Massage Therapy: A Review Of The Evidence

Does Massage Work?

Massage Therapy

A Review of The Evidence

The RMT Education Project is an initiative that is working to promote the benefits of massage therapy to an international audience. In this post I have put together an overview of best available supporting evidence applicable to massage therapy.

Definiton: 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."

Mechanism of Action: 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 (Traeger et al. 2017Chou 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)
• Plantar Fasciitis (Faser et al. 2017)
• 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)
• 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.

Ault, P., Plaza, A., Paratz, J. (2018). Scar massage for hypertrophic burns scarring-A systematic review. Burns.

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.

Busse, J.W., Craigie, S., Juurlink, D.N, ... Guyatt GH. (2017). Guideline for opioid therapy and chronic noncancer pain. CMAJ.

Chen, L., Michalsen, A. (2017). Management of chronic pain using complementary and integrative medicine. BMJ.

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. 

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.

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.

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. 

Fraser, J.J., Glaviano, N.R., Hertel, J. (2017). Utilization of Physical Therapy Intervention Among Patients With Plantar Fasciitis in the United States. JOSPT.

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)

Hawk, C., Minkalis, A.L., ... Bhalerao, S. (2017). Systematic Review of Nondrug, Nonsurgical Treatment of Shoulder Conditions. J Manipulative Physiol Ther.

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)

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.

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.

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.

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.

Millstine, D., Chen, C., Bauer, B. (2017). Complementary and integrative medicine in the management of headache. BMJ.

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.

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)

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.

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.

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)

Traeger, A., Buchbinder, R., Harris, I., Maher, C. (2017). Diagnosis and management of low-back pain in primary care. CMAJ.

Wenger, H.C., Cifu, A.S. (2017). Treatment of Low Back Pain. JAMA.