Does Massage Work?

/ Richard Lebert, RMT/
Does Massage Work?

Does Massage Work?

A Review of The Research

Massage therapy should no longer be considered a luxury, as it is a non-pharmacological intervention supported by current best practice guidelines from the Canadian Medical Association and the American Medical Association.

Despite these best practice guidelines there is still not wide support from the health care system. As a result most who chose to use this approach, still pay out of pocket for a treatment.

Now is the time to ‘bridge the gap’ with the medical profession and provide easier access to massage therapy. To help support the growth of the profession, I have put together an overview of best available supporting evidence applicable to massage therapy.

What is Massage Therapy?

The Canadian Massage Therapy Alliance (CMTA) 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."

Why Does Massage Therapy Work?

A biopsychosocial model of massage therapy 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:

• Neuroplasticity - Massage has an affect on peripheral and central processes - input from large sensory neurons prevents the spinal cord from amplifying nociceptive signaling.

• 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.

• Mechanotherapy - Mechanical input can be used to stimulate molecular signalling this enhances tissue remodeling and repair.

Does Massage Work?

Based on the available evidence the inclusion of massage therapy as a readily accessible adjunct to standard medical care has the potential to improve health related quality of life for a number of conditions, including but not limited to:
• Low Back Pain (Traeger et al. 2017, Wenger et al. 2017)
• Neck Pain (Busse et al. 2017, Côté et al. 2016)
• Headaches and Migraines (Busse et al. 2017, Millstine et al. 2017)
• Temporomandibular Disorder (Martins et al. 2016, Randhawa et al. 2016)
• Shoulder Pain (Hawk et al. 2017, Steuri, et al. 2017)
• Carpal Tunnel Syndrome (Huisstede et al. 2017)
• Hip Osteoarthritis (Cibulka et al. 2017)
• Knee Osteoarthritis (Ali et al. 2017, Busse et al. 2017)
• Plantar Fasciitis (Faser et al. 2017)
• Chronic Ankle Instability (Powden et al. 2017)
• Post-Operative Pain (Boitor et al. 2017, Kukimoto et al. 2017)
• Cancer-Related Fatigue (Hilfiker et al. 2017, Kinkead et al. 2018)
• Fibromyalgia (Busse et al. 2017)
• Delayed Onset Muscle Soreness (Guo et al. 2017)
• Postpartum Maternal Sleep (Owais et al. 2018)

More to Explore

Ali, A., Rosenberger, L., Weiss, T.R., Milak, C., Perlman, A.I. (2017). Massage Therapy and Quality of Life in Osteoarthritis of the Knee: A Qualitative Study. Pain Med.
https://www.ncbi.nlm.nih.gov/pubmed/27590465

Boitor, M., Gélinas, C., Richard-Lalonde, M., Thombs, B.D. (2017). The Effect of Massage on Acute Postoperative Pain in Critically and Acutely Ill Adults Post-thoracic Surgery: Systematic Review and Meta-analysis of Randomized Controlled Trials. Heart Lung.
https://www.ncbi.nlm.nih.gov/pubmed/28619390

Busse, J.W., Craigie, S., Juurlink, D.N, ... Guyatt GH. (2017). Guideline for opioid therapy and chronic noncancer pain. CMAJ.
https://www.ncbi.nlm.nih.gov/pubmed/28483845

Chen, L., Michalsen, A. (2017). Management of chronic pain using complementary and integrative medicine. BMJ.
https://www.ncbi.nlm.nih.gov/pubmed/28438745

Cibulka, M.T., Bloom, N.J., Enseki, K.R., ... McDonough, C.M. (2017). Hip Pain and Mobility Deficits-Hip Osteoarthritis: Revision 2017. J Orthop Sports Phys Ther.
https://www.ncbi.nlm.nih.gov/pubmed/28566053

Côté, P., Wong, J.J., Sutton, D., ... Salhany, R. (2016). Management of neck pain and associated disorders: A clinical practice guideline from the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Eur Spine J.
https://www.ncbi.nlm.nih.gov/pubmed/26984876 

Fraser, J.J., Glaviano, N.R., Hertel, J. (2017). Utilization of Physical Therapy Intervention Among Patients With Plantar Fasciitis in the United States. J Orthop Sports Phys Ther.
https://www.ncbi.nlm.nih.gov/pubmed/28142368

