Massage Therapy and Neck Pain

massage therapy and neck pain

Massage Therapy & Neck Pain

Research Links

For those who suffer from neck back pain, massage therapy has been shown to be a safe, effective non-pharmacological therapeutic intervention that is simple to carry out, economical, and has very few side effects (Brosseau et al. 2012Bussières et al. 2016Côté et al. 2016Nahin et al. 2016Sutton et al. 2016Wong et al. 2016van der Velde et al. 2016).

Why Does Massage Therapy Work?

Massage therapy is a clinically-oriented multi-modal approach (manual therapy, remedial exercise and patient education) based on a biopsychosocial model and on the three pillars of evidence based practice (best available evidence, clinical expertise and patient values).

The mechanism by which massage therapy alleviates localized pain is not clear, biological factors (physiology), psychological (i.e. thoughts, emotions, and behaviors) and social (i.e. culture, and religion) factors play a significant role in the experience and reduction of pain.

In terms of clinical responses to massage therapy there are a couple of proposed mechanisms of action:

  • Contextual responses: This is likely to play a role in any therapeutic intervention, the way we present ourselves and present our techniques has influence on the treatment. The magnitude of a response may be influenced by mood, expectation, and conditioning (Bialosky et al. 2017).
  • Endogenous pain modulation: Massage has a modulatory affect on peripheral and central processes via input from large sensory neurons that prevents the spinal cord from amplifying the nociceptive signal. This anti-nociceptive effect of massage therapy can help ease aches and pain. (Bishop et al. 2015Vigotsky et al. 2015).
  • Improved blood flow: Researchers demonstrated that compression and its release improves localized blood flow. It is proposed that improved perfusion and oxygen delivery to the muscle, encourages the removal of cellular exudates and drainage of metabolic waste (Moraska et al. 2013).
  • An increase in parasympathetic activity: Studies have demonstrated an increase in parasympathetic activity following local compression of myofascial triggerpoints. This alteration within the autonomic nervous system result in changes to regional perfusion (Takamoto et al. 2009).
  • Myofascial trigger points: Randomised controlled trials have demonstrated that compression at myofascial triggerpoints (MTrPs) significantly improved subjective pain scores compared with compression at Non-MTrPs and the control treatments for patients suffering form neck pain (Morikawa et al. 2017).  
  • Immunomodulation: One interesting paper suggests that the application of massage induces a phenotype change, prompting the transition of M1 macrophages into the M2 macrophages (Waters-Banker et al. 2014).

Physicians, now more than ever are recommending conservative treatment including massage, acupuncture and exercise as part of a multi-modal approach for patients suffering from neck pain, anxiety and stress. Below you will finds links and clinical research related to neck pain.


More to Explore

Brosseau, L., Wells, G.A., Tugwell, P., Casimiro, L., Novikov, M., ... Cohoon C. (2012). Ottawa Panel evidence-based clinical practice guidelineon therapeutic massage for neck pain. J Bodyw Mov Ther.
https://www.ncbi.nlm.nih.gov/pubmed/22703740

Bussières, A. E., Stewart, G., Al-Zoubi, F., Decina, P., Descarreaux, M., Hayden, J., . . . Ornelas, J. (2016). The Treatment of Neck Pain–Associated Disorders and Whiplash-Associated Disorders: A Clinical Practice Guideline. Journal of Manipulative and Physiological Therapeutics.
https://www.ncbi.nlm.nih.gov/pubmed/27836071

Cook, A. J., Wellman, R. D., Cherkin, D. C., Kahn, J. R., & Sherman, K. J. (2015). Randomized clinical trial assessing whether additional massage treatments for chronic neck pain improve 12- and 26-week outcomes. The Spine Journal.
https://www.ncbi.nlm.nih.gov/pubmed/26096474

Costello, M., Puentedura, E. ‘, Cleland, J., & Ciccone, C. D. (2016). The immediate effects of soft tissue mobilization versus therapeutic ultrasound for patients with neck and arm pain with evidence of neural mechanosensitivity: A randomized clinical trial. Journal of Manual & Manipulative Therapy.
https://www.ncbi.nlm.nih.gov/pubmed/27559283

De Meulemeester, K.E., Castelein, B., Coppieters, I., Barbe, T., Cools, A., Cagnie, B. (2017). Comparing Trigger Point Dry Needling and Manual Pressure Technique for the Management of Myofascial Neck/Shoulder Pain: A Randomized Clinical Trial. J Manipulative Physiol Ther. 
https://www.ncbi.nlm.nih.gov/pubmed/28017188

Frieden, T. R., & Houry, D. (2016). Reducing the Risks of Relief — The CDC Opioid-Prescribing Guideline. New England Journal of Medicine.
https://www.ncbi.nlm.nih.gov/pubmed/26977701

