The Medical Minute: Massage Therapy - aye, there's the rub

July 13, 2005

By John Messmer
Penn State Family and Community Medicine
Penn State Milton S. Hershey Medical Center
Penn State College of Medicine

Just about anyone who has had a professional massage will tell you they felt better for the experience. What's not to like about 30 to 60 minutes of relaxation with soothing music and someone to work the stiffness out of your muscles? But is it just a way to relax or is it therapeutic - that is, does it actually treat anything? At the National Center for Complementary and Alternative Medicine, a division of the National Institutes of Health (NIH), a number of studies have been underway to answer that question.

There are different types of massage. Some are designed to induce relaxation and some endeavor to manipulate tissues to fix a problem. It's difficult to answer the question of whether massage therapy has a beneficial medical effect because there are so many types of massage. Also, scientific studies commonly rely on comparing a treatment to placebo in people who are unaware they are getting a placebo -- the so-called "blinded" study. It's easy to tell whether you are getting a massage or not, so blinded studies can not be done. It can be compared to other types of therapy, however.

The Cochrane Collaboration, an international agency that analyzes medical evidence, has concluded there is evidence that massage can help treat low back pain, specifically acupressure massage more so than classic Swedish massage which is less forceful. On the other hand, deep friction massage was not found to be effective for tendonitis.

The NIH has funded studies on the benefits of various complementary and alternative medical treatments for several years. The results for massage are mixed. Massage has been shown to improve mood in cancer patients and enhance their immune systems, but it is not certain that it increases the recovery from cancer. Non-migraine headache duration is shortened by massage, but the intensity of the pain is the same in one study. It might even help children with attention deficit according to another study.

Just because there is evidence of benefit in some situations, we cannot assume that massage will help with any medical problem. Back pain can have many causes: muscular tightness, arthritis, disc disease or abdominal pathology such as an aortic aneurysm or pancreatic cancer, for example. Before engaging a massage therapist for back pain, it's critical to have the cause of the pain diagnosed by a physician. If the cause is amenable to massage therapy, it could reduce the amount of pain medication needed. With recent evidence of potential cardiac risk from anti-inflammatory agents, if massage helps, it could be safer than medication.

Many physicians already recommend massage for many types of painful conditions from acute strains to arthritis associated pain and fibromyalgia. Insurance plans may not cover the cost, but with a written order from your doctor, it might be a medical expense for tax purposes.

Although some people prefer a more luxurious setting, it's not necessary to go to a high priced spa for a massage. Many communities have formally trained and certified massage therapists whose prices might just make it worth a try.

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Last Updated March 19, 2009