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NCCIH Clinical Digest

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Massage Therapy for Health:
What the Science Says

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December 2018
massage therapy

   

Clinical Guidelines, Scientific Literature, Info for Patients: 

Low-Back Pain

Several reviews of research have found weak evidence that massage may be helpful for low-back pain. Clinical guidelines issued by the American College of Physicians in 2017 included massage as an option for treating acute/subacute low-back pain but did not include massage therapy among the options for treating chronic low-back pain.

What Does the Research Show?

  • The Agency for Healthcare Research and Quality, in a 2016 evaluation of nondrug therapies for low-back pain, examined 20 studies that compared massage to usual care or other interventions and found that there was evidence that massage was helpful for chronic low-back pain but that the strength of evidence was low. The agency also looked at 6 studies that compared different types of massage but found that the evidence was insufficient to show whether any types were more effective than others.
  • A 2015 Cochrane review found evidence that massage may provide short-term relief from low-back pain, but the evidence is not of high quality. The long-term effects of massage for low-back pain have not been established.
  • Clinical practice guidelines issued by the American College of Physicians in 2017 included massage therapy as an option for treating acute/subacute low-back pain but did not include massage therapy among the options for treating chronic low-back pain.

 

Neck and Shoulder Pain

Massage therapy may provide short-term benefits for neck or shoulder pain.

What Does the Research Show?

  • 2016 review of four randomized controlled trials found that massage therapy may provide short-term benefits from neck pain. However, a 2012 Cochrane review of 15 trials on massage therapy for neck pain concluded that no recommendations for practice can be made at this time because the effectiveness of massage for neck pain remains uncertain.
  • A 2013 review of 12 studies of massage for neck pain (757 total participants) found that massage therapy was more helpful for both neck and shoulder pain than inactive therapies but was not more effective than other active therapies. For shoulder pain, massage therapy had short-term benefits only.   
  • A 2014 randomized controlled trial involving 228 participants with chronic nonspecific neck pain found that 60-minute massages given multiple times per week was more effective than fewer or shorter sessions.  The participants were randomized to 5 groups receiving various doses of massage (a 4-week course consisting of 30-minute visits 2 or 3 times weekly or 60-minute visits 1, 2, or 3 times weekly) or to a single control group (a 4-week period on a wait list).

 

Osteoarthritis 

Only a few studies have examined massage therapy for osteoarthritis, but results of some of these studies suggest that massage may have short-term benefits in relieving knee pain.

What Does the Research Show?

  • A 2017 systematic review of seven randomized controlled trials involving 352 participants with arthritis found low- to moderate-quality evidence that massage therapy is superior to nonactive therapies in reducing pain and improving functional outcomes. A 2013 review of two randomized controlled trials found positive short-term (less than 6 months) effects in the form of reduced pain and improved self-reported physical functioning. Results of a 2006 randomized controlled trial of 68 adults with OA of the knee who received standard Swedish massage over 8 weeks demonstrated statistically significant improvements in pain and physical function.

 

Headache

Only a small number of studies have looked at massage for headache, and results have not been consistent.

What Does the Research Show?

  • Limited evidence from two small studies suggests massage therapy is possibly helpful for migraines, but clear conclusions cannot be drawn. A 2011 systematic review of these two studies concluded that massage therapy might be equally effective as propranolol and topiramate in the prophylactic management of migraine.
  • A 2016 randomized controlled trial with 64 participants evaluated 2 types of massage (lymphatic drainage and traditional massage), once a week for 8 weeks, in patients with migraine. The frequency of migraines decreased in both groups, compared with people on a waiting list.
  • In a 2015 randomized controlled trial, 56 people with tension headaches were assigned to receive massage at myofascial trigger points or an inactive treatment (detuned ultrasound) twice a week for 6 weeks or to be on a waiting list. People who received either massage or the inactive treatment had a decrease in the frequency of headaches, but there was no difference between the two groups.

 

Cancer Symptoms and Treatment Side Effects

With appropriate precautions, massage therapy can be part of supportive care for cancer patients who would like to try it; however, the evidence that it can relieve pain and anxiety is not strong. 2014 clinical practice guidelines for the care of breast cancer patients include massage as one of several approaches that may be helpful for stress reduction, anxiety, depression, fatigue, and quality of life.

What Does the Research Show?

