Back Pain
Cherkin, D.C., Eisenberg, D., Sherman, K.J., Barlow, W.,,Kaptchuk, T.J., Street, J. & Deyo, R.A. (2001). Randomized trial comparing traditional Chinese medical acupuncture, therapeutic massage, and self-care education for chronic low back pain. Archives of Internal Medicine, 161, 1081-8.
METHODS: 262 patients who had persistent back pain received Traditional Chinese Medical acupuncture, therapeutic massage, or self-care educational materials for up to 10 massage or acupuncture visits over 10 weeks. RESULTS: At 10 weeks, massage was superior to self-care on the symptom scale and the disability scale. Massage was also superior to acupuncture on the disability scale. The massage group used the least medications and had the lowest costs of subsequent care.
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Degan, M., Fabris, F., Vanin, F., Bevilacqua, M., Genova, V., Mazzucco, M. & Negrisolo, A. (2000). The effectiveness of foot reflexotherapy on chronic pain associated with a herniated disk. Professioni Infermieristiche, 53, 80-7.
METHODS: A group of 40 persons suffering almost exclusively from a lumbar-sacral disc hernia received three treatments of reflexology massage for a week. RESULTS: sixty-three percent of the group reported a reduction in pain.
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Ernst, E. (1999). Massage therapy for low back pain: a systematic revierw. Journal of Pain Symptom Management, 17, 65-69.
Massage therapy is frequently employed for low back pain. The aim of this sytematic review was to find the evidence for or against its efficacy in this indication. Four random clinical trials were located in which massage was tested as a monotherapy for low back pain. All were burdened with major methodological flaws. One of these studies suggests that massage is superior to no treatment. Two trials imply that it is equally effective as spinal manipulation or transcutaneous electrical stimulation. One study suggests that it is less effective than spinal manipulation. It is concluded that too few trials of massage therapy exist for a reliable evaluation of its efficacy. Massage seems to have some potential as a therapy for low back pain.
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Ginsberg, F. and Famaey, J. P. (1987). A double-blind study of topical massage with Rado-Salil ointment in mechanical low-back pain. Journal of International Medical Research, 15, 148-153.
METHOD: Forty patients with acute mechanical low-back pain were treated in a double-blind manner with either Rado-Salil or placebo for 14 days. RESULTS: Statistically significant improvements in spontaneous pain, muscular contracture and in both the patient’s and physician’s opinions occurred by day 3. These improvements persisted at day 14 and, in addition, there were statistically significant improvements in the finger-floor distance and the degree of lumbar extension. Treatment with Rado-Salil also allowed significant reduction in the use of oral analgesics. Only a few localized transient side-effects, requiring no specific treatment, were observed.
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Hernandez-Reif, M., Field, T., Diego, M., & Fraser, M. (2006). Lower Back Pain And Sleep Disturbance Are Reduced Following Massage Therapy. Journal of Bodywork and Movement Therapies, In Press.
METHOD: Twenty-four adults with lower back pain were randomly assigned to a massage therapy or a progressive muscle relaxation group. Sessions were 30 minutes long twice a week for five weeks. On the first and last day of the 5-week study, participants completed questionnaires, provided a urine sample and were assessed for range of motion. RESULTS: By the end of the study, the massage therapy group, as compared to the relaxation group, reported experiencing less pain, depression, anxiety and improved sleep. They also showed improved trunk flexion, and their serotonin and dopamine levels were higher.
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Hernandez-Reif, M., Field, T., Krasnegor, J., & Theakston, H. (2001). Lower back pain is reduced and range of motion increased after massage therapy. International Journal of Neuroscience, 106, 131-145.
METHOD: A randomized between-groups design evaluated massage therapy versus relaxation for chronic low back pain. Treatment effects were evaluated for reducing pain, depression, anxiety and stress hormones, and sleeplessness and for improving trunk range of motion associated with chronic low back pain. RESULTS: By the end of the study, the massage therapy group, as compared to the relaxation group, reported experiencing less pain, depression, anxiety and improved sleep. They also showed improved trunk and pain flexion performance, and their serotonin and dopamine levels were higher.
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Hsieh, L.L., Kuo, C.H., Yen, M.F., & Chen, T.H. (2004). A randomized controlled clinical trial for low back pain treated by acupressure and physical therapy. Prev Med., 39, 168-76.
METHODS: The aim of this study was to compare the efficacy of acupressure with that of physical therapy in reducing low back pain. 146 participants with chronic low back pain were randomly assigned to the acupressure group or the physical therapy group, each with a different treatment technique. RESULTS: The mean posttreatment pain score after a 4-week treatment in the acupressure group was lower than that in the physical therapy group. At the 6-month follow-up assessment, the mean pain score in the acupressure group was still lower than that of the physical therapy group.
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Kalauokalani, D., Cherkin, D.C., Sherman, K.J., Koepsell, T.D., & Deyo, R.A. (2001). Lessons from a trial of acupuncture and massage for low back pain: patient expectations and treatment effects. Spine, 26, 1418-24.
METHODS: 135 patients with chronic low back pain who received acupuncture or massage were studied. Study participants were asked to describe their expectations regarding the helpfulness of each treatment on a scale of 0 to 10. RESULTS: Improved function was observed for 86% of the participants with higher expectations for the treatment they received, as compared with 68% of those with lower expectations. Patients who expected greater benefit from massage than from acupuncture were more likely to experience better outcomes with massage than with acupuncture, and vice versa.
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Kolich, M., Taboun, S.M., & Mohamed, AI. (2000). Low back muscle activity in an automobile seat with a lumbar massage system. International Journal of Occupational Safety & Ergonomics, 6,113-28.
METHODS: This investigation was conducted to determine the effects of a massaging lumbar support system on low back muscle activity. The apparatus was a luxury-level automobile seat massage. The dependent variable was the change in the EMG signal. RESULTS: One minute of lumbar massage every five minutes was found to have a beneficial effect on low back muscle activity as compared to no massage.
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Pope, M. H., Phillips, R. B., Haugh, L. D., Hsieh, C. Y., MacDonald, L., and Haldeman, S. (1994). A prospective randomized three-week trial of spinal manipulation, transcutaneous muscle stimulation, massage and corset in the treatment of subacute low back pain. Spine, 19, 2571-2577.
METHOD: A randomized prospective trial of manipulation, massage, corset and transcutaneous muscle stimulation (TMS) was conducted in patients with subacute low back pain. The authors determined the relative efficacy of chiropractic treatment to massage, corset, and TMS. Patients were enrolled for a period of 3 weeks. They were evaluated once a week by questionnaires, visual analog scale, range of motion, maximum voluntary extension effort, straight leg raising and a fatigue test. RESULTS: After 3 weeks, the manipulation group scored the greatest improvements in flexion and pain while the massage group had the best extension effort and fatigue time, and the muscle stimulation group the best extension.
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Preyde, M. (2000). Effectiveness of massage therapy for subacute low-back pain: a randomized controlled trial. CMAJ, 162, 1815-20.
METHOD: This randomized controlled trial compared comprehensive massage therapy (soft-tissue manipulation, remedial exercise and posture education), 2 components of massage therapy and placebo in the treatment of subacute (between 1 week and 8 months) low-back pain. Subjects with subacute low-back pain were randomly assigned to 1 of 4 groups: comprehensive massage therapy, soft-tissue manipulation only, remedial exercise with posture education only or a placebo of sham laser therapy. Each subject received 6 treatments within approximately 1 month. Outcome measures obtained at baseline, after treatment and at 1-month follow-up consisted of the Roland Disability Questionnaire (RDQ), the McGill Pain Questionnaire (PPI and PRI), the State Anxiety Index and the Modified Schober test (lumbar range of motion). RESULTS: The comprehensive massage therapy group had improved function, less intense pain and a decrease in the quality of pain compared with the other 3 groups. At 1-month follow-up 63% of subjects in the comprehensive massage therapy group reported no pain as compared with 27% of the soft-tissue manipulation group, 14% of the remedial exercise group and 0% of the sham laser therapy group.
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Sherman, K.J., Cherkin, D.C., Connelly, M.T., Erro, J., Savetsky, J.B., Davis, R.B. & Eisenberg, D.M. (2004). Complementary and alternative medical therapies for chronic low back pain: What treatments are patients willing to try? BMC Complement Altern Med, 19,4-9.
METHOD: Patients with chronic low back pain using automated visit data from one health care organization in Boston and another in Seattle were interviewed. RESULTS: Except for chiropractic, knowledge about these therapies was low. Chiropractic and massage had been used by the largest fractions of respondents (54% and 38%, respectively), mostly for back pain (45% and 24%, respectively). Among prior users of specific CAM therapies for back pain, massage was rated most helpful. Users of chiropractic reported treatment-related “significant discomfort, pain or harm” more often (23%) than users of other therapies (5-16%). Respondents expected massage would be most helpful (median of 7 on a 0 to 10 scale) and meditation least helpful (median of 3) in relieving their current pain. Most respondents indicated they would be “very likely” to try acupuncture, massage, or chiropractic for their back pain if they did not have to pay out of pocket and their physician thought it was a reasonable treatment option.
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Yip, Y.B., & Tse, S.H. (2004). The effectiveness of relaxation acupoint stimulation and acupressure with aromatic lavender essential oil for non-specific low back pain in Hong Kong: a randomized controlled trial. Complement Ther Med, 12, 28-37.
