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One Massage Study Does Not “Prove” a Point…

July 9, 2015 by Tracy Walton 24 Comments


…For a massage claim to be accurate, it needs to be backed by the strongest evidence. Yet some of the massage studies we’ve quoted for years are neither strong, nor conclusive.

In a few weeks, the Massage Therapy Foundation will release my free e-book, “Five Myths and Truths about Massage Therapy.” When it’s up, I’ll link to it here.

In preparing the book, I reviewed a lot of massage research.

I also reviewed a lot of reviews of massage research. In a research review, someone else already waded through the research, rated it and reported their conclusions.

From Angie’s List to Zappos

These days, consumers make a lot of decisions based on reviews and ratings. One star, five stars. Fit too small, chapters too long, service too slow. Fit perfect, page-turner, excellent service.

For those without the time to try on 18 pairs of shoes, reviews are real time savers.

In health care, reviews are time savers, too, but at a much higher standard. No hiding behind an anonymous screen name. (I’m talking to YOU, BatmanFan472.) Not so fast with the rant or the bad experience.

Typically, research reviews meet established standards of thought and transparency. Far from the haste of the average Yelp yelp, a good research review takes months to write.

Good thing, because many practices in health care are based on these reviews. Most practitioners don’t have the time or skills to analyze all the research in their profession. They need someone else to review it for them.

In massage therapy, we need that, too.

The Reviews of Massage Research Matter Most

It takes at least one high-level research review to truly settle a question.

In massage therapy, we got by for years on hearsay and testimonial (the equivalent of the modern day online review) about the benefits of our work. In better moments, we’ve zoomed out and seen patterns in our practice–a certain approach that seems to lead to certain outcomes. Better sleep, fewer headaches, more flexibility. Our data was empirical, limited to our observations.

So we all cheered when massage research started to appear in the literature. We pointed to this study or that one to “prove” its benefits. Typically, our claims about massage rested on a single randomized, controlled trial (RCT).

Yet even a good RCT has its limits. It’s from a single group of investigators, in a single time period, with a single sample of research subjects. Mistakes happen. Bias happens. Something gets skewed. Only a handful of people were tested. We’re still on shaky ground when we depend on a single study to back up our claims.

From a single study, we can’t say massage will “work.”

Instead, a large body of research–multiple studies–are needed to tell us anything conclusive.

That’s where the research reviews come in.

More accurate information can be found in aย  good systematic review of the research, which is higher on the research ladder than a single trial. A systematic review tells us whether (or not) massage does what we say it does. From dredging the literature, the reviewer can return a yes, no, or maybe.

Levels of Evidence Strongest Weakest 7-1-15
I explain all these massage cartoons in the e-book. I promise.

Now look at the top of the ladder. The highest, strongest level of evidence is a meta-analysis. A good meta-analysis is a systematic review that quantifies the effect of massage, telling us how strong the effect might be. In clinical research, it’s an ultimate search for truth. In massage therapy, we should look to these reviews, rather than a single study, for the benefits.

Here. I made you a thing.

It’s a list. I’m sharing a pile of systematic reviews and meta-analyses below. Here, you’ll find reviews of massage research on everything from cancer to depression to blood pressure.

Presumably some of the reviews show stronger analysis than others, but I haven’t rated or reviewed them. To analyze each analysis would require much higher level research skills than I possess, so I’m leaving the list of reviews unreviewed.ย  Some of the articles are free for the taking, and there are links to the full article. Otherwise, I’ve shared links to the abstracts (summaries) of those reviews at the US National Library of Medicine.

These reviews tell us, at a glance, what the authors saw in a body of massage research.

Some of the conclusions might surprise you.

Some are disappointing. They don’t say what we want them to say. But I think our profession is big enough to handle it. I believe that true seekers of healing are also seekers of truth.

The truths unearthed by good clinical research will have much to teach us about the effects of massage and how it works. For now, there are a lot of gaps in information. The gaps remind us that there is still a good deal of mystery in massage therapy, and that we live with both the known and the unknown. In massage therapy, the better we get at discerning the difference, the stronger we grow as a profession.

