Updated Biopsychosocial Model of Massage Therapy

My current goal is to promote the value of massage therapy to medical professionals by synthesizing and simplifying noteworthy finds and best available supporting evidence applicable to massage therapy.

As part of an upcoming presentation I have put together a post outlining potential responses to massage therapy, here is a brief excerpt.

The Biopsychosocial Model of Massage Therapy

A biopsychosocial model of massage therapy helps put into context the interconnected and multidirectional interaction between: physiology, thoughts, emotions, behaviors, culture, and beliefs.

The biopsychosocial massage therapy has been shown to be a safe, non-pharmacological therapeutic intervention that is simple to carry out, economical, and has very few side effects. In terms of clinical responses to massage therapy there are a couple of proposed mechanisms of action, including but not limited to:

• Neurodynamics - “A clinical concept that uses movement (1) to assess increased mechanosensitivity of the nervous system; and (2) to restore the altered homeostasis in and around the nervous system.” (Grieve's Modern Musculoskeletal Physiotherapy).

• Neuroplasticity - Touch can help sharpen the image of the self in our body maps.

• Contextually Aided Recovery - The way we present ourselves and present our techniques is tied to clinical outcomes, the magnitude of a response may be influenced by mood, expectation, and conditioning.

• Neuromodulation - Massage has an affect on peripheral and central processes - input from large sensory neurons may prevent the spinal cord from amplifying nociceptive signaling.

• Social Grooming - Nervous system regulated by touch (social grooming) helps modulate the activity of neural circuits important for maintaining resting state. This reduced physiological and behavioural reactivity to stressors results in improved mood/affect.

• Mechanotherapy - "Any intervention that introduces mechanical forces with the goal of altering molecular pathways and inducing a cellular response that enhances tissue growth, modeling, remodeling, or repair.” (Thompson et al. 2016).

More to Explore

Related Links
• Myofascial Techniques
• Sports Massage
• Active Release Treatments
• Medical Acupuncture
• Cupping
• Taping

Massage Therapy: Injury Specific Treatments
As the body of knowledge to support the use of massage therapy continues to grow, understanding the basic science behind what we do and the guiding principles of adaptability enable us to apply this work to a number of conditions including, but not limited to:
• Sports Related Aches and Pain
• Shoulder Injuries
• Carpal Tunnel Syndrome 
• Post-Operative Patients
• Compartment Syndrome
• Dupuytren's Disease
• Low Back Pain 
• Neck Pain
• Post-Concussion Syndrome
• Temporal Mandibular Disorder (TMD)
• Scar Management 

Research Links

Best, T. M., & Crawford, S. K. (2017). Massage and postexercise recovery: The science is emerging. British Journal of Sports Medicine.

Best, T.M., Gharaibeh, B., Huard, J. (2013). Stem cells, angiogenesis and muscle healing: a potential role in massage therapies? Br J Sports Med.

Bialosky, J.E., Bishop, M.D., Penza, C.W. (2017). Placebo Mechanisms of Manual Therapy: A Sheep in Wolf's Clothing? J Orthop Sports Phys Ther.

Bialosky, J. E., Bishop, M. D., Price, D. D., Robinson, M. E., & George, S. Z. (2009). The mechanisms of manual therapy in the treatment of musculoskeletal pain: A comprehensive model. Manual Therapy. 

Bishop, M. D., Torres-Cueco, R., Gay, C. W., Lluch-Girbés, E., Beneciuk, J. M., & Bialosky, J. E. (2015). What effect can manual therapy have on a patient's pain experience? Pain Management.
https://www.ncbi.nlm.nih.gov/pubmed/26401979 (OPEN ACCESS)

Bove, G.M., Chapelle, S.L., Hanlon, K.E., Diamond, M.P., Mokler, D.J. (2017). Attenuation of postoperative adhesions using a modeled manual therapy. PLoS One.
https://www.ncbi.nlm.nih.gov/pubmed/28574997/ (OPEN ACCESS)

Chaitow, L. (2016). Dosage and manual therapies – Can we translate science into practice? Journal of Bodywork and Movement Therapies.