METHOD: This study assessed the effect of acupoint stimulation with electrodes combined with acupressure using an aromatic essential oil (lavender) as an add-on-treatment on pain relief and enhancing the physical functional activities among adults with sub-acute or chronic non-specific low back pain. The intervention was an 8-session relaxation acupoint stimulation followed by acupressure with lavender oil over a 3-week period. The control group received usual care only. RESULTS: One week after the end of treatment, the intervention group had a 39% greater reduction in VAS pain intensity than the control group, improved walking time and greater lateral spine flexion range.
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Behavior Problems
Escalona, A., Field, T., Cullen, C., Hartshorn, K., & Cruz, C. (2001). Behavior problem preschool children benefit from massage therapy. Early Child Development and Care 161, 1-5.
METHOD: Twenty preschool children with behavior problems were randomly assigned to a massage group or a story reading attention control group. The sessions occurred for 15-minutes twice a week for a month. Pre and post session ratings were made on the first and last days of the study by teachers who were blind to the child’s group assignment. RESULTS: These revealed that the children in the massage therapy group: 1) were more drowsy, less active, less talkative and had lower anxiety levels after the sessions; and 2) were less anxious and more cooperative by the end of the study.
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Blood Flow
Mori, H., Ohsawa, H., Tanaka, T.H., Taniwaki, E., Leisman, G. & Nishijo, K. (2004). Effect of massage on blood flow and muscle fatigue following isometric lumbar exercise. Med Sci Monit, 10, 173-8.
METHOD: Subjects participated in two experimental sessions (massage and rest conditions). Subjects lay prone on the table and were instructed to extend their trunks until the inferior portion of their rib cage no longer rested on the table. Subjects held this position for 90 seconds (Load I). Subjects then received massage on the lumbar region or rested for 5 minutes, then repeated the same load (Load II). Skin blood flow (SBF), muscle blood volume (MBV), skin temperature (ST), and subjects’ subjective feelings of fatigue were evaluated using Visual Analogue Scale (VAS). RESULTS: An increase of MBV between pre- and post-load II periods was higher after massage than after rest. An increase of SBF at pre- and post-load II was observed only under massage condition. An increase of SBF between post-load I and pre-load II periods was higher after massage than after rest. An increase of ST between post-load I and post-load II periods was greater after massage than after rest. The VAS score was lower with massage than with rest in the post-treatment period.
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Shoemaker, J. K., Tidus, P. M., & Mader, R. (1997). Failure of manual massage to alter limb blood flow: Measures by Doppler ultrasound. Medicine and Science in Sports and Exercise 1, 610-14.
METHOD: The ability of manual massage to alter muscle blood flow through three types of massage treatments in a small (forearm) and a large (quadriceps) muscle mass was tested in 10 healthy individuals. A certified massage therapist administered effleurage, petrissage, and tapotement treatments to the forearm flexors (small muscle mass) and quadriceps (large muscle mass) muscle groups in a counterbalanced manner. Limb blood flow was determined from mean blood velocity (MBV) (pulsed Doppler) and vessel diameter (echo Doppler). MBV values were obtained from the continuous data sets prior to treatment, and at 5, 10, and 20 s and 5 min following the onset of massage, Arterial diameters were measured immediately prior to and following the massage treatments; these values were not different and were averaged for the blood flow calculations. RESULTS: The MBV and blood flows for brachial and femoral arteries, respectively, were not altered by any of the massage treatments in either the forearm or quadriceps muscle groups. Mild voluntary handgrip and knee extension contractions resulted in peak blood velocities and blood flow for brachial and femoral arteries, respectively, which were significantly elevated from rest. The results indicated that manual massage did not elevate muscle blood flow irrespective of massage type or the muscle mass receiving the treatment.
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Blood Pressure
Hernandez-Reif, M., Field, T., Krasnegor, J. & Theakston, H.(2000). High blood pressure and associated symptoms were reduced by massage therapy. Journal of Bodywork and Movement Therapies, 4, 31-38.
METHOD: Thirty adults with controlled hypertension (for at least the last six months) were randomly assigned to either a massage therapy group or a progressive relaxation group. Those in the massage group were given twice-weekly 30-minute massage sessions for five weeks. Participants in the progressive muscle relaxation group received instructions on completing self-administered, twice-weekly 30-minute exercises for five weeks. Researchers instructed subjects to only perform their session on assigned days to ensure compatibility with the massage group’s schedule. Relaxation sessions began with participants breathing deeply for several minutes while in a supine position with the hands alongside the body. They then followed instructions to tighten and then relax different muscles, moving upward from the feet to the head. Muscle groups included were of the feet, calves, thighs, hands, arms, back and face. Pre- and post-treatment assessments included: a state anxiety inventory (STAI) to assess current emotions; a salivary sample to measure the levels of the stress hormone cortisol; systolic blood pressure and diastolic blood pressure measures; the Center for Epidemiological Studies Depression Scale (CES-D) questionnaire to rate depressive symptoms; Symptom Checklist-90-Revised (SCL-90-R) self-report symptom inventory of depression, anxiety and hostility; and urinary catecholamines (biologically active amines which affect the nervous and cardiovascular systems) and cortisol measurement. RESULTS: Results showed that while both group had lower anxiety levels (STAI) and lower levels of depression (CES-D), only the massage therapy group showed decreases in sitting diastolic and systolic blood pressure; decreases in salivary and urinary cortisol stress-hormone levels; and lower scores for depression, anxiety and hostility.
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Kurosawa, M., Lundeberg, T., Agren, G., Lund, I., & Uvnas-Moberg, K. (1995). Massage-like stroking of the abdomen lowers blood pressure in anesthetized rats: influence of oxytocin. Journal of the Autonomic Nervous System, 56, 26-30.
METHOD: The aim of this study was to determine how massage-like stroking of the abdomen in rats influences arterial blood pressure. The participation of oxytocinergic mechanisms in this effect was also investigated. The ventral and/or lateral sides of the abdomen were stroked in pentobarbital anesthetized, artificially ventilated rats. Arterial blood pressure was recorded with a pressure transducer via catheter in the carotid artery. RESULTS: Stroking of the ventral or both ventral and lateral sides of the abdomen for 1 minute caused a marked decrease in arterial blood pressure (approx. 50 mmHg). After cessation of the stimulation blood pressure returned to the control level within 1 min. The maximum decrease in blood pressure was achieved at frequencies of 0.083 Hz or more. Stroking only the lateral sides of the abdomen elicited a significantly smaller decrease in blood pressure (approx. 30 mmHg decrease) than stroking the ventral side. The decrease in blood pressure caused by stroking was not altered by an oxytocin antagonist. In contrast, the administration of oxytocin diminished the effect, which was antagonized by a simultaneous injection of the oxytocin antagonist. These results indicate that the massage-like stroking of the abdomen decreases blood pressure in anesthetized rats. This effect does not involve intrinsic oxytocinergic transmission. However, since exogenously applied oxytocin was found to diminish the effect of stroking, oxytocin may exert an inhibitory modulatory effect on this reflex arc.
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McNamara, M.E., Burnham, D.C., Smith, C., & Carroll, D.L. (2003). The effects of back massage before diagnostic cardiac catheterization. Alternative Therapies, 9, 50-57.
METHOD: The purpose of this study was to measure the effects of a 20-minute back massage on the physiological and psychological human responses of patients admitted for a diagnostic cardiac catheterization. A randomized clinical trial design was used. Data were compared in a repeated measures design before massage, immediately following the back massage or standard care, and 10 minutes later. Forty-six subjects admitted from home for a diagnostic cardiac catheterization were included in the study. Heart rate, heart rate variability, blood pressure, respiration, peripheral skin temperature, pain perception, and psychological state were the main outcome measures. RESULTS: There was a reduction in systolic blood pressure in the treatment group. In addition, main effects were noted for time for diastolic blood pressure, respiration, total Profile of Mood States score and pain perception in both groups.
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Olney, C.M. (2005).The effect of therapeutic back massage in hypertensive persons: a preliminary study. Biol Res Nurs, 7, 98-105.
METHOD: This study tested the effects of a regularly applied back massage on the BP of patients with clinically diagnosed hypertension. A 10-min back massage was given to the experimental group, three times a week for 10 sessions. The control group relaxed in the same environment for 10 min, three times a week for 10 sessions. RESULTS: Systolic BP decreased over time, as did the diastolic BP.
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Cardiovascular
Boone, T. & Cooper, R. (1995). The effect of massage on oxygen consumption at rest. American Journal of Chinese Medicine, 23, 37-41.
METHOD: This study determined the effect of massage on oxygen consumption at rest. Ten healthy, adult males volunteered to serve as subjects. During the Control Session, each subject was placed in the supine position on a massage table to remain motionless for 30 minutes. During the Treatment Session, each subject received a 30-minute sports massage of the lower extremities. Oxygen consumption was measured. RESULTS: The subjects’ oxygen consumption did not change with the massage. Also, there were no significant differences in heart rate, stroke volume, cardiac output, and arteriovenous oxygen difference during the massage. These findings indicate that massaging the lower extremities results in neither an increase nor a decrease in the subjects’ expenditure of energy at rest.
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Boone, T., Tanner, M., & Radosevich, A. (2001). Effects of a 10-minute back rub on cardiovascular responses in healthy subjects. American Journal of Chinese Medicine. 29, 47-52
METHODS: This study determined the cardiovascular responses to a 10-minute back rub. Twelve healthy, college-age males and females volunteered to participate as subjects. The subjects were assessed for 10 minutes on a massage table lying on one side. During the treatment period, a back rub was administered. Oxygen consumption and cardiac output were measured. RESULTS: The central and peripheral components of oxygen consumption were changed and cardiac output decreased. These results indicate that the back rub was effective in inducing relaxation.