Either way, read to your heart’s content. And keep an eye out for the massage myths e-book! I’ll post a link here.

Massage Therapy and Blood Pressure

Liao IC, Chen SL, Wang MY, Tsai PS. Effects of Massage on Blood Pressure in Patients With Hypertension and Prehypertension: A Meta-analysis of Randomized Controlled Trials. J Cardiovasc Nurs. 2014 Nov 21. [Epub ahead of print]. Abstract at http://www.ncbi.nlm.nih.gov/pubmed/25419947

Moyer CA, Rounds J, Hannum J. A meta-analysis of massage therapy research. Psychol Bull. 2004 Jan; 130(1):3-18. Abstract at http://www.ncbi.nlm.nih.gov/pubmed/14717648

Xiong XJ, Li SJ, Zhang YQ. Massage therapy for essential hypertension: a systematic review. J Hum Hypertens. 2014 Jul 3. oi: 10.1038/jhh.2014.52. [Epub ahead of print]. Abstract at http://www.ncbi.nlm.nih.gov/pubmed/24990417.

Massage Therapy and Injury, Pain, Soreness

Cheng YH, Huang GC. Efficacy of Massage Therapy on Pain and Dysfunction in Patients with Neck Pain: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med. 2014; 2014: 204360. Published online Feb 20, 2014. doi:ย  10.1155/2014/204360. Free Full-text article at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3950594/

Ernst E. Does post-exercise massage treatment reduce delayed onset muscle soreness? A systematic review. British Journal of Sports Medicine. 32(3): 212-14, Sept. 1998. Free full-text article at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1756095/.

Furlan AD, Imamura M, Dryden T, Irvin E. Massage for low-back pain. Cochrane Database of Systematic Reviews 2008, Issue 4. Art. No.: CD001929. DOI: 10.1002/14651858.CD001929.pub2 – See more at: http://summaries.cochrane.org/CD001929/BACK_massage-for-low-back-pain

Keeratitanont K, Jensen MP, Chatchawan U, Auvichayapat P. The efficacy of traditional Thai massage for the treatment of chronic pain: A systematic review. Complement Ther Clin Pract. 2015 Feb;21(1):26-32. doi: 10.1016/j.ctcp.2015.01.006. Epub 2015 Jan 3. Abstract at http://www.ncbi.nlm.nih.gov/pubmed/25682523.

Kong LJ, Zhan HS, Cheng YW, Yuan WA, Chen B, Fang M. Massage therapy for neck and shoulder pain: a systematic review and meta-analysis. Evid Based Complement Alternat Med. 2013; 2013: 613279. Published online Feb 28, 2013. doi:ย  10.1155/2013/613279. Free full-text article at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3600270/.

Loew LM, Brosseau L, Tugwell P, Wells GA, Welch V, Shea B, Poitras S, De Angelis G, Rahman P. Deep transverse friction massage for treating lateral elbow or lateral knee tendinitis. Cochrane Database of Systematic Reviews 2014, Issue 11. Art. No.: CD003528. DOI: 10.1002/14651858.CD003528.pub2 – See more at: http://summaries.cochrane.org/CD003528/MUSKEL_deep-transverse-friction-massage-for-the-treatment-of-lateral-elbow-or-lateral-knee-tendinitis

Moyer CA, Rounds J, Hannum J. A meta-analysis of massage therapy research. Psychol Bull. 2004 Jan; 130(1):3-18. Abstract at http://www.ncbi.nlm.nih.gov/pubmed/14717648

Massage Therapy and Cancer

Lee SH, Kim JY, Yeo S, Kim SH, Lim S. Meta-analysis of massage therapy on cancer pain. Integr Cancer Ther. 2015 Jul;14(4):297-304. doi: 10.1177/1534735415572885. Epub 2015 Mar 17. Abstract at http://www.ncbi.nlm.nih.gov/pubmed/25784669.