Furlan, A. D., Yazdi, F., Tsertsvadze, A., Gross, A., Tulder, M. V., Santaguida, L., . . . Tsouros, S. (2012). A Systematic Review and Meta-Analysis of Efficacy, Cost-Effectiveness, and Safety of Selected Complementary and Alternative Medicine for Neck and Low-Back Pain. Evidence-Based Complementary and Alternative Medicine.
https://www.ncbi.nlm.nih.gov/pubmed/22203884

Gerber, L.H., Sikdar, S., Aredo, J.V., Armstrong, K., Rosenberger, W.F., Shao, H., Shah, J.P. (2017). Beneficial Effects of Dry Needling for Treatment of Chronic Myofascial Pain Persist for 6 Weeks After Treatment Completion. PM R.
https://www.ncbi.nlm.nih.gov/pubmed/27297448

Gross, A., Langevin, P., Burnie, S. J., Bédard-Brochu, M., Empey, B., Dugas, E., . . . Leblanc, F. (2015). Manipulation and mobilisation for neck pain contrasted against an inactive control or another active treatment. Cochrane Database of Systematic Reviews.
https://www.ncbi.nlm.nih.gov/pubmed/26397370

Haller, H., Lauche, R., Cramer, H., Rampp, T., Saha, F. J., Ostermann, T., & Dobos, G. (2016). Craniosacral Therapy for the Treatment of Chronic Neck Pain. The Clinical Journal of Pain.
https://www.ncbi.nlm.nih.gov/pubmed/26340656 (OPEN ACCESS)

Kjaer, P., Kongsted, A., Hartvigsen, J., ... Povlsen, T.M. (2017). National clinical guidelines for non-surgical treatment of patients with recent onset neck pain or cervical radiculopathy. Eur Spine J.
https://www.ncbi.nlm.nih.gov/pubmed/28523381

Morikawa, Y., Takamoto, K., Nishimaru, H., Taguchi, T., Urakawa, S., Sakai, S., Ono, T., Nishijo, H. (2017). Compression at Myofascial Trigger Point on Chronic Neck Pain Provides  Pain Relief through the Prefrontal Cortex and Autonomic Nervous System: A Pilot Study. Front Neurosci.
https://www.ncbi.nlm.nih.gov/pubmed/28442987 (OPEN ACCESS)

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

Nee, R.J., Vicenzino, B., Jull, G.A., Cleland, J.A., & Coppieters, M.W. (2012). Neural tissue management provides immediate clinically relevant benefits without harmful effects for patients with nerve-related neck and arm pain: a randomised trial. Journal of Physiotherapy.
https://www.ncbi.nlm.nih.gov/pubmed/22341379

Sherman, K. J., Cook, A. J., Wellman, R. D., Hawkes, R. J., Kahn, J. R., Deyo, R. A., & Cherkin, D. C. (2014). Five-Week Outcomes From a Dosing Trial of Therapeutic Massage for Chronic Neck Pain. The Annals of Family Medicine.
https://www.ncbi.nlm.nih.gov/pubmed/24615306

Sherman, K. J., Cherkin, D. C., Hawkes, R. J., Miglioretti, D. L., & Deyo, R. A. (2009). Randomized Trial of Therapeutic Massage for Chronic Neck Pain. The Clinical Journal of Pain.
https://www.ncbi.nlm.nih.gov/pubmed/19333174

Sutton, D. A., Côté, P., Wong, J. J., Varatharajan, S., Randhawa, K. A., Yu, H., . . . Stupar, M. (2016). Is multimodal care effective for the management of patients with whiplash-associated disorders or neck pain and associated disorders? A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. The Spine Journal.
https://www.ncbi.nlm.nih.gov/pubmed/25014556

van der Velde, G., Yu, H., Paulden, M., Côté, P., Varatharajan, S., Shearer, H.M., Wong, J.J.,...,Taylor-Vaisey, A. (2016). Which interventions are cost-effective for the management of whiplash-associated and neck pain-associated disorders? A systematic review of the health economic literature by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. The Spine Journal.
https://www.ncbi.nlm.nih.gov/pubmed/26631759

Wong, J. J., Shearer, H. M., Mior, S., Jacobs, C., Côté, P., Randhawa, K., . . . Taylor-Vaisey, A. (2016). Are manual therapies, passive physical modalities, or acupuncture effective for the management of patients with whiplash-associated disorders or neck pain and associated disorders? an update of the bone and joint decade task force on neck pain and its associated disorders by the optima collaboration. The Spine Journal.
https://www.ncbi.nlm.nih.gov/pubmed/26707074