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Delaney, J.P., Leong, K.S., Watkins, A., & Brodie, D. (2002). The short-term effects of myofascial trigger point massage therapy on cardiac autonomic tone in healthy subjects. Journal of Advanced Nursing, 37, 364-71.
METHOD: This study investigated the effects of myofascial trigger-point massage therapy to the head, neck and shoulder areas on cardiac autonomic tone. A 5-minute cardiac interbeat interval recording, systolic and diastolic blood pressure and subjective self-evaluations of muscle tension and emotional state were taken before and after intervention. RESULTS: Following myofascial trigger-point massage therapy there was a significant decrease in heart rate, systolic blood pressure and diastolic blood pressure. Analysis of heart rate variability revealed a significant increase in parasympathetic activity following myofascial trigger-point massage therapy. Additionally both muscle tension and emotional state showed significant improvement.
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Lewis, P., Nichols, E., Mackey, G., Fadol, A., Sloane, L., Villagomez, E., & Liehr, P. (1997). The effect of turning and backrub on mixed venous oxygen saturation in critically ill patients. American Journal of Critical Care, 6, 132-140.
METHOD: A repeated-measures design was used to examine the effect of a change in body position (right or left lateral) and timing of backrub (immediate or delayed) on mixed venous oxygen saturation in 57 surgical ICU patients. Mixed venous oxygen saturation was recorded at 1-minute intervals for 5 minutes in each of three periods: baseline, after turning, and after backrub. Subjects were randomly assigned to body position and timing of backrub. Subjects in the immediate-backrub group were turned and given a 1-minute backrub. Mixed venous oxygen saturation was measured at 1-minute intervals for 5 minutes at two points: after the backrub and then with the patient lying on his side. For subjects in the delayed-backrub group, saturation was measured at 1-minute intervals for 5 minutes at two different points: after the subject was turned to his side and after the backrub. RESULTS: Both position and timing of backrub had significant effects on mixed venous oxygen saturation across conditions over time. Subjects positioned on their left side had a significantly greater decrease in saturation when the backrub was started. At the end of the backrub, saturation was significantly lower in subjects lying on their left side than in subjects lying on their right side. The pattern of change differed according to the timing of the backrub, and return to baseline levels of saturation after intervention differed according to body position. Two consecutive interventions (change in body position and backrub) caused a greater decrease in mixed venous oxygen saturation than the two interventions separated by a 5-minute equilibration period. Turning to the left side decreased oxygen saturation more than turning to the ride side did. Oxygen saturation returned to clinically acceptable ranges within 5 minutes of the intervention.
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McNamara, M.E., Burnham, D.C., Smith, C., & Carroll, D.L. (2003). The effects of back massage before diagnostic cardiac catheterization. Altern Ther Health Med., 9, 50-7.
METHOD: The purpose of this study was to measure the effects of a 20-minute back massage on the physiological and psychological human responses of patients admitted for a diagnostic cardiac catheterization. RESULTS: There was a significant reduction in systolic blood pressure in the treatment group. In addition, main effects were noted for time for diastolic blood pressure, respiration, total Profile of Mood States score and pain perception in both groups.
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Carpal Tunnel Syndrome
Field, T., Diego, M., Cullen, C., Hartshorn, K., Gruskin, A., Hernandez-Reif, M., & Sunshine, W. (2004). Carpal tunnel syndrome symptoms are lessened following massage therapy. Journal of Bodywork and Movement Therapies, 8, 9-14.
METHOD: The objective of this study was to determine the effectiveness of massage therapy for relieving the symptoms of Carpal Tunnel Syndrome (CTS). Sixteen adults with CTS symptoms were randomized to a 4-week massage therapy or control group. Participants in the massage therapy group were taught a self-massage routine that was done daily at home. They were also massaged once a week by a therapist. The participants’ diagnosis was based on a nerve conduction velocity test, the Phalen test, and the Tinel sign test performed by a physician. The participants were also given the State Trait Anxiety Inventory (STAI), the Profile of Mood States (POMS), a visual analog scale for pain and a test of grip strength. RESULTS: Participants in the massage therapy group improved on median peak latency and grip strength. They also experienced lower levels of perceived pain, anxiety, and depressed mood.
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Chronic Fatigue Syndrome
Field, T, Sunshine, W., Hernandez-Reif, M., Quintino, O., Schanberg, S., Kuhn, C., & Burman, I. (1997). Chronic fatigue syndrome: massage therapy effects on depression and somatic symptoms in chronic fatigue syndrome. Journal of Chronic Fatigue Syndrome, 3, 43-51.
METHOD: Twenty chronic fatigue syndrome subjects were randomly assigned to a massage therapy or a SHAM TENS (transcutaneous electrical stimulation) control group. RESULTS: Immediately following the massage therapy versus SHAM TENS on the first and last days of the study the massage therapy group had lower depression and anxiety scores and lower cortisol levels. Longer-term effects (last day versus first day) suggested that the massage therapy versus the SHAM TENS group had lower depression, emotional distress and somatic symptom scores, more hours of sleep and lower epinephrine and cortisol levels.
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Constipation
Bishop, E., McKinnon, E., Weir, E., & Brown, D.W. (2003). Reflexology in the management of encopresis and chronic constipation. Paediatr Nrs., 15, 20-1.
METHOD: This study investigated the efficacy of treating patients with encopresis and chronic constipation with reflexology. An observational study was carried out of 50 children between three and 14 years of age who had a diagnosis of encopresis/chronic constipation. The children received six sessions of 30-minutes of reflexology to their feet. With the help of their parents they completed questionnaires on bowel movements and soiling patterns before, during and after the treatment. A further questionnaire was completed by parents pre and post treatment on their attitude towards reflexology. Forty-eight of the children completed the sessions. RESULTS: The number of bowel movements increased and the incidence of soiling decreased.
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Cystic Fibrosis
Hernandez-Reif, M., Field, T., Krasnegor, J., Martinez, E., Schwartzman, M. & Mavunda, K. (1999). Children with cystic fibrosis benefit from massage therapy. Journal of Pediatric Psychology, 24, 175-181.
METHOD: Parents massaged their children with cystic fibrosis to reduce anxiety and their children’s anxiety and to improve the children’s mood and peak air flow readings. Twenty children (5-12 years old) with cystic fibrosis and their parents were randomly assigned to a massage therapy or a reading control group. Parents in the treatment group were instructed and asked to conduct a 20-minute child massage every night at bedtime for one month. Parents in the reading control group were instructed to read for 20 minutes a night with their child for one month. On days 1 and 30, the parents and children answered questions relating to present anxiety levels and the children answered questions relating to mood, and their peak air flow was measured. RESULTS: Following the first and last massage session, the children and parents reported reduced anxiety. Mood and peak air flow readings also improved for the children in the massage therapy group.
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Depression
Field, T., Morrow, C., Valdeon, C., Larson, S., Kuhn, C., & Schanberg, S.(1992). Massage reduces depression and anxiety in child and adolescent psychiatric patients. Journal of the American Academy of Child & Adolescent Psychiatry, 31, 125-131.
METHOD: A 30-minute back massage was given daily for a 5-day period to 52 hospitalized depressed and adjustment disorder children and adolescents. RESULTS: Compared with a control group who viewed relaxing videotapes, the massaged subjects were less depressed and anxious and had lower saliva cortisol levels after the massage. In addition, nurses rated the subjects as being less anxious and more cooperative on the last day of the study, and nighttime sleep increased over this period. Finally, urinary cortisol and norepinephrine levels decreased, but only for the depressed subjects.
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Field, T., Grizzle, N., Scafidi, F., & Schanberg, S. (1996). Massage and relaxation therapies’ effects on depressed adolescent mothers. Adolescence, 31, 903-911.
METHOD: Thirty-two depressed adolescent mothers received ten 30-minute sessions of massage therapy or relaxation therapy over a five-week period. Subjects were randomly assigned to each group. RESULTS: Although both groups reported lower anxiety following their first and last therapy sessions, only the massage therapy group showed behavioral and stress hormone changes including a decrease in anxious behavior, pulse, and salivary cortisol levels. A decrease in urine cortisol levels suggested lower stress following the five-week period for the massage therapy group.
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Onozawa, K., Glover, V., Adams, D., Modi, N., & Kumar, R.C. (2001). Infant massage improves mother-infant interaction for mothers with postnatal depression. Journal of Affective Disorders, 63(1-3).
METHOD: Thirty-four primiparous depressed mothers at 4 weeks postpartum were randomly assigned either to an infant massage class and a support group (massage group) or to a support group (control group). Each group attended five weekly sessions. RESULTS: The depression scores fell in both groups. However, improvement of mother-infant interactions was seen only in the massage group.
Diabetes
Field, T., Hernandez-Reif, M., LaGreca A., Shaw, K., Schanberg, S., & Kuhn, C. (1997). Massage therapy lowers blood glucose levels in children with Diabetes Mellitus. Diabetes Spectrum ,10, 237-239.
METHOD: Twenty diabetic children were randomly assigned to a touch therapy or relaxation therapy group. The children’s parents were taught one or the other therapy and were asked to provide them for 20 minutes before bedtime each night for 30 days. RESULTS: The immediate effects of the touch therapy were reduced parent anxiety and depressed mood and reduced child anxiety, fidgetiness and depressed affect. Over the 30 day period compliance on insulin and food regulation improved and blood glucose levels decreased from 159 to within the normal range (121).
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Elderly
Field, T., Hernandez-Reif, M., Quintino, O., Schanberg, S. & Kuhn, C. (1998). Elder retired volunteers benefit from giving massage therapy to infants. Journal of Applied Gerontology, 17, 229-239.