Guo, J., Li, L., Gong, Y., Zhu, R., Xu, J., Zou, J., Chen, X. (2017). Massage Alleviates Delayed Onset Muscle Soreness after Strenuous Exercise: A Systematic Review and Meta-Analysis. Front Physiol. (OPEN ACCESS)
https://www.ncbi.nlm.nih.gov/pubmed/29021762

Hawk, C., Minkalis, A.L., ... Bhalerao, S. (2017). Systematic Review of Nondrug, Nonsurgical Treatment of Shoulder Conditions. J Manipulative Physiol Ther.
https://www.ncbi.nlm.nih.gov/pubmed/28554433

Hilfiker, R., Meichtry, A., Eicher, M., ... Taeymans, J. (2017). Exercise and other non-pharmaceutical interventions for cancer-related fatigue in patients during or after cancer treatment: a systematic review incorporating an indirect-comparisons meta-analysis. Br J Sports Med. (OPEN ACCESS)
https://www.ncbi.nlm.nih.gov/pubmed/28501804

Huisstede, B.M., van den Brink, J., Randsdorp, M.S., Geelen, S.J., Koes, B.W. (2017). The Effectiveness of Surgical and Post-Surgical Interventions for Carpal Tunnel Syndrome-A Systematic Review. Arch Phys Med Rehabil.
https://www.ncbi.nlm.nih.gov/pubmed/28577858

Kinkead, B., Schettler, P.J., Larson, E.R., ... Rapaport, M.H. (2018). Massage therapy decreases cancer-related fatigue: Results from a randomized early phase trial. Cancer.
https://www.ncbi.nlm.nih.gov/pubmed/29044466

Kukimoto, Y., Ooe, N., Ideguchi, N. (2017). The Effects of Massage Therapy on Pain and Anxiety after Surgery: A Systematic Review and Meta-Analysis. Pain Manag Nurs.
https://www.ncbi.nlm.nih.gov/pubmed/29173797

Martins, W. R., Blasczyk, J. C., ... Oliveira, R. J. (2016). Efficacy of musculoskeletal manual approach in the treatment of temporomandibular joint disorder: A systematic review with meta-analysis. Manual Therapy.
https://www.ncbi.nlm.nih.gov/pubmed/26144684

Millstine, D., Chen, C., Bauer, B. (2017). Complementary and integrative medicine in the management of headache. BMJ.
https://www.ncbi.nlm.nih.gov/pubmed/28512119

Owais, S., Chow, C.H.T., Furtado, M., Frey, B.N., Van Lieshout, R.J. (2018). Non-pharmacological interventions for improving postpartum maternal sleep: A systematic review and meta-analysis. Sleep Med Rev.
https://www.ncbi.nlm.nih.gov/pubmed/29449122/

Powden, C.J., Hoch, J.M., Hoch, M.C. (2017). Rehabilitation and Improvement of Health-Related Quality-of-Life Detriments in Individuals With Chronic Ankle Instability: A Meta-Analysis. J Athl Train. (OPEN ACCESS)
https://www.ncbi.nlm.nih.gov/pubmed/28704635

Randhawa, K., Bohay, R., Côté, P., Velde, G., . . . Taylor-Vaisey, A. (2016). The Effectiveness of Non-invasive Interventions for Temporomandibular Disorders. The Clinical Journal of Pain.
https://www.ncbi.nlm.nih.gov/pubmed/25924094

Steuri, R., Sattelmayer, M., Elsig, S., Kolly, C., Tal, A., Taeymans, J., Hilfiker, R. (2017). Effectiveness of conservative interventions including exercise, manual therapy and medical management in adults with shoulder impingement: a systematic review and meta-analysis of RCTs. Br J Sports Med. (OPEN ACCESS)
https://www.ncbi.nlm.nih.gov/pubmed/28630217

Traeger, A., Buchbinder, R., Harris, I., Maher, C. (2017). Diagnosis and management of low-back pain in primary care. CMAJ.
https://www.ncbi.nlm.nih.gov/pubmed/29133540

Wenger, H.C., Cifu, A.S. (2017). Treatment of Low Back Pain. JAMA.
https://www.ncbi.nlm.nih.gov/pubmed/28829855