What’s the Bottom Line?
How much do we know about massage?
A lot of research on the effects of massage therapy has been carried out.
What do we know about the effectiveness of massage?
While often preliminary or conflicting, there is scientific evidence that massage may help with back pain and may improve quality of life for people with depression, cancer, and HIV/AIDS.
What do we know about the safety of massage?
Massage therapy appears to have few risks if it is used appropriately and provided by a trained massage professional.
What Is Massage Therapy?
The term “massage therapy” includes many techniques, and the type of massage given usually depends on your needs and physical condition.
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- Massage therapy dates back thousands of years. References to massage appear in ancient writings from China, Japan, India, and Egypt.
- In general, massage therapists work on muscle and other soft tissue to help you feel better.
- In Swedish massage, the therapist uses long strokes, kneading, deep circular movements, vibration, and tapping.
- Sports massage combines techniques of Swedish massage and deep tissue massage to release chronic muscle tension. It is adapted to the needs of athletes.
- Myofascial trigger point therapy focuses on trigger points—areas that are painful when pressed and are associated with pain elsewhere in the body.
- Massage therapy is sometimes done using essential oils as a form of aromatherapy.
What the Science Says About the Effectiveness of Massage
A lot of the scientific research on massage therapy is preliminary or conflicting, but much of the evidence points toward beneficial effects on pain and other symptoms associated with a number of different conditions. Much of the evidence suggests that these effects are short term and that people need to keep getting massages for the benefits to continue.
Researchers have studied the effects of massage for many conditions. Some that they have studied more extensively are the following
- A 2008 systematic review and 2011 NCCIH-funded clinical trial concluded that massage may be useful for chronic low-back pain.
- Massage may help with chronic neck pain, a 2009 NCCIH-funded clinical trial reported.
- Massage may help with pain due to osteoarthritis of the knee, according to a 2012 NCCIH-funded study.
- Studies suggest that for women in labor, massage provided some pain relief and increased their satisfaction with other forms of pain relief, but the evidence is not strong, a 2012 review concluded.
Numerous systematic reviews and clinical studies have suggested that at least for the short term, massage therapy for cancer patients may reduce pain, promote relaxation, and boost mood. However, the National Cancer Institute urges massage therapists to take specific precautions with cancer patients and avoid massaging:
- Open wounds, bruises, or areas with skin breakdown
- Directly over the tumor site
- Areas with a blood clot in a vein
- Sensitive areas following radiation therapy.
- A 2010 meta-analysis of 17 clinical trials concluded that massage therapy may help to reduce depression.
- Brief, twice-weekly yoga and massage sessions for 12 weeks were associated with a decrease in depression, anxiety, and back and leg pain in pregnant women with depression, a 2012 NCCIH-funded randomized controlled trial showed. Also, the women’s babies weighed more than babies born to women who didn’t receive the therapy.
- However, a 2013 research review concluded that there is not enough evidence to determine if massage helps pregnant mothers with depression.
- A 2010 review concluded that massage may help older people relax.
- For generalized anxiety disorder, massage therapy was no better at reducing symptoms than providing a relaxing environment and deep breathing lessons, according to a small, 2010 NCCIH-supported clinical trial.
A 2010 review concluded that massage therapy may help temporarily reduce pain, fatigue, and other symptoms associated with fibromyalgia, but the evidence is not definitive. The authors noted that it is important that the massage therapist not cause pain.
Clinical trials on the effects of massage for headaches are preliminary and only somewhat promising.
Massage therapy may help improve the quality of life for people with HIV or AIDS, a 2010 systematic review of four small clinical trials concluded.
Massaging preterm infants using moderate pressure may improve weight gain, a 2010 review suggested. We don’t have enough evidence to know if massage benefits healthy infants who are developing normally, a 2013 review determined.
Researchers have studied massage for the following but it’s still unclear if it helps:
- Behavior of children with autism or autism spectrum disorders
- Immune function in women with breast cancer
- Anxiety and pain in patients following heart surgery
- Quality of life and glucose levels in people with diabetes
- Lung function in children with asthma.
What the Science Says About the Safety and Side Effects of Massage Therapy
Massage therapy appears to have few risks when performed by a trained practitioner. However, massage therapists should take some precautions in people with certain health conditions.
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- In some cases, pregnant women should avoid massage therapy. Talk with your health care provider before getting a massage if you are pregnant.
- People with some conditions such as bleeding disorders or low blood platelet counts should avoid having forceful and deep tissue massage. People who take anticoagulants (also known as blood thinners) also should avoid them. Massage should not be done in any potentially weak area of the skin, such as wounds.
- Deep or intense pressure should not be used over an area where the patient has a tumor or cancer, unless approved by the patient’s health care provider.
NCCIH-sponsored studies have investigated the effects of massage on a variety of conditions including
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- The effects of an 8-week course of Swedish massage compared to usual care on pain and function in adults with osteoarthritis of the knee
- Whether massage helps with generalized anxiety disorder
- The effect of massage therapy on cancer-related fatigue
- How massage therapy and progressive muscle relaxation compare for reducing chronic low-back pain in patients referred from primary care practices
- The frequency and length of massages needed to address neck pain.