METHOD: This exploratory within-subjects study compared the effects of elder volunteers giving massage to infants versus receiving massage themselves. Three times a week for 3 weeks, 10 elder volunteers received massage sessions. For another 3 weeks, three times per week, the same elderly volunteers massaged infants at a nursery school. RESULTS: Immediately after the first-and last-day sessions of giving massages, the elder retired volunteers had less anxiety and depression and lower stress hormone (salivary cortisol) levels. Over the 3-week period, depression and catecholamines (norepinephrine and epinephrine) decreased and lifestyle and health improved. These effects were not as strong for the 3-week period when they received massage, possibly because the elder retired volunteers initially felt awkward about being massaged and because they derived more satisfaction from massaging the infants.
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Hartshorn, K., Delage, J., Field, T., & Olds, L. (2001). Senior citizens benefit from movement therapy. Journal of Bodywork and Movement Therapies, 5, 1-5.
METHOD: Sixteen senior citizens participated in four, 50-minute movement therapy sessions over a 2-week period and were compared to 16 senior citizens who belonged to a wait list control group who received the movement sessions only after the end of the study. RESULTS: The movement therapy participants improved in their functional motion on the Tinetti scale, and specifically on the gait scale, their leg strength increased, and their leg pain significantly decreased.
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Endorphins
Day, J. A., Mason, R. R., & Chesrown, S. E. (1987). Effect of massage on serum level of beta-endorphin and beta-lipotropin in healthy adults. Physical Therapy ,67, 926-930.
METHOD: The effect of massage was evaluated on the levels of endogenous opiates in peripheral venous blood. The results were based on findings from 21 healthy, adult volunteers. The volunteers were assigned randomly to either the Control Group (n = 11) that rested but received no massage or the Experimental Group (n = 10) that received a 30-minute complete back massage. RESULTS: No significant pretreatment or posttreatment difference was found in blood beta-endorphin or beta-lipotropin levels between the groups. The results indicate that massage did not change the measured serum levels of beta-endorphin or beta-lipotropin in these healthy subjects without pain.
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Exercise
Brooks, C.P., Woodruff, L.D., Wright, L.L. & Donatelli, R. (2005). The immediate effects of manual massage on power-grip performance after maximal exercise in healthy adults. J Altern Complement Med, 11, 1093-101.
METHOD: This study assessed the effects of using manual massage to improve power-grip performance immediately after maximal exercise in healthy adults. Fifty-two volunteer massage-school clients, staff, faculty, and students participated. Subjects randomly received either a 5-minute forearm/hand massage of effleurage and friction (to either the dominant hand or nondominant hand side), 5 minutes of passive shoulder and elbow range of motion, or 5 minutes of nonintervention rest. RESULTS: After 3 minutes of isometric exercise, power grip was consistently fatigued to at least 60% of baseline, with recovery occurring over the next 5 minutes. Massage had a greater effect than no massage or than placebo on grip performance after fatigue, especially in the nondominant-hand group.
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Drust, B., Atkinson, G., Gregson, W., French, D. & Binningsley, D. (2003). The effects of massage on intra muscular temperature in the vastus lateralis in humans. Int J Sports Med, 24, 395-9.
METHOD: The aim of the current investigation was to evaluate the effect of different durations of massage, and ultrasound treatment, on the temperature of the vastus lateralis muscle in males. Deep effleurage massage of the vastus lateralis was performed on seven healthy males for 5, 10 and 15 min periods. A 5-min period of ultrasound at 45 KHz was also completed by all subjects. Intra muscular temperature (at 1.5, 2.5 and 3.5 cm) and thigh skin temperature were assessed pre and post treatment. Heart rate was monitored continuously throughout all conditions. RESULTS: Pre treatment intra muscular temperature increased as depth of measurement increased. Changes in muscle temperature at 1.5 and 2.5 cm were significantly greater following massage than ultrasound. No significant differences between massage treatments and ultrasound were noted when intra muscular temperature was measured at 3.5 cm. Massage also significantly increased both heart rate and thigh skin temperature compared to ultrasound. Increases in intra muscular temperature, heart rate and thigh skin temperature were the same irrespective of massage duration. These data suggest that massage and ultrasound have only limited effects on deep muscle temperature.
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Hemmings, B., Smith, M., Graydon, J. & Dyson, R. (2000). Effects of massage on physiological restoration, perceived recovery, and repeated sports performance. Br J Sports Med, 34, 109-14
METHODS: Eight amateur boxers completed two performances on a boxing ergometer on two occasions in a counterbalanced design. Boxers initially completed performance 1, after which they received a massage or passive rest intervention. Each boxer then gave perceived recovery ratings before completing a second performance, which was a repeated simulation of the first. Heart rates and blood lactate and glucose levels were also assessed before, during, and after all performances. RESULTS: A repeated measures analysis of variance showed no significant group differences for either performance, although a main effect was found showing a decrement in punching force from performance 1 to performance 2 . The massage intervention significantly increased perceptions of recovery compared with the passive rest intervention. Blood lactate concentration after the second performance was significantly higher following massage.
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Hilbert, J.E., Sforzo, G.A. & Swensen, T. (2003). The effects of massage on delayed onset muscle soreness. Br J Sports Med, 37, 72-5.
METHODS: Eighteen volunteers were randomly assigned to either a massage or control group. Delayed onset muscle soreness was induced with six sets of eight maximal eccentric contractions of the right hamstring, which were followed 2 h later by 20 min of massage or sham massage (control). Peak torque and mood were assessed at 2, 6, 24, and 48 h postexercise. Range of motion (ROM) and intensity and unpleasantness of soreness were assessed at 6, 24, and 48 h postexercise. Neutrophil count was assessed at 6 and 24 h postexercise. RESULTS: Intensity of soreness was significantly lower in the massage group relative to the control group at 48 h postexercise.
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Mori, H., Ohsawa, H., Tanaka, T.H., Taniwaki, E., Leisman, G. & Nishijo, K. (2004). Effect of massage on blood flow and muscle fatigue following isometric lumbar exercise. Med Sci Monit, 10, 173-8.
METHODS: Twenty-nine healthy male subjects participated in two experimental sessions (massage and rest conditions). Subjects lay prone on the table and were instructed to extend their trunks until the inferior portion of their rib cage no longer rested on the table. Subjects held this position for 90 seconds (Load I). Subjects then either received massage on the lumbar region or rested for 5 minutes, then repeated the same load (Load II). Skin blood flow (SBF), muscle blood volume (MBV), skin temperature (ST), and subjects’ subjective feelings of fatigue were evaluated using Visual Analogue Scale (VAS). RESULTS: An increase of MBV between pre- and post-load II periods was higher after massage than after rest. An increase of SBF at pre- and post-load II was observed only under massage condition. An increase of SBF between post-load I and pre-load II periods was higher after massage than after rest. An increase of ST between post-load I and post-load II periods was greater after massage than after rest. The VAS score was lower with massage than with rest in the post-treatment period.
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Rinder, A.N. & Sutherland, C.J. (1995). An investigation of the effects of massage on quadriceps performance after exercise fatigue. Complement Ther Nurs Midwifery, 1, 99-102.
METHODS: Thirteen males and 7 females completed their maximum number of leg extensions against a half maximum load. In a randomised, crossover study they were exercised to fatigue using an ergonometer, ski-squats and leg extensions followed either by a 6 min massage or rest after which they again completed their maximum number of leg extensions against half maximum load. The process was repeated a few days later with the alternative condition (rest or massage). RESULTS: Massage after exercise fatigue significantly improved quadriceps performance compared to rest.
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Robertson, A., Watt, J.M. & Galloway, S.D. (2004). Effects of leg massage on recovery from high intensity cycling exercise. Br J Sports Med, 4 ,173-6.
METHODS: Nine male games players participated. They attended the laboratory on two occasions one week apart and at the same time of day. Dietary intake and activity were replicated for the two preceding days on each occasion. After baseline measurement of heart rate and blood lactate concentration, subjects performed a standardised warm up on the cycle ergometer. This was followed by six standardised 30 second high intensity exercise bouts, interspersed with 30 seconds of active recovery. After five minutes of active recovery and either 20 minutes of leg massage or supine passive rest, subjects performed a second standardised warm up and a 30 second Wingate test. Capillary blood samples were drawn at intervals, and heart rate, peak power, mean power, and fatigue index were recorded. RESULTS: Significantly lower fatigue index was observed in the massage trial.
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Rodenburg, J. B., Steenbeek, D., Schiereck, P., & Bar, P. R. (1994). Warm-up, stretching and massage diminish harmful effects of eccentric exercise. International Journal of Sports Medicine. 15, 414-419.
METHOD: The combination of a warm-up, stretching exercises and massage were assessed for their effects on subjective scores for delayed onset muscle soreness (DOMS) and functional and biochemical measures. Fifty people, randomly assigned to a treatment and a control group, exercised with the forearm flexors for 30 min. The treatment group also performed a warm-up and stretching protocol followed by forearm exercise and massage. RESULTS: The median values at the five post-exercise time points differed significantly for DOMS measured when the arm was extended. Significant effects for treatment were found on the maximal force, the flexion angle of the elbow and the creatine kinase activity in blood.
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Smith, L. L., Keating, M. N., Holbert, D., Spratt, D. J., McCammon, M. R., Smith, S. S., and Israel, R. G. (1994). The effects of athletic massage on delayed onset muscle soreness, creatine kinase, and neutrophil count: a preliminary report. Journal of Orthopaedic & Sports Physical Therapy, 19, 93-99.
