoskeletal Science and Practice.
https://www.ncbi.nlm.nih.gov/pubmed/28286240
Thompson, W. R., Scott, A., Loghmani, M. T., Ward, S. R., & Warden, S. J. (2016). Understanding Mechanobiology: Physical Therapists as a Force in Mechanotherapy and Musculoskeletal Regenerative Rehabilitation. Physical Therapy. (OPEN ACCESS)
https://www.ncbi.nlm.nih.gov/pubmed/26637643
Vigotsky, A. D., & Bruhns, R. P. (2015). The Role of Descending Modulation in Manual Therapy and Its Analgesic Implications. Pain Research and Treatment. (OPEN ACCESS)
https://www.ncbi.nlm.nih.gov/pubmed/26788367
Walker, S.C., Trotter, P.D., Swaney, W.T., Marshall, A., Mcglone, F.P. (2017). C-tactile afferents: Cutaneous mediators of oxytocin release during affiliative tactile interactions? Neuropeptides.
https://www.ncbi.nlm.nih.gov/pubmed/28162847
Webb, T.R., Rajendran, D. (2016). Myofascial techniques: What are their effects on joint range of motion and pain? - A systematic review and meta-analysis of randomised controlled trials. J Bodyw Mov Ther.
https://www.ncbi.nlm.nih.gov/pubmed/27634094