Massage Therapy: A Review Of The Evidence

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 Make You Feel Better?

The responses to massage therapy are multifactorial - physiological and psychological factors interplay in a complex manner. The biopsychosocial model provides a practical framework for investigating the complex interplay between massage therapy and clinical outcomes.

Based off the biopsychosocial model, investigation into mechanisms of action should extend beyond local tissue changes and include peripheral and central endogenous pain modulation. An observed favorable outcome may be explained by a number of overlapping mechanism in the periphery, spinal cord, and brain represented in the image below.

Proposed Mechanisms of Massage Therapy

Massage Therapy: A Review Of The Evidence

Massage therapy has a growing body of evidence supporting 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 (Chou et al. 2017, Foster et al. 2018Traeger et al. 2017Qaseem et al. 2017)
• Neck Pain (Busse et al. 2017Chou et al. 2018Côté et al. 2016)
• Headaches and Migraines (Busse et al. 2017Millstine et al. 2017)
• Temporomandibular Disorder (Martins et al. 2016Randhawa et al. 2016)
• Shoulder Pain (Hawk et al. 2017Steuri, 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, Nahin et al. 2016)
• Plantar Fasciitis (Fraser et al. 2018)
• 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)
• Pain Management in Labour (Smith et al. 2018)
• Hypertrophic Scarring (Ault 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

Ault, P., Plaza, A., Paratz, J. (2018). Scar massage for hypertrophic burns scarring-A systematic review. Burns.
https://www.ncbi.nlm.nih.gov/pubmed/28669442

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

Chou, R., Deyo, R., Friedly, ... Brodt, E.D. (2017). Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline. Ann Intern Med.
https://www.ncbi.nlm.nih.gov/pubmed/28192793 

Chou, R., Côté, P., ... Cedraschi, C. (2018). The Global Spine Care Initiative: applying evidence-based guidelines on the non-invasive management of back and neck pain to low- and middle-income communities. Eur Spine J.
https://www.ncbi.nlm.nih.gov/pubmed/29460009/

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 

Foster, N.E., Anema, J.R., Cherkin, D., ... Maher, C.G. (2018). Prevention and treatment of low back pain: evidence, challenges, and promising directions. Lancet.
https://www.ncbi.nlm.nih.gov/pubmed/29573872

Fraser, J.J., Corbett, R., Donner, C., Hertel, J. (2018). Does manual therapy improve pain and function in patients with plantar fasciitis? A systematic review. J Man Manip Ther.
https://www.ncbi.nlm.nih.gov/pubmed/29686479

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

Nahin, R. L., Boineau, R., ... Weber, W. J. (2016). Evidence-Based Evaluation of Complementary Health Approaches for Pain Management in the United States. Mayo Clinic Proceedings. (OPEN ACCESS)
https://www.ncbi.nlm.nih.gov/pubmed/27594189

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

Qaseem, A., Wilt, T.J., McLean, R.M., Forciea, M.A. (2017). Clinical Guidelines Committee of the American College of Physicians.. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med.
https://www.ncbi.nlm.nih.gov/pubmed/28192789

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

Smith, C.A., Levett, K.M., ... Suganuma, M. (2018). Massage, reflexology and other manual methods for pain management in labour. Cochrane Database Syst Rev.
https://www.ncbi.nlm.nih.gov/pubmed/29589380

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