METHOD: It was hypothesized that athletic massage administered 2 hours after eccentric exercise would disrupt an initial crucial event in acute inflammation, the accumulation of neutrophils. This would result in a diminished inflammatory response and a concomitant reduction in delayed onset muscle soreness (DOMS) and serum creatine kinase (CK). Untrained males were randomly assigned to a massage or control group. All performed five sets of isokinetic eccentric exercise of the elbow flexors and extensors. Two hours after exercise, massage subjects received a 30-minute athletic massage; control subjects rested. Delayed onset muscle soreness and CK were assessed before exercise and at 8, 24, 48, 72, 96, and 120 hours after exercise. Circulating neutrophils were assessed before and immediately after exercise, and at 30-minute intervals for 8 hours; cortisol was assessed before and immediately after exercise, and at 30-minute intervals for 8 hours; CK was assessed at similar times. RESULTS: A trend analysis revealed a significant treatment by time interaction effect for 1) DOMS, with the massage group reporting reduced levels; 2) CK, with the massage group displaying reduced levels; 3) neutrophils, with the massage group displaying a prolonged elevation; and 4) cortisol, with the massage group showing a diminished diurnal reduction. The results of this study suggest that sports massage will reduce DOMS and CK when administered 2 hours after the termination of eccentric exercise. This may be due to a reduced emigration of neutrophils and/or higher levels of serum cortisol.
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Viitasalo, J. T., Niemela, K., Kaappola, R., Korjus, T., Levola, M., Mononen, H. V., Rusko, H. K., and Takala, T. E. (1995). Warm underwater water-jet massage improves recovery from intense physical exercise. European Journal of Applied Physiology & Occupational Physiology, 71, 431-438.
METHOD: The effects of warm underwater water-jet massage on neuromuscular functioning, selected biochemical parameters (serum creatine kinase, lactic dehydrogenase, serum carbonic anhydrase, myoglobin, urine urea and creatinine) and muscle soreness were studied among 14 junior track and field athletes. Each subject spent, in a randomized order, two identical training weeks engaged in five strength/power training sessions lasting 3 days. RESULTS: The training weeks differed from each other only in respect to underwater water-jet massage treatments. These were used three times (20 min each) during the treatment week and not used during the control week. During the treatment week continuous jumping power decreased and ground contact time increased significantly less (P < 0.05) and serum myoglobin increased more than during the control week. It is suggested that underwater water-jet massage in connection with intense strength/power training increases the release of proteins from muscle tissue into the blood and enhances the maintenance of neuro-muscular performance capacity.
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Zainuddin, Z., Newton, M., Sacco, P. & Nosaka, K. (2005). Effects of massage on delayed-onset muscle soreness, swelling, and recovery of muscle function. J Athl Train, 40, 174-80.
METHOD: This study tested the hypothesis that massage applied after eccentric exercise would effectively alleviate delayed-onset muscle soreness (DOMS) without affecting muscle function. We used an arm-to-arm comparison model with 2 independent variables (control and massage) and 6 dependent variables (maximal isometric and isokinetic voluntary strength, range of motion, upper arm circumference, plasma creatine kinase activity, and muscle soreness). A 2-way repeated-measures analysis of variance and paired t-tests were used to examine differences in changes of the dependent variable over time between control and massage conditions. Ten healthy subjects with no history of upper arm injury and no experience in resistance training, performed 10 sets of 6 maximal isokinetic eccentric actions of the elbow flexors with each arm on a dynamometer, separated by 2 weeks. One arm received 10 minutes of massage 3 hours after eccentric exercise; the contralateral arm received no treatment. RESULTS: Delayed-onset muscle soreness was significantly less for the massage condition for peak soreness in extending the elbow joint and palpating the brachioradialis muscle. Soreness while flexing the elbow joint and palpating the brachialis muscle was also less with massage. Massage treatment had significant effects on plasma creatine kinase activity, with a significantly lower peak value at 4 days postexercise , and upper arm circumference, with a significantly smaller increase than the control at 3 and 4 days postexercise.
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Facial Massage
Yamada, Y., Hatayama, T., Hirata, T., Maruyama, K., et al.(1986). A psychological effect of facial estherapy. Tohoku Psychologica Folia, 45, 6-16.
METHOD: Changes in emotion, level of arousal, and facial skin state were assessed in 24 female undergraduates by the use of 3 types of checklists. RESULTS: Two adjective checklists indicated that on items of both general deactivation and deactivation-sleep factors, many subjective rating scores were heightened after the facial esthetic massage and most subjects in the experimental group showed that the subjective state of their faces was much improved.
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Fibromyalgia
Field, T., Diego, M., Cullen, C., Hernandez-Reif, M., & Sunshine, W. (2002). Fibromyalgia pain and substance P decreases and sleep improves following massage therapy. Journal of Clinical Rheumatology.
METHOD: To determine the effects of massage therapy versus relaxation therapy on sleep, substance P and pain in fibromyalgia patients, twenty four adult fibromyalgia patients were randomly assigned to a massage therapy or relaxation therapy group. They received 30-minute treatments twice a week for five weeks. RESULTS: Both groups showed a decrease in anxiety and depressed mood immediately after the first and last therapy sessions. However, across the course of the study only the massage therapy group reported an increase in the number of sleep hours and a decrease in their sleep movements. In addition, substance P levels decreased and the patients’ physicians assigned lower disease and pain ratings and rated fewer tenderpoints in the massage therapy group.
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Sunshine, W., Field, T., Schanberg, S., Quintino, O., Kilmer, T., Fierro, K., Burman, I., Hashimoto, M., McBride, C., & Henteleff, T. (1996). Massage therapy and transcutaneous electrical stimulation effects on fibromyalgia. Journal of Clinical Rheumatology, 2, 18-22.
METHOD: Thirty adult fibromyalgia syndrome subjects were randomly assigned to a massage therapy, a transcutaneous electrical stimulation (TENS), or a transcutaneous electrical stimulation no-current group (Sham TENS) for 30-minute treatment sessions two times per week for 5 weeks. RESULTS: The massage therapy subjects reported lower anxiety and depression, and their cortisol levels were lower immediately after the therapy sessions on the first and last days of the study. The TENS group showed similar changes, but only after therapy on the last day of the study. The massage therapy group improved on the dolorimeter measure of pain. They also reported less pain the last week, less stiffness and fatigue, and fewer nights of difficult sleeping. Thus, massage therapy was the most effective therapy with these fibromyalgia patients.
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Headache
Foster, K.A., Liskin, J., Cen, S., Abbott, A., Armisen, V., Globe, D., Knox, L., Mitchell, M., Shtir, C., & Azen, S. (2004). The Trager approach in the treatment of chronic headache: a pilot study. Altern Ther Health Med., 10, 40-6.
METHOD: Thirty-three volunteers with a self-reported history of chronic headache and with at least one headache per week for at least 6 months received Trager massage. RESULTS: Participants randomized to Trager massage demonstrated a significant decrease in the frequency of headaches, improvement in head quality of life and a 44% decrease in medication usage.
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Hernandez-Reif, M., Field, T., Dieter, J., Swerdlow. & Diego, M., (1998). Migraine Headaches are Reduced by Massage Therapy. International Journal of Neuroscience, 96, 1-11.
METHOD: Twenty-six adults with migraine headaches were randomly assigned to a massage therapy group, which received twice-weekly 30-minute massages for five consecutive weeks or a wait-list control group. RESULTS: The massage group reported fewer distress symptoms, less pain, more headache free days, fewer sleep disturbances and taking fewer analgesics. They also showed increased serotonin levels.
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Quinn, C., Chandler, C., & Moraska, A. (2002). Massage therapy and frequency of chronic tension headaches. American Journal of Public Health, 92, 1657-1661.
METHOD: This study examined the effects of massage therapy on chronic, nonmigraine headache. Four chronic tension headache sufferers (aged 18-55 yrs) received structured massage therapy treatment directed toward the neck and shoulder muscles during a 4-wk period. RESULTS: Massage therapy reduced the number of weekly headaches. Headache frequency was significantly reduced within the initial week of massage treatment, and continued for the remainder of the study. A trend toward reduction in average duration of each headache event between the baseline period and the treatment period was also observed.
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Hypertension
Hernandez-Reif, M., Field, T., Krasnegor, J., Theakston, H., Hossain, Z., & Burman, I. (2000). High blood pressure and associated symptoms were reduced by massage therapy. Journal of Bodywork and Movement Therapies, 4, 31-38.
METHOD: High blood pressure is associated with elevated anxiety, stress and stress hormones, hostility, depression and catecholamines. Massage therapy and progressive muscle relaxation were evaluated as treatments for reducing blood pressure and associated symptoms. Adults who had been diagnosed as hypertensive received ten 30-minute massage sessions over five weeks or they were given progressive muscle relaxation instructions (control group). RESULTS: Sitting diastolic blood pressure decreased after the first and last massage therapy sessions and reclining diastolic blood pressure decreased from the first to the last day of the study. Although both groups reported less anxiety, only the massage therapy group reported less depression and hostility and showed decreased urinary and salivary hormone levels (cortisol). Massage therapy may be effective in reducing diastolic blood pressure and symptoms associated with hypertension.
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Job Stress
Katz, J., Wowk, A., Culp, D., & Wakeling, H. (1999). Pain and tension are reduced among hospital nurses after on-site massage treatments: a pilot study. Journal of Perianesthesia Nursing, 14, 128-133.
