The scientific case for massage therapy
Massage for low back pain is the most studied massage question, and the answer is fairly clear — it probably works at least a little. More below.
Unfortunately, most other evidence about massage benefits is indirect and/or weak. Some research helps us to understand why people like massage, or why it’s likely that there are numerous minor or general health benefits. But there are no smoking guns, no “proof” that it “works” — that is, we have no clinically significant therapeutic effectiveness for a good variety of health problems.
For instance, basic research has shown that touch is neurologically complex and probably has many physiological effects. In 2009, Swedish researchers identified specialized nerve fibers that respond only to light stroking of a certain speed.7 This is interesting, and it certainly suggests that massage can provide a rich and novel sensory experience — surprise surprise! — but it is far from proof that massage can fix anything.
Another interesting indirect example: stretching massages muscles with movement, and so it may feel good for some of the same reasons and share some of the same benefits. And indeed a 2011 study of simple, static stretching showed a clear, good effect on heart rate regulation8 — just from pulling on muscles, which may not be very different from pushing on them. It’s pretty reasonable to guess that movement (and manipulation) of soft tissues has systematic regulatory effects.
While many benefits of massage are still disconcertingly uncertain and hotly debated (by some), there are two truly proven ones. Massage researcher and psychologist Dr. Christopher explains that the only truly confirmed benefits of massage are its effects on mood (“affect”),9 specifically:
- massage reduces depression
- massage reduces anxiety
Dr. Moyer believes that more importance should be placed on these effects, and that they should even be the basis of “a new subfield for MT research and practice: affective massage therapy (AMT).”
Building on what is already known about the effects of massage therapy on anxiety and depression, everything possible should now be done to better understand and to optimize the ways that massage therapy influences affect, the observable components of an individual’s feelings, moods and emotions.
Christopher A Moyer
Perhaps one of the reasons massage reduces depression and anxiety: it’s relaxing. While not proven as well as you might think, it is a pretty safe bet,10 and the idea is further supported by evidence that massage therapy may reduces blood pressure1112 and helps people to sleep, even when they are under the unusual stresses of hospital care.13 These are all unsurprising … and unremarkable. Relaxation is an important component of wellness and pain management, and I do not underestimate its value, but it is hardly curative.
And, as many critics have pointed out, massage is a super expensive way to relax. On average, professional massage therapists charge about a buck a minute — vastly more than millions of people can afford on a regular basis. This economic perspective is often completely ignored in discussions of whether or not massage works. It probably does … but does it work well enough for the price? A nap is also quite relaxing, and a lot cheaper. If massage is to be considered a more cost-effective treatment for any medical problem than napping, we really must establish that it does more — quite a lot more — than just mellow people out.
Many studies done by the Touch Research Institute14 — although almost certainly of generally low quality and strongly biased in favour of massage15 — show many other broadly defined modest benefits to massage therapy in many circumstances—everything from rheumatoid (bad) arthritis16 to cancer17 to autism.18 In a recent study in Annals of Internal Medicine, both massage and ordinary, simple touching have been shown to help cancer patients — indicating that massage was helpful and yet unremarkable at the same time.19 (A more recent and better-designed Korean study was even more encouraging, showing that massage was quite a bit more helpful for patients with the deep, grinding pain of bone cancer than simply receiving compassionate attention.20)
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