One Massage Study Does Not “Prove” a Point…

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…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 a  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.

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.  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:  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:  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, Jørgensen T, Ørtenblad 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:  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.