METHOD: The aims of this pilot study were (1) to evaluate the feasibility of carrying out a series of eight 15-minute workplace-based massage treatments, and (2) to determine whether massage therapy reduced pain and stress experienced by nursing staff at a large teaching hospital. Twelve hospital staff (10 registered nurses and 2 nonmedical ward staff) working in a large tertiary care center volunteered to participate. Participants received up to eight, workplace-based, 15-minute Swedish massage treatments provided by registered massage therapists. Pain, tension, relaxation, and the Profile of Mood States were measured before and after each massage session. RESULTS: Pain intensity and tension levels were significantly lower after massage. In addition, relaxation levels and overall mood state improved significantly after treatments.
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Cady, S. H., & Jones, G. E. (1997). Massage therapy as a workplace intervention for reduction of stress. Perceptual & Motor Skills, 84, 157-158.
METHOD: The effectiveness of a 15-min. on-site massage while seated in a chair was evaluated for reducing stress as indicated by blood pressure. 52 employed participants’ blood pressures were measured before and after a 15-min. massage at work. RESULTS: Analyses showed a significant reduction in participants’ systolic and diastolic blood pressure after receiving the massage.
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Field, T., Ironson, G., Scafidi, F., Nawrocki, T., Goncalves, A., Burman, I., Pickens, J., Fox, N., Schanberg, S., & Kuhn, C. (1996). Massage therapy reduces anxiety and enhances EEG pattern of alertness and math computations. International Journal of Neuroscience, 86, 197-205.
METHOD: Twenty-six adults were given a chair massage and 24 control group adults were asked to relax in the massage chair for 15 minutes, two times per week for five weeks. On the first and last days of the study they were monitored for EEG before, during and after the sessions. In addition, before and after the sessions they performed math computations, they completed POMS Depression and State Anxiety Scales and they provided a saliva sample for cortisol. At the beginning of the sessions they completed Life Events, Job Stress and Chronic POMS Depression Scales. RESULTS: Analyses revealed the following: 1) frontal delta power increased for both groups, suggesting relaxation; 2) the massage group showed decreased frontal alpha and beta power (suggesting enhanced alertness), while the control group showed increased alpha and beta power; 3) the massage group showed increased speed and accuracy on math computations while the control group did not change; 4) anxiety levels were lower following the massage but not the control sessions, although mood state was less depressed following both the massage and control sessions; 5) salivary cortisol levels were lower following the massage but not the control sessions but only on the first day; and 6) at the end of the 5 week period depression scores were lower for both groups but the job stress score was lower only for the massage group.
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Field, T., Quintino, O., Henteleff, T., Wells-Keife, L., & Delvecchio-Feinberg, G. (1997). Job stress reduction therapies. Alternative Therapies in Health and Medicine, 3, 54-56.
METHOD: The immediate effects of brief massage therapy, music relaxation with visual imagery, muscle relaxation, and social support group sessions were assessed in 100 hospital employees at a major public hospital. RESULTS: Each of the groups reported decreases in anxiety, depression, fatigue, and confusion, as well as increased vigor following the sessions. That the groups did not differ on these variables suggests that these particular therapies, when applied for short periods of time, are equally effective for reducing stress among hospital employees.
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Massage Therapists
Lee, A.C. & Kemper, K.J. (2000). Practice patterns of massage therapists. Journal of Alternative & Complementary Medicine, 6, 527-9.
METHODS: To describe the practice patterns of licensed massage therapists (LMTs). One hundred and twenty-six (126) massage practices were randomly selected from the Greater Boston Area yellow pages. RESULTS: Most respondents were Caucasian (95%) and female (80%). Their mean age was 41 years old. Half held a college degree; on average, practitioners received 1000 hours of training in massage therapy. The majority were in group practices (59%) and saw an average of 20 patients per week. The typical visit lasted 50-60 minutes; the cost was $60 and rarely covered by insurance (5%). Half of the respondents offered sliding scales to patients, but only 11% accepted Medicaid patients. Respondents reported less than 1 visit per week from pediatric and adolescent patients (<21 years old).
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Nausea
Ming, J.L., Kuo, B.I., Lin, J.G., & Lin, L.C. (2002). The efficacy of acupressure to prevent nausea and vomiting in post-operative patients. J Adv Nurs., 39, 343-51.
METHOD: The aim of this study was to examine the effect of stimulating two acupressure points on prevention of post-operative nausea and vomiting. The Rhodes Index of Nausea, Vomiting and Retching questionnaire was used as a tool to measure incidence. To control the motion sickness variable, the subjects who underwent functional endoscopic sinus surgery under general anaesthesia were randomly assigned to a finger-pressing group, a wrist-band group, and a control group. The acupoints and treatment times were similar in the finger-pressing group and wrist-band pressing group, whereas only conversation was employed in the control group. RESULTS: Significant differences in the incidence of the post-operative nausea and vomiting were found between the acupressure, wrist-band, and control groups, with a reduction in the incidence rate of nausea from 73% to 43% and vomiting incidence rate from 90% to 43% in the acupressure group..
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Pain
Hasson, D., Arnetz, B., Jelveus, L., & Edelstam, B. (2004). A randomized clinical trial of the treatment effects of massage compared to relaxation tape recordings on diffuse long-term pain. Psychother Psychosom., 73, 17-24.
METHOD: The purpose of this randomized clinical trial was to assess possible effects of massage as compared to listening to relaxation tapes on musculoskeletal pain. 129 patients suffering from long-term musculoskeletal pain were randomized to either a massage or relaxation group, and assessed before, during and after treatment. RESULTS: During treatment there was a significant improvement in self-rated health, mental energy, and muscle pain only in the massage group as compared to the relaxation group.
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Kubsch, S.M., Neveau, T., & Vandertie, K. (2000). Effect of cutaneous stimulation on pain reduction in emergency department patients. Complementary Therapies in Nursing & Midwifery, 6, 25-32.
METHODS: Tactile stimulation was used with 50 emergency department patients to relieve pain. Another objective was to determine the effect of tactile stimulation on blood pressure and heart rate. RESULTS: Following stimulation, subjects reported significantly reduced pain, and demonstrated reduced heart rate, and blood pressure readings.
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Lundeberg, T. (1984). Long-term results of vibratory stimulation as a pain relieving measure for chronic pain. Pain, 20, 13-23.
METHOD: 267 patients with chronic neurogenic or musculoskeletal pain were given vibratory stimulation for their pain. The patients were observed for 18 months or until they terminated the treatment. RESULTS: About half of the successfully relieved patients (59% of the total number of patients) reported more than 50% pain relief, as scored on a visual analogue and an adjective scale. Seventy-two percent of these patients reported increased social activity and greater than 50% reported reduced intake of analgesic drugs after 12 months of home treatment.
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Lundeberg, T., Abrahamsson, P., Bondesson, L., & Haker. E. (1987). Effect of vibratory stimulation on experimental and clinical pain. Scandinavian Journal of Rehabilitation Medicine, 20, 149-159.
METHOD: The effect of vibratory stimulation on experimental pain of the skin overlying the right and left extensor carpi radialis longus muscle induced by electrical stimulation was studied in 16 healthy subjects and in 18 patients suffering from chronic epicondyalgia of the right elbow. RESULTS: In the healthy subjects there were no side differences whereas in the patients, the skin pain threshold over the painful right muscle was lower than that of the left unaffected side under resting conditions. After vibratory stimulation, the skin pain threshold increased bilaterally by 1.1-1.6 times the pre-stimulation threshold in the healthy subjects and by 1.2-2.3 times this threshold in the patients. In 8 of the healthy subjects there was an increase in peripheral blood flow during stimulation and in 8 there was a small decrease. In 13 patients the change in pain threshold was seen in phase with the local increase and decrease in peripheral blood flow. In all individuals, the pain thresholds were regained within 45 minutes of cessation of stimulation. This was in contrast to the general subjective pain in the patients; 12 patients reported that the relief of pain lasted for a period of 1-7 hours.
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Lundeberg, T., Abrahamsson, P., & Haker, E. (1987). Vibratory stimulation compared to placebo in alleviation of pain. Scandinavian Journal of Rehabilitation Medicine, 19, 153-158.
METHOD: The placebo effect of vibratory stimulation was studied in 72 patients with chronic pain syndromes in a double-blind crossover trial using a vibrator and a “placebo unit”. RESULTS: Pain alleviation was reported by 48% of the patients during vibratory stimulation compared with 34% for placebo treatment.
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Nixon, M., Teschendorff, J., Finney, J., & Karnilowicz, W. (1997). Expanding the nursing repertoire: The effect of massage on post-operative pain. Australian Journal of Advanced Nursing, 14, 21-26.
METHOD: A treatment group of 19 patients and a control group of 20 patients were compared on the impact of massage therapy on patients’ perceptions of post-operative pain. RESULTS: Controlling for age, the results indicated that massage produced a significant reduction in patients’ perceptions of pain over a 24 hour period.
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Piotrowski, M.M., Paterson, C., Mitchinson, A., Kim, H.M., Kirsh, M., Hinshaw, D.B. (2003). Massage as adjuvant therapy in the management of acute postoperative pain: a preliminary study in men. J Am Coll Surg., 197, 1037-46.
METHOD: This prospective randomized clinical trial compared pain relief after major operations in 202 patients who received one of three nursing interventions: massage, focused attention, or routine care. Interventions were performed twice daily starting 24 hours after the operation through postoperative day 7. Perceived pain was measured each morning. RESULTS: The rate of decline in the unpleasantness of postoperative pain was accelerated by massage. Use of opioid analgesics was not altered significantly by the interventions.