Chaudhry, H., Bukiet, B., Ji, Z., Stecco, A., & Findley, T. (2014). Deformations Experienced in the Human Skin, Adipose Tissue, and Fascia in Osteopathic Manipulative Medicine. JAOA.

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

Crane, J., Ogborn, D., Cupido, C., Melov, S., Hubbard, A., Bourgeois, J., & Tarnopolsky, M. (2012). Massage Therapy Attenuates Inflammatory Signaling After Exercise-Induced Muscle Damage. Science Translational Medicine.

Ellingsen, D., Leknes, S., Løseth, G., Wessberg, J., & Olausson, H. (2016). The Neurobiology Shaping Affective Touch: Expectation, Motivation, and Meaning in the Multisensory Context. Frontiers in Psychology.

Fryer, G. (2017). Integrating osteopathic approaches based on biopsychosocial therapeutic mechanisms. Part 1: The mechanisms. International Journal of Osteopathic Medicine.

Fryer, G. (2017). Integrating osteopathic approaches based on biopsychosocial therapeutic mechanisms. Part 2: Clinical approach. International Journal of Osteopathic Medicine.

Gilbert, K. K., James, C. R., Apte, G., Brown, C., Sizer, P. S., Brismée, J., & Smith, M. P. (2015). Effects of simulated neural mobilization on fluid movement in cadaveric peripheral nerve sections: Implications for the treatment of neuropathic pain and dysfunction. Journal of Manual & Manipulative Therapy.
http://www.ncbi.nlm.nih.gov/pubmed/26917940 (OPEN ACCESS)

Louw, A., Nijs, J., Puentedura, E. (2017). A clinical perspective on a pain neuroscience education approach to manual therapy. Journal of Manual & Manipulative Therapy.

Mancini, F., Nash, T., Iannetti, G.D., Haggard, P. (2014). Pain relief by touch: a quantitative approach. Pain.

Mancini, F., Beaumont, A., Hu, L., Haggard, P., & Iannetti, G. D. (2015). Touch inhibits subcortical and cortical nociceptive responses. Pain.

Melzack, R. & Wall, P.D. (1965). Pain mechanisms: a new theory. Science.

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)

Newell, D., Lothe, L.R., Raven, T.J. (2017). Contextually Aided Recovery (CARe): a scientific theory for innate healing. Chiropr Man Therap.

Nummenmaa, L., Tuominen, L., Dunbar, R., ... Sams, M. (2016). Social touch modulates endogenous μ-opioid system activity in humans. Neuroimage.

Parravicini, G., Bergna, A., (2017). Biological effects of direct and indirect manipulation of the fascial system. Narrative review. Journal of Bodywork & Movement Therapies.

Pelletier, R., Higgins, J., Bourbonnais, D. (2015). Addressing Neuroplastic Changes in Distributed Areas of the Nervous System Associated With Chronic Musculoskeletal Disorders. Phys Ther.

Rabey, M., Hall, T., Hebron, C., Palsson, T.S., Christensen, S.W., Moloney, N. (2017). Reconceptualising manual therapy skills in contemporary practice. Musculoskeletal Science and Practice.

Thompson, W. R., Scott, A., Loghmani, M. T., Ward, S. R., & Warden, S. J. (2016). Understanding Mechanobiology: Physical Therapists as a Force in Mechanotherapy and Musculoskeletal Regenerative Rehabilitation. Physical Therapy. 
https://www.ncbi.nlm.nih.gov/pubmed/26637643 (OPEN ACCESS)

Vigotsky, A. D., & Bruhns, R. P. (2015). The Role of Descending Modulation in Manual Therapy and Its Analgesic Implications: A Narrative Review. Pain Research and Treatment. 
https://www.ncbi.nlm.nih.gov/pubmed/26788367 (OPEN ACCESS)

Walker, S.C., Trotter, P.D., Swaney, W.T., Marshall, A., Mcglone, F.P. (2017). C-tactile afferents: Cutaneous mediators of oxytocin release during affiliative tactile interactions?  Neuropeptides.

Webb, T.R., Rajendran, D. (2016). Myofascial techniques: What are their effects on joint range of motion and pain? - A systematic review and meta-analysis of randomised controlled trials. J Bodyw Mov Ther.