Pan YQ, Yang KH, Wang YL, Zhang LP, Liang HQ. Massage interventions and treatment-related side effects of breast cancer: a systematic review and meta-analysis. Int J Clin Oncol. 2014 Oct;19(5):829-41. doi: 10.1007/s10147-013-0635-5. Epub 2013 Nov 26. Abstract at http://www.ncbi.nlm.nih.gov/pubmed/24275985.

Wilkinson S. Barnes K. Storey L. Massage for symptom relief in patients with cancer: systematic review. J Adv Nurs. 2008 Sep;63(5):430-9. doi: 10.1111/j.1365-2648.2008.04712.x. Abstract at http://www.ncbi.nlm.nih.gov/pubmed/18727744.

Massage Therapy and Immunity, HIV/AIDS

Hillier SL, Louw Q, Morris L, Uwimana J, Statham S. Massage therapy for people with HIV/AIDS. Cochrane Database of Systematic Reviews 2010, Issue 1. Art. No.: CD007502. DOI: 10.1002/14651858.CD007502.pub2. http://summaries.cochrane.org/CD007502/HIV_massage-therapy-for-people-with-hivaids

Tejero-Fernandez V, Membrilla-Mesa M, Galiano-Castillo N, Arroyo-Morales M. Immunological effects of massage after exercise: A systematic review. Phys Ther Sport 2014 Jul 21. pii: S1466-853X(14)00062-5. doi: 10.1016/j.ptsp.2014.07.001. [Epub ahead of print]. Abstract at http://www.ncbi.nlm.nih.gov/pubmed/25116861.

Massage Therapy and Infants

Bennett C, Underdown A, Barlow J. Massage for promoting mental and physical health in typically developing infants under the age of six months. Cochrane Database Syst Rev. 2013 Apr 30;4:CD005038. doi: 10.1002/14651858.CD005038.pub3.

Wang L, He JL, Zhang XH. The efficacy of massage on preterm infants: a meta-analysis. Am J Perinatol. 2013 Oct;30(9):731-8. doi: 10.1055/s-0032-1332801. Epub 2013 Jan 15. Abstract at http://www.ncbi.nlm.nih.gov/pubmed/23322391.

Massage Therapy and Mood

Coelho HF, Boddy K, Ernst E. Massage therapy for the treatment of depression: a systematic review. Int J Clin Pract. 2008 Feb;62(2):325-33. Epub 2007 Dec 11. Abstract at: http://www.ncbi.nlm.nih.gov/pubmed/18081800.

Hou WH, Chiang PT, Hsu TY, Chiu SY, Yen YC. Treatment effects of massage therapy in depressed people: a meta-analysis. J Clin Psychiatry. 2010 Jul;71(7):894-901. doi: 10.4088/JCP.09r05009blu. Epub 2010 Mar 23. Abstract at http://www.ncbi.nlm.nih.gov/pubmed/20361919.

Moyer CA, Rounds J, Hannum J. A meta-analysis of massage therapy research. Psychol Bull. 2004 Jan; 130(1):3-18. Abstract at http://www.ncbi.nlm.nih.gov/pubmed/14717648

Massage Therapy and Asthma

Hondras MA, Linde K, Jones AP. Manual therapy for asthma. Cochrane Database of Systematic Reviews 2005, Issue 2. Art. No.: CD001002. DOI: 10.1002/14651858.CD001002.pub2 – See more at: http://summaries.cochrane.org/CD001002/AIRWAYS_manual-therapy-for-asthma

Massage Therapy and Dementia

Hansen NV, Jรธrgensen T, ร˜rtenblad L. Massage and touch for dementia. Cochrane Database of Systematic Reviews 2006, Issue 4. Art. No.: CD004989. DOI: 10.1002/14651858.CD004989.pub2 – See more at: http://summaries.cochrane.org/CD004989/DEMENTIA_insufficient-evidence-to-draw-conclusions-about-the-possibility-that-massage-and-touch-interventions-are-effective-for-dementia-or-associated-problems

Massage Therapy and Fibroymyalgia

Li YH, Wang FY, Feng CQ, Yang XF, Sun YH. Massage Therapy for Fibromyalgia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. PLoS One. 2014; 9(2): e89304. Published online Feb 20, 2014. doi:ย  10.1371/journal.pone.0089304 (Free full-text article.)