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van den Dolder, P.A., & Roberts, D.L. (2003). A trial into the effectiveness of soft tissue massage in the treatment of shoulder pain. Aust J Physiother., 49, 183-8.
METHOD: The purpose of this single blinded randomized controlled trial was to investigate the effects of soft tissue massage on range of motion, reported pain and reported function in patients with shoulder pain. Twenty-nine patients referred to physiotherapy for shoulder pain were randomly assigned to a treatment group that received six treatments of soft tissue massage around the shoulder (n = 15) or to a control group that received no treatment while on the waiting list for two weeks (n = 14). Measurements were taken both before and after the experimental period by a blinded assessor. Active range of motion was measured for flexion, abduction and hand-behind-back movements. Pain was assessed with the Short Form McGill Pain Questionnaire (SFMPQ) and functional ability was assessed with the Patient Specific Functional Disability Measure (PSFDM). RESULTS: The treatment group showed significant improvements in range of motion compared with the control group for abduction, flexion and hand-behind-back. Massage reduced pain as reported on the descriptive section of the SFMPQ by a mean of 5 points and on the visual analogue scale by an average of 27 mm, and it improved reported function on the PSFDM by a mean of 9 points.
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Walach, H., Guthlin, C., & Konig, M. (2003). Efficacy of massage therapy in chronic pain: a pragmatic randomized trial. J Altern Complement Med., 9, 837-46.
METHOD: Classic massage was compared to standard medical care (SMC) in chronic pain conditions of back, neck, shoulders, head and limbs. Pain was rated at pretreatment, post-treatment, and 3 month follow-up, as well as pain adjective list, depression, anxiety, mood, and body concept. RESULTS: 29 patients were randomized, 19 to receive massage, 10 to SMC. Pain improved significantly in both groups, but only in the massage group was it still significantly improved at follow-up. Depression and anxiety were improved significantly by both treatments, yet only the massage group maintained at follow-up.
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Wang, H.L., & Keck, J.F. (2004). Foot and hand massage as an intervention for postoperative pain. Pain Manag Nurs., 5, 59-65.
METHOD: The purpose of this pretest-posttest design study was to investigate whether a 20-minute foot and hand massage (5 minutes to each extremity), which was provided 1 to 4 hours after a dose of pain medication, would reduce pain perception and sympathetic responses among postoperative patients. RESULTS: Participants reported decreases in pain intensity. Decreases in sympathetic responses to pain (i.e., heart rate and respiratory rate) were observed although blood pressure remained unchanged. The patients experienced moderate pain after they received pain medications.
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Physicians’ Perspectives
Verhoef, M.J., & Page, S.A. (1998). Physicians’ perspectives on massage therapy. Canadian Family Physician, 44, 1018-40.
METHOD: The purpose of this study was to examine the knowledge, opinions, and referral behavior of family physicians with respect to massage therapy and to explore factors associated with referral. Three hundred family physicians were mailed a survey containing questions about sociodemographic and practice characteristics, perceived knowledge of massage therapy, opinions about the usefulness and legislation (government regulations) of massage therapy, and referral behavior. RESULTS: Fifty-four percent of physicians completed the questionnaire. Sixty-eight percent of respondents indicated they had minimal or no knowledge. Of the remaining, most (83%) believed massage therapy was a useful adjunct to their own practice. Moreover, 71% had referred patients to massage therapists and most (72%) perceived increasing demand from their patients for massage therapy. Approximately half of the physicians surveyed supported government regulation of massage therapy. Thus, the physicians demonstrated a discrepancy between their knowledge of massage therapy and their opinions of, and referrals to, the profession. Physicians who referred patients to massage therapists generally held more positive opinions and had more knowledge of the discipline.
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Posttraumatic Stress
Field, T., Seligman, S., Scafidi, F., & Schanberg, S. (1996). Alleviating posttraumatic stress in children following Hurricane Andrew. Journal of Applied Developmental Psychology, 17, 37-50.
METHOD: Massage therapy was evaluated for the reduction of anxiety and depression levels of children as measured by behavioral observations, their drawings, and their cortisol levels. Sixty 1st-5th graders who showed classroom behavior problems following Hurricane Andrew were randomly assigned to a massage therapy or a video attention group. RESULTS: Scores on the Posttraumatic Stress Disorder Index suggest that the subjects were experiencing severe posttraumatic stress. Subjects who received massage reported being happier and less anxious and had lower salivary cortisol levels after the therapy than the video subjects. The massage group showed more sustained changes as manifested by lower scores for anxiety, depression, and self-drawings. The massage therapy subjects were also observed to be more relaxed.
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Pregnancy
Field, T., Hernandez-Reif, M., Hart, S., Theakston, H., Schanberg, S., Kuhn, C. & Burman, I. (1999). Pregnant women benefit from massage therapy. Journal of Psychosomatic Obstetrics & Gynecology, 20, 31-38.
METHOD: Twenty-six pregnant women were assigned to a massage therapy or a relaxation therapy group for 5 weeks. The therapies consisted of 20-min sessions twice a week. RESULTS: Both groups reported feeling less anxious after the first session and less leg pain after the first and last session. Only the massage therapy group, however, reported reduced anxiety, improved mood, better sleep and less back pain by the last day of the study. In addition, urinary stress hormone levels (norepinephrine) decreased for the massage therapy group, and the women had fewer complications during labor and their infants had fewer postnatal complications (e.g., less prematurity).
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Norheim, A.J., Pederson, E.J., Fonnebo, V., & Berge, L. (2001). Acupressure treatment of morning sickness in pregnancy. A randomized, double-blind, placebo-controlled study. Scand J Prim Health Care, 19, 43-7.
METHOD: The purpose of this study was to find out whether acupressure wristband could alleviate nausea and vomiting in early pregnancy. Symptoms were recorded according to intensity, duration and nature of complaints in 97 pregnant women of 8-12 weeks gestation. RESULTS: 71% of women in the intervention group reported both less intensive morning sickness and reduced duration of symptoms.
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Werntoft, E., & Dykes, A.K. (2001). Effect of acupressure on nausea and vomiting during pregnancy. A randomized, placebo-controlled, pilot study. J Reprod Med., 46, 835-9.
METHOD: The purpose of this study was to compare the anti-emetic effect of acupressure in a group of healthy women with normal pregnancy and nausea and vomiting during pregnancy with a similar group receiving acupressure at a placebo point and another, similar group not receiving any treatment. RESULTS: Relief from nausea appeared one day after starting treatment in both the acupressure and placebo groups The acupressure group experienced significantly less nausea after 14 days as compared to the other two groups.
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Premenstrual Syndrome
Hernandez-Reif, M., Martinez, A., Field, T., Quintero, O., & Hart, S. (2000). Premenstrual syndrome symptoms are relieved by massage therapy. Journal of Psychosomatic Obstetrics & Gynecology, 21, 9-15.
METHOD: Twenty-four women with premenstrual syndrome were randomly assigned to a massage therapy or a relaxation therapy group. RESULTS: The massage group showed decreases in anxiety, depressed mood and pain immediately after the massage sessions. In addition, by the last day of the study the massage therapy group reported a reduction in menstrual distress symptoms including pain and water retention. These data suggest that massage therapy is effective for treating premenstrual syndrome.
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Sexual Abuse
Field, T., Hernandez-Reif, M., Hart, S., Quintino, O., Drose, L., Field, T., Kuhn, C., & Schanberg, S. (1997). Sexual abuse effects are lessened by massage therapy. Journal of Bodywork and Movement Therapies, 1, 65-69.
METHOD: Women (mean age = 35 years) who had experienced sexual abuse, were given a 30-minute massage twice a week for 1 month. RESULT: Immediately after the massage the women reported being less depressed and less anxious and their salivary cortisol levels decreased following the session. Over the 1-month treatment period the massage therapy group experienced a decrease in depression and in life event stress. Although the relaxation therapy control group also reported a decrease in anxiety and depression, their stress hormones did not change, and they reported an increasingly negative attitude toward touch.
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Sleep
Field, T., Kilmer, T., Hernandez-Reif, M. & Burman, I. Preschool Children’s Sleep and Wake Behavior: Effects of Massage Therapy. Early Child Development and Care, 120, 39-44.
METHOD: Preschool children received 20-minute massages twice a week for five weeks. RESULTS: The massaged children as compared to the children in the wait-list control group had better behavior ratings on state, vocalization, activity and cooperation after the massage sessions on the first and last days of the study. Their behavior was also rated more optimally by their teachers by the end of the study. Also, at the end of the 5 week period parents of the massaged children rated their children as having less touch aversion and being more extraverted. Finally, the massaged children had a shorter latency to naptime sleep by the end of the study.
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Richards, K.C. (1998). Effect of a back massage and relaxation intervention on sleep in critically ill patients. American Journal of Critical Care, 7, 288-299.
METHOD: Critically ill patients are deprived of sleep and its potential healing qualities, although many receive medications to promote sleep. No one has adequately evaluated holistic nonpharmacological techniques designed to promote sleep in critical care practice. This study determined the effects of (1) a back massage and (2) combined muscle relaxation, mental imagery, and a music audiotape on the sleep of older men with a cardiovascular illness who were hospitalized in a critical care unit. Sixty-nine subjects were randomly assigned to a 6-minute back massage (n=24); a teaching session on relaxation and a 7.5 minute audiotape at bedtime consisting of muscle relaxation, mental imagery, and relaxing background music (n=28); or the usual nursing care (controls, n=17). Polysomnography was used to measure 1 night of sleep for each patient and the sleep efficiency index was the primary variable of interest. RESULTS: The analyses showed improved quality of sleep in the back-massage group.
