by Cynthia M. Johnson, MA
Forms of Massage
Touch-based therapy is one of the oldest forms of medical care. We stroke and rub areas of our body that hurt. Massage therapy turns this instinct into a professional treatment. There are many types of massage. Most massage therapists use more than one. Swedish massage is one of the most common types. It uses long strokes and gentle kneading motions that affect surface muscle tissues. Deep-tissue massage uses more pressure to reach deeper levels of muscles. Shiatsu or acupressure massage also use deep pressure, but they do so according to the principles of acupuncture theory. This can differ from those of Western-oriented massage therapies. Neuromuscular massage applies strong pressure to tender spots that are known as trigger points.
Looking at the Evidence
There is some evidence that massage may be helpful for some medical purposes, but it is not strong. There are many reasons for this, but the main obstacle is that it is hard to determine the effectiveness of a hands-on therapy.
This is why all studies of massage fall short. Many researchers have designed studies that compare massage to no treatment. But these studies can't provide reliable evidence about the effect of a treatment. If a benefit is seen, there is no way to know whether it was caused by massage or just attention. Attention alone will almost always produce a benefit. More meaningful trials used some sort of placebo treatment for the control group, referred to as “sham” massage. However, using a placebo treatment that is very different in form from the treatment under study is not ideal.
Other studies have simply involved giving people massages and seeing whether they improved. It is hard to evaluate the benefit of these studies. If a treatment of any kind is given, a lot of people will think they have improvement. It doesn't matter whether or not the treatment does anything on its own. This is known as the placebo effect.
Here is a summary of what is known about the effects of massage. The best evidence for massage is on low back pain.
Massage for Low Back Pain
More studies are needed, but it does appear that massage may offer benefits for low back pain. It may improve function and ease symptoms. The benefits may be greatest when it is paired with exercise and education. The effects may also last up to a year.
Massage may also be helpful for health problems such as:
How to Choose a Therapist
You will want to choose a therapist who is licensed in your state. Most US states require massage therapists to be licensed. Organizations like the http://www.amtamassage.org/index.html have online databases that can help you find a therapist in your area.
Massage involves talent that goes beyond specific training, certification, or license. Some people are simply gifted with their hands. Also, a massage type that works for one person may not work for another. Trial and error is often needed to find the best massage therapist and massage type for you.
Massage is generally safe, but it can sometimes temporarily make pain worse even when it is done right. If massage is done too forcefully on fragile people, bone fractures and other internal injuries are also possible. Luckily, licensed massage therapists have been trained in ways to avoid causing these problems.
American Massage Therapy Association
Massage Therapy Foundation
Manual therapies for chronic low back pain. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/manual-therapies-for-chronic-low-back-pain. Accessed October 21, 2021.
Massage therapy. EBSCO Natural and Alternative Treatments website. Available at: https://www.ebscohost.com/academic/natural-alternative-treatments. Accessed October 21, 2021.
Last reviewed October 2021 by EBSCO Medical Review Board
Last Updated: 10/21/2021
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