Massage Therapy and Labor Support

Smith CA, Levett KM, Collins CT, Jones L. Massage, reflexology and other manual methods for pain management in labour. Cochrane Database of Systematic Reviews 2012, Issue 2. Art. No.: CD009290. DOI: 10.1002/14651858.CD009290.pub2 – See more at: http://summaries.cochrane.org/CD009290/PREG_massage-reflexology-and-other-manual-methods-for-managing-pain-in-labour.

That’s it for now, but more could pop up next month! To find reviews on your own, go to the National Library of Medicine and select “Review” under “Article Type.” This will filter out the other papers and select research reviews.

And one more time, repeat:

One Massage Study Does Not Prove a Point.

Filed Under: Effects of Massage, Ethics, Massage Education, Massage Research, Myths in Massage

Comments

  1. Jill Berkana says

    July 10, 2015 at 1:06 pm

    Wow. Thank you so much! Looking forward to what follows.

    Reply
    • Tracy Walton says

      July 21, 2015 at 3:27 pm

      You’re welcome, Jill! I’ll post when it is out! ๐Ÿ™‚

      Reply
  2. Susan Gee says

    July 12, 2015 at 8:56 am

    Thank you Tracy! Having this information gathered is of great benefit. I will use it often.

    Reply
    • Tracy Walton says

      July 21, 2015 at 3:27 pm

      Use away, Susan! ๐Ÿ™‚

      Reply
  3. Greg says

    July 13, 2015 at 1:24 pm

    I have taken your class, which I enjoyed very much and am really looking forward to your ebook. Thank you so much for continuing to bring clarification to massage therapy and its many claims.

    Reply
    • Tracy Walton says

      July 21, 2015 at 3:26 pm

      Greg, I love clarity and I am glad for the chance to promote it.

      Reply
  4. Cynthia Hill-Meriwether says

    July 13, 2015 at 4:01 pm

    Thanks a lot. I have a masters degree and totally get it. I know this took some time to hunt all these up and make this list and I really appreciate it.

    Cynthia

    Reply
    • Tracy Walton says

      July 21, 2015 at 3:26 pm

      You are welcome, Cynthia!

      Reply
  5. Nikki says

    August 6, 2015 at 9:14 am

    This is great! Thank you!

    Reply
    • Tracy Walton says

      August 10, 2015 at 7:11 pm

      ๐Ÿ™‚

      Reply
  6. Mike Hovi says

    October 19, 2015 at 8:01 pm

    Thank you so much for compiling this information and for the e-book to come. I look forward to reading it and sharing it with my students and staff

    Program Director
    The Soma Institute
    55 East Jackson Blvd
    Suite 300
    Chicago, IL 60604

    Reply
    • Tracy Walton says

      October 20, 2015 at 9:27 am

      Mike, you are welcome! I’m glad you will be making it available to your school community!

      Reply
  7. Geralyn Vasile says

    January 21, 2016 at 9:19 am

    Thank you for all of this information I am an MT and am making a presentation at a hospital outside of Boston next month to doctors during grand rounds on tbe benefits of massage. I will be very careful with language. More hesitant now refer to immune system benefits.

    Reply
    • Tracy Walton says

      January 21, 2016 at 11:20 am

      Good luck on your presentation, Geralyn!

      Reply
  8. Veronica says

    February 5, 2016 at 7:52 pm

    Great work

    Reply
    • Tracy Walton says

      February 26, 2016 at 11:42 am

      Thank you, Veronica.