  • Clinical practice guidelines issued in 2009 by the Society for Integrative Oncology recommends considering massage therapy delivered by an oncology-trained massage therapist as part of a multimodality treatment approach in patients experiencing anxiety or pain.
  • In 2017 the Society for Integrative Oncology issued guidelines on the evidence-based use of integrative therapies during and after breast cancer treatment, recommending the use of massage therapy to improve mood disturbance in breast cancer survivors after active treatment (grade B). This recommendation is based on results from six trials.
  • In clinical practice guidelines issued by the American College of Chest Physicians in 2013, massage therapy is suggested as part of a multi-modality cancer supportive care program for lung cancer patients whose anxiety or pain is not adequately controlled by usual care.
  • A 2016 Cochrane review of 19 small studies involving 1,274 participants found some studies suggesting that massage with or without aromatherapy may help relieve pain and anxiety in people with cancer; however, the quality of the evidence was very low and results were not consistent. 
  • Another 2016 systematic review and meta-analysis of 16 studies concluded that based on the available evidence, weak recommendations are suggested for massage therapy, compared to an active comparator, for the treatment of pain, fatigue, and anxiety.

 

Fibromyalgia

Results of research suggest that massage therapy may be helpful for some fibromyalgia symptoms.

What Does the Research Show?

  • A 2014 systematic review and meta-analysis of 9 studies (404 total participants) concluded that massage therapy, if continued for at least 5 weeks, improved pain, anxiety, and depression in people with fibromyalgia but did not have an effect on sleep disturbance.
  • A 2015 systematic review and meta-analysis of 10 studies (478 total participants) compared the effects of different kinds of massage therapy and found that most styles of massage had beneficial effects on the quality of life in fibromyalgia. Swedish massage may be an exception; 2 studies of this type of massage (56 total participants) did not show benefits.

 

HIV/AIDS

There is some evidence that massage therapy may have benefits for anxiety, depression, and quality of life in people with HIV/AIDS, but the amount of research and number of people studied are small.

What Does the Research Show?

  • A 2010 review of four studies involving a total of 178 participants concluded that massage therapy may help improve the quality of life for people with HIV or AIDS.
    A 2013 randomized controlled trial of 54 people suggested that massage may be helpful for depression in people with HIV; and a 2017 study of 29 people with HIV found that massage may be helpful for anxiety.

 

Infant Care

There is some evidence that premature infants who are massaged may have improved weight gain. No benefits of massage for healthy full-term infants have been clearly demonstrated.

What Does the Research Show?

  • In a 2017 review of 34 randomized controlled trials of massage therapy for premature infants, 20 of the studies (1,250 total infants) evaluated the effect of massage on weight gain, with most showing an improvement. The mechanism by which massage therapy might increase weight gain is not well understood. Some studies suggested other possible benefits of massage but because the amount of evidence is small, no conclusions can be reached about effects other than weight gain.
  • A 2013 Cochrane review of 34 studies of healthy full-term infants didn’t find clear evidence of beneficial effects of massage in these low-risk infants.

Safety

The risk of harmful effects from massage therapy appears to be low. However, there have been rare reports of serious side effects, such as blood clot, nerve injury, or bone fracture. Some of the reported cases have involved vigorous types of massage, such as deep tissue massage, or patients who might be at increased risk of injury.

References

NCCIH Clinical Digest is a service of the National Center for Complementary and Integrative Health, NIH, DHHS. NCCIH Clinical Digest, a monthly e-newsletter, offers evidence-based information on complementary health approaches, including scientific literature searches, summaries of NCCIH-funded research, fact sheets for patients, and more.

The National Center for Complementary and Integrative Health is dedicated to exploring complementary health products and practices in the context of rigorous science, training complementary health researchers, and disseminating authoritative information to the public and professionals. For additional information, call NCCIH's Clearinghouse toll-free at 1-888-644-6226, or visit the NCCIH Web site at nccih.nih.gov. NCCIH is 1 of 27 institutes and centers at the National Institutes of Health, the Federal focal point for medical research in the United States.

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Content is in the public domain and may be reprinted, except if marked as copyrighted (©). Please credit the National Center for Complementary and Integrative Health as the source. All copyrighted material is the property of its respective owners and may not be reprinted without their permission.

This page last modified December 19, 2018

Massage Therapy for Health | NCCIH

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