Massage Therapy Research Review

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.

Some of the best supporting evidence comes from recent recommendations from The Canadian Medical Association (Busse et al. 2017), The American College of Physicians (Chou et al. 2017, Qaseem et al. 2017), The Ontario Protocol for Traffic Injury Management (OPTIMa) (Wong et al. 2017) and The Mayo Clinic (Nahin et al. 2016).

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

Evidence Based Massage Therapy

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

Treatments often include, but are not limited to education, reassurance, remedial exercises, classical swedish massage, myofascial mobilization, instrument-assisted soft tissue mobilization, cupping, taping, non-thrust mobilization, strain-counterstrain, muscle energy techniques and neural mobilizations.

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. If you are not yet aware of the growing body of evidence to support the work that we do, here is a list of systematic reviews that lend credibility to massage therapy.

• Back pain (Busse et al. 2017, Chou et al. 2017, Qaseem et al. 2017, Nahin et al. 2016, Wong et al. 2017)
• Neck pain (Brosseau et al. 2012, Busse et al. 2017, Bussières et al. 2016, Côté et al. 2016, Nahin et al. 2016, Sutton et al. 2016, Wong et al. 2016, van der Velde et al. 2016)
• Temporomandibular joint disorder (Martins et al. 2016, Randhawa et al. 2016)
• Tension Headaches (Busse et al. 2017, Chaibi et al. 2014, Nahin et al. 2016, Varatharajan et al. 2016)
• Migraines (Busse et al. 2017, Chaibi et al. 2011)
• Lateral Epicondylitis (Piper et al. 2016, Sutton et al. 2016)
• Dupuytren's Disease (Ball et al. 2016)
• Carpal Tunnel Syndrome (Piper et al. 2016, Huisstede et al 2017)
• Chronic Exertional Compartment Syndrome (Rajasekaran et al. 2016)
• Knee Osteoarthritis (Busse et al. 2017, Xu et al. 2017, Salamh et al. 2017)
• Ankle Sprains (Doherty et al. 2017)
• Plantar Heel Pain (Piper et al. 2016, Sutton et al. 2016)
• Arthritis (Nelson et al. 2017)
• Labour Pain (Jones et al. 2012, Smith et al. 2012)
• Fibromyalgia (Yuan et al. 2015)
• Scar Management (Anthonissen et al. 2016)
• Cancer-Related Fatigue (Hilfiker et al. 2017)

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.

• 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 (Bialosky et al. 2017).

• Neuromodulation - Massage has an affect on peripheral and central processes - input from large sensory neurons may prevent the spinal cord from amplifying nociceptive signaling (Bishop et al. 2015, Vigotsky et al. 2015).

• 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 (Ellingsen et al. 2016, Walker et al. 2017).

• 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).