      Reply
  9. Linda McGeachy says

    June 20, 2016 at 12:02 pm

    As curriculum director and instructor for a massage therapy school, I have found your publication to be an excellent resource in the classroom to introduce students to the concepts of massage reseach. I am using it as a starting point for an assignment in evaluating research literature.
    Thank you so much for making a very complicated subject understandable.

    Reply
    • Tracy Walton says

      June 20, 2016 at 12:43 pm

      You are welcome, Linda! Glad it’s working in the classroom.

      Reply
  10. brian says

    February 16, 2018 at 2:57 pm

    I have taught at 2 massage therapy schools, for a total of 6 semesters of class, while pursuing a PhD in physiology; every semester, when I gave your PDF document (5 Myths and Truths About Massage Therapy) to students I almost had a riot in my hands.

    99% of the people who join massage therapy schools I taught at were not interested in learning anything; they showed up in class to tell me that whatever they believed in is correct and that I was an evil person for showing them that human beings do not produce toxins.

    Massage therapy has always been and will always be an “assistive… alternative” type of therapy mostly because of the mindset and behaviour of the vast majority of people who are massage therapists.

    Reply
    • Tracy Walton says

      July 19, 2018 at 5:41 am

      Brian, I JUST saw this comment, months later, to approve it. (Something strange going on with wordpress.) I’m sorry about the lapse in posting it, and I”m sorry you have encountered such resistance. I’m glad you have persisted. I do think there are costs to our resistance to changing our ideas and notions. Thank you.

      Reply
  11. Kimberly Griffin says

    December 21, 2018 at 3:38 pm

    Hi Tracy! I have recently moved from Michigan, an up-and-coming state as far as massage is concerned, to Florida, where it is the “real deal.” I have been a massage therapist since 2004 and have not taken much continuing education since then. Now, at the end of 2018 I’m realizing I barely know anything. I am so glad your site showed up on my search for local hospice massage opportunities (it was lumped in with Oncology massage, which is an intensive on your site). I’m wanting to learn more about how I can perform meaningful research to help further the profession. Your eBook, the links on this page, and what I’m learning through the NIH as far as research into pain and CAM are exactly what I need. Thank you for sharing!

    Reply
  12. Teresa Geoghegan Brown says

    January 16, 2019 at 6:34 pm

    Thank you Tracy!
    I have been using/promoting your e-book in the classroom for several years now. Thank you so much for having the passion to walk this path of education for students, practitioners, and the field as a whole. I particularly enjoy your sacred cows approach and your easy to chew sections for students who may not be initially interested. Much gratitude.

    Massage Instructor
    Massage Institute of Memphis,LLC

    Reply
  13. Melissa says

    January 25, 2019 at 1:56 am

    I have hemachromatosis and am wondering if massage affects iron levels in the blood

    Reply
    • Tracy Walton says

      January 25, 2019 at 10:28 am

      Dear Melissa: Unfortunately, I do not know whether massage affects blood iron levels.

      Reply

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Why take a course in oncology massage therapy?

There are so many good reasons. Here are a few:

Service. During cancer treatment and beyond, people need support. They need symptom relief. They need sleep. Oncology massage therapy (OMT) can help people cope during cancer treatment, at end of life, post-treatment, and during diagnosis.
Practice building. With the right skills, you can meet growing client demand and build your practice. You can be part of cancer care. It is better for your business to be able to work with people right then, right where they are, than to refer them out or send them home.
Career satisfaction and longevity. OMT is immensely satisfying work. Your steady presence and your hands can make a huge difference in someone's day or week. You might even find our approach to be easier on your hands and alignment. We offer new ways to provide comfort without effort and "deep tissue" work.

To practice OMT, massage therapists need to know what to ask clients before the massage, and how to use the client's answers. They need to know how to think through what to do, and how to communicate with clients in difficult circumstances. They need confidence, sensitivity, strong interview and table-side instruction. They need to learn from actual case studies and real-world exercises, and good chances to practice.

We provide these learning experiences in our 4-Day Intensive, Oncology Massage Therapy: Caring for Clients with Cancer.

Learn more...

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