Training, Licensing, and Certification
In the United States, 44 states and the District of Columbia regulate massage therapists. Cities, counties, or other local governments also may regulate massage. Training standards and requirements for massage therapists vary greatly by state and locality.
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Most states that regulate massage therapists require them to have a minimum of 500 hours of training from an accredited training program. The National Certification Board for Therapeutic Massage and Bodywork certifies practitioners who pass a national examination and fulfill other requirements.
More to Consider
- Do not use massage therapy to replace conventional care or to postpone seeing a health care provider about a medical problem.
- If you have a medical condition and are unsure whether massage therapy would be appropriate for you, discuss your concerns with your health care provider, who may also be able to help you select a massage therapist.
- Ask about the training, experience, and credentials of the massage therapist you are considering. Also ask about the number of treatments that might be needed, the cost, and insurance coverage.
- For more tips on finding a complementary health practitioner, such as a massage therapist, see the National Center for Complementary and Integrative Health’s (NCCIH) Web page How To Find a Complementary Health Practitioner.
- Tell all your health care providers about any complementary and integrative health approaches you use. Give them a full picture of what you do to manage your health. This will ensure coordinated and safe care.
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The NCCIH Clearinghouse provides information on NCCIH and complementary and integrative health approaches, including publications and searches of Federal databases of scientific and medical literature. The Clearinghouse does not provide medical advice, treatment recommendations, or referrals to practitioners.
A service of the National Library of Medicine (NLM), PubMed® contains publication information and (in most cases) brief summaries of articles from scientific and medical journals. For guidance from NCCIH on using PubMed, see How To Find Information About Complementary Health Approaches on PubMed
To provide resources that help answer health questions, MedlinePlus (a service of the National Library of Medicine) brings together authoritative information from the National Institutes of Health as well as other Government agencies and health-related organizations.
NIH Clinical Research Trials and You
The National Institutes of Health (NIH) has created a Web site, NIH Clinical Research Trials and You, to help people learn about clinical trials, why they matter, and how to participate. The site includes questions and answers about clinical trials, guidance on how to find clinical trials through ClinicalTrials.gov and other resources, and stories about the personal experiences of clinical trial participants. Clinical trials are necessary to find better ways to prevent, diagnose, and treat diseases.
Cochrane Database of Systematic Reviews
The Cochrane Database of Systematic Reviews is a collection of evidence-based reviews produced by the Cochrane Library, an international nonprofit organization. The reviews summarize the results of clinical trials on health care interventions. Summaries are free; full-text reviews are by subscription only.
- 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 of Systematic Review. 2013;(4):CD005038. Accessed at www.thecochranelibrary.com on January 6, 2014.
- Bureau of Labor Statistics. Occupational Outlook Handbook. Massage Therapists. Bureau of Labor Statistics Web site. Accessed at www.bls.gov/ooh/Healthcare/Massage-therapists.htm on April 23, 2013.
- Cherkin DC, Sherman KJ, Kahn J, et al. A comparison of the effects of 2 types of massage and usual care on chronic low back pain: a randomized, controlled trial. Annals of Internal Medicine. 2011;155(1):1–9.
- Corbin L. Safety and efficacy of massage therapy for patients with cancer. Cancer Control. 2005;12(3):158–164.
- Furlan AD, Imamura M, Dryden T, et al. Massage for low-back pain. Cochrane Database of Systematic Reviews. 2008;(4):CD001929 [edited 2010]. Accessed at www.thecochranelibrary.com on January 2, 2014.
- Hillier SL, Louw Q, Morris L, et al. Massage therapy for people with HIV/AIDS. Cochrane Database of Systematic Reviews. 2010;(1):CD007502. Accessed at www.thecochranelibrary.com on January 2, 2014.
- Kalichman L. Massage therapy for fibromyalgia symptoms. Rheumatology International. 2010;30(9):1151–1157.
- Lee MS, Kim JI, Ernst E. Massage therapy for children with autism spectrum disorders: a systematic review. Journal of Clinical Psychiatry. 2011;72(3):406–411.
- Perlman AI, Ali A, Njike VY, et al. Massage therapy for osteoarthritis of the knee: a randomized dose-finding trial. PLoS One. 2012;7(2):e30248.
- Sherman KJ, Ludman EJ, Cook AJ, et al. Effectiveness of therapeutic massage for generalized anxiety disorder: a randomized controlled trial. Depression and Anxiety. 2010;27(5):441–450.
NCCIH thanks the following people for their technical expertise and review of the content update of this publication: Tiffany Field, Ph.D., Touch Research Institute, University of Miami School of Medicine; Andrea Furlan, M.D., Ph.D., Institute for Work & Health; Karen Sherman, Ph.D., M.P.H., Group Health Research Institute; Partap Khalsa, D.C., Ph.D., and John (Jack) Killen, Jr., M.D., NCCIH.
This publication is not copyrighted and is in the public domain. Duplication is encouraged.