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Smoking
Hernandez-Reif, M., Field, T., & Hart, S. (1999). Smoking cravings are reduced by self-massage. Preventive Medicine, 28, 28-32.
METHOD: Attempts at smoking cessation have been correlated with severe withdrawal symptoms, including intense cigarette cravings, anxiety, and depressed mood. Massage therapy has been shown to reduce anxiety and stress hormones and improve mood. Twenty smokers were randomly assigned to a self-massage treatment or a control group. The treatment group was taught to conduct a hand or ear self-massage during three cravings a day for 1 month. RESULTS: Self-reports revealed lower anxiety scores, improved mood, and fewer withdrawal symptoms. In addition, the self-massage group smoked fewer cigarettes per day by the last week of the study. These findings suggest that self-massage may be an effective adjunct treatment for attempting smoking cessation, to alleviate smoking-related anxiety, reduce cravings and withdrawal symptoms, improve mood, and reduce the number of cigarettes smoked.
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Spinal Cord Injuries
Diego, M.A., Field, T., Hernandez-Reif, M., Hart, S., Brucker, B., Field, Tory, Burman, I. (2002). Spinal cord patients benefit from massage therapy. International Journal of Neuroscience, 112, 133-142.
METHOD: The study assessed the effects of massage therapy on depression, functionality and upper body muscle strength and range of motion on spinal cord injury patients. Twenty spinal cord injury individuals recruited from a medical school outpatient clinic were randomly assigned to a massage therapy or a control group. Patients in the massage therapy group received two-40-minute massage therapy sessions per week for five weeks. Patients in the control group practiced a range of motion exercise routine targeting the arms, neck, shoulders and back two times per week for five weeks. RESULTS: Although both the massage and exercise group appeared to benefit from treatment, only the massage group showed lower anxiety and depression scores and significantly increased their muscle strength and wrist range of motion.
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Stroke
Mok, E., & Woo, C.P. (2004). The effects of slow-stroke back massage on anxiety and shoulder pain in elderly stroke patients. Complement Ther Nurs Midwifery, 10, 209-16.
METHOD: This study explored the effect of slow-stroke back massages on anxiety and shoulder pain in hospitalized elderly patients with stroke. The scores were compared for self-reported pain, anxiety, blood pressure, heart rate and pain of two groups of patients before and immediately after, and three days after the intervention. The intervention consisted of ten minutes of slow-stroke back massage (SSBM) for seven consecutive evenings. One hundred and two patients participated in the entire study and were randomly assigned to a massage group or a control group. RESULTS: The results revealed that the massage intervention significantly reduced the patients’ levels of pain perception and anxiety. In addition to the subjective measures, all physiological measures (systolic and diastolic blood pressure and heart rate) changed positively, indicating relaxation. The prolonged effect of SSBM was also evident, as reflected by the maintenance of the psycho-physiological parameters three days after the massage. The patients’ perceptions of SSBM, determined from a questionnaire, revealed positive support for SSBM for elderly stroke patients.
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Blood Flow
Mori, H., Ohsawa, H., Tanaka, T.H., Taniwaki, E., Leisman, G. & Nishijo, K. (2004). Effect of massage on blood flow and muscle fatigue following isometric lumbar exercise. Med Sci Monit, 10, 173-8.
METHOD: Subjects participated in two experimental sessions (massage and rest conditions). Subjects lay prone on the table and were instructed to extend their trunks until the inferior portion of their rib cage no longer rested on the table. Subjects held this position for 90 seconds (Load I). Subjects then received massage on the lumbar region or rested for 5 minutes, then repeated the same load (Load II). Skin blood flow (SBF), muscle blood volume (MBV), skin temperature (ST), and subjects’ subjective feelings of fatigue were evaluated using Visual Analogue Scale (VAS). RESULTS: An increase of MBV between pre- and post-load II periods was higher after massage than after rest. An increase of SBF at pre- and post-load II was observed only under massage condition. An increase of SBF between post-load I and pre-load II periods was higher after massage than after rest. An increase of ST between post-load I and post-load II periods was greater after massage than after rest. The VAS score was lower with massage than with rest in the post-treatment period.
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Shoemaker, J. K., Tidus, P. M., & Mader, R. (1997). Failure of manual massage to alter limb blood flow: Measures by Doppler ultrasound. Medicine and Science in Sports and Exercise 1, 610-14.
METHOD: The ability of manual massage to alter muscle blood flow through three types of massage treatments in a small (forearm) and a large (quadriceps) muscle mass was tested in 10 healthy individuals. A certified massage therapist administered effleurage, petrissage, and tapotement treatments to the forearm flexors (small muscle mass) and quadriceps (large muscle mass) muscle groups in a counterbalanced manner. Limb blood flow was determined from mean blood velocity (MBV) (pulsed Doppler) and vessel diameter (echo Doppler). MBV values were obtained from the continuous data sets prior to treatment, and at 5, 10, and 20 s and 5 min following the onset of massage, Arterial diameters were measured immediately prior to and following the massage treatments; these values were not different and were averaged for the blood flow calculations. RESULTS: The MBV and blood flows for brachial and femoral arteries, respectively, were not altered by any of the massage treatments in either the forearm or quadriceps muscle groups. Mild voluntary handgrip and knee extension contractions resulted in peak blood velocities and blood flow for brachial and femoral arteries, respectively, which were significantly elevated from rest. The results indicated that manual massage did not elevate muscle blood flow irrespective of massage type or the muscle mass receiving the treatment.
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Blood Pressure
Hernandez-Reif, M., Field, T., Krasnegor, J. & Theakston, H.(2000). High blood pressure and associated symptoms were reduced by massage therapy. Journal of Bodywork and Movement Therapies, 4, 31-38.
METHOD: Thirty adults with controlled hypertension (for at least the last six months) were randomly assigned to either a massage therapy group or a progressive relaxation group. Those in the massage group were given twice-weekly 30-minute massage sessions for five weeks. Participants in the progressive muscle relaxation group received instructions on completing self-administered, twice-weekly 30-minute exercises for five weeks. Researchers instructed subjects to only perform their session on assigned days to ensure compatibility with the massage group’s schedule. Relaxation sessions began with participants breathing deeply for several minutes while in a supine position with the hands alongside the body. They then followed instructions to tighten and then relax different muscles, moving upward from the feet to the head. Muscle groups included were of the feet, calves, thighs, hands, arms, back and face. Pre- and post-treatment assessments included: a state anxiety inventory (STAI) to assess current emotions; a salivary sample to measure the levels of the stress hormone cortisol; systolic blood pressure and diastolic blood pressure measures; the Center for Epidemiological Studies Depression Scale (CES-D) questionnaire to rate depressive symptoms; Symptom Checklist-90-Revised (SCL-90-R) self-report symptom inventory of depression, anxiety and hostility; and urinary catecholamines (biologically active amines which affect the nervous and cardiovascular systems) and cortisol measurement. RESULTS: Results showed that while both group had lower anxiety levels (STAI) and lower levels of depression (CES-D), only the massage therapy group showed decreases in sitting diastolic and systolic blood pressure; decreases in salivary and urinary cortisol stress-hormone levels; and lower scores for depression, anxiety and hostility.
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Kurosawa, M., Lundeberg, T., Agren, G., Lund, I., & Uvnas-Moberg, K. (1995). Massage-like stroking of the abdomen lowers blood pressure in anesthetized rats: influence of oxytocin. Journal of the Autonomic Nervous System, 56, 26-30.
METHOD: The aim of this study was to determine how massage-like stroking of the abdomen in rats influences arterial blood pressure. The participation of oxytocinergic mechanisms in this effect was also investigated. The ventral and/or lateral sides of the abdomen were stroked in pentobarbital anesthetized, artificially ventilated rats. Arterial blood pressure was recorded with a pressure transducer via catheter in the carotid artery. RESULTS: Stroking of the ventral or both ventral and lateral sides of the abdomen for 1 minute caused a marked decrease in arterial blood pressure (approx. 50 mmHg). After cessation of the stimulation blood pressure returned to the control level within 1 min. The maximum decrease in blood pressure was achieved at frequencies of 0.083 Hz or more. Stroking only the lateral sides of the abdomen elicited a significantly smaller decrease in blood pressure (approx. 30 mmHg decrease) than stroking the ventral side. The decrease in blood pressure caused by stroking was not altered by an oxytocin antagonist. In contrast, the administration of oxytocin diminished the effect, which was antagonized by a simultaneous injection of the oxytocin antagonist. These results indicate that the massage-like stroking of the abdomen decreases blood pressure in anesthetized rats. This effect does not involve intrinsic oxytocinergic transmission. However, since exogenously applied oxytocin was found to diminish the effect of stroking, oxytocin may exert an inhibitory modulatory effect on this reflex arc.
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McNamara, M.E., Burnham, D.C., Smith, C., & Carroll, D.L. (2003). The effects of back massage before diagnostic cardiac catheterization. Alternative Therapies, 9, 50-57.
METHOD: The purpose of this study was to measure the effects of a 20-minute back massage on the physiological and psychological human responses of patients admitted for a diagnostic cardiac catheterization. A randomized clinical trial design was used. Data were compared in a repeated measures design before massage, immediately following the back massage or standard care, and 10 minutes later. Forty-six subjects admitted from home for a diagnostic cardiac catheterization were included in the study. Heart rate, heart rate variability, blood pressure, respiration, peripheral skin temperature, pain perception, and psychological state were the main outcome measures. RESULTS: There was a reduction in systolic blood pressure in the treatment group. In addition, