The Power of Touch: Exploring the Science Behind Massage Therapy
/The Power of Touch: Exploring the Science Behind Massage Therapy
For thousands of years, various massage techniques have been used worldwide to address a wide range of health issues. While the specific approaches and names may differ the core benefits of massage often share many similarities. However, one key element has been missing in the world of massage therapy: a unified theoretical framework for understanding how massage therapy works.
The available evidence suggests that the effects of massage cannot be explained by a single mechanism. Instead, it acts through a complex interplay of interconnected responses. This aligns with the concept of a "whole-person approach," which emphasizes the interconnectedness of biological, psychological, and social factors that contribute to our overall health and well-being.
So, How Does Massage Therapy Work?
Before diving into effects and outcome it is important to establish clearly defined terminology. In this resource massage and massage therapy have two different definition that was originally established by a group of international therapists and researchers (Kennedy et al., 2016).
Massage is a patterned and purposeful soft-tissue manipulation accomplished by use of digits, hands, forearms, elbows, knees and/or feet, with or without the use of emollients, liniments, heat and cold, hand-held tools or other external apparatus, for the intent of therapeutic change.
Massage therapy consists of the application of massage and non-hands-on components, including health promotion and education messages, for self-care and health maintenance; therapy, as well as outcomes, can be influenced by: therapeutic relationships and communication; the therapist’s education, skill level, and experience; and the therapeutic setting.
Here we see the contemporary practice of massage therapy defined as a multi-modal approach that includes, but is not limited to classical massage, Swedish massage, myofascial mobilization, instrument-assisted soft tissue mobilization (IASTM), cupping, joint mobilization, counterstrain, neuromuscular therapy, muscle energy techniques, neural mobilizations, manual lymphatic drainage, and education. Each treatment approach in massage therapy may vary and despite being called different names, most of these techniques have similar effects and outcomes (Bialosky et al., 2018).
The Total Treatment Effects can be broken down into three components: specific effects, contextual effects, and non-specific effects.
The Total Treatment Effect
Massage therapists may have their own unique treatment methods (e.g. light touch, soft tissue massage, mobilization, cupping, and instrument assisted soft tissue manipulation), but overall, their treatments share the same common concepts. The overall impact of this intervention, known as the total treatment effect, can be analyzed through three lenses:
1. Specific effects: These are directly attributable to the massage techniques themselves. They include:
Affective touch: The soothing and calming experience of human touch has been shown to stimulate the release of neurochemicals (neurotransmitters and neuropeptides) associated with a sense of comfort, well-being and relaxation.
Mechanical factors: The effect that massage therapy can have on the musculoskeletal system (mediated by nerves, hormones, cytokines, neuropeptides and chemokines).
Neurological factors: The stimulation of nervous system pathways, leading to pain relief, relaxation, and mood modulation.
2. Contextual effects: These consider the environment and relationships surrounding the treatment. The patient-therapist rapport, expectations (set), and physical surroundings (setting) can all influence outcomes.
3. Non-specific effects: These encompass natural recovery processes, like the body's inherent healing ability and spontaneous improvement over time.
The total treatment effect emerges from the combined influence of various factors. This framework allows for a more comprehensive understanding of treatment efficacy, acknowledging the interplay between specific biological effects, the treatment context, and the body's inherent ability to self-heal.
Massage therapists may have their own unique treatment methods, but overall, their treatments share the same common concepts. Massage therapy involves the application of mechanical forces to the outside of the body with therapeutic intent and it may include light touch, soft tissue massage, mobilization, cupping, and instrument assisted soft tissue manipulation.
Key Message
Massage therapy is a clinically-oriented healthcare option that can improve quality of life for patients with a variety of conditions. Acknowledging the multidimensional nature of massage therapy – specific effects, contextual effects, and non-specific effects – paves the way for an evidence-based, approach. It allows therapists to have a unified theoretical framework for understanding how massage therapy works.
In terms of research there are many systematic reviews, meta-analyses, and clinical practice guidelines supporting massage therapy and its effectiveness in reducing pain and improving health-related quality of life in a variety of health conditions and rehabilitation, including but not limited to: low back pain, osteoarthritis, fibromyalgia, headache, and post-cancer pain.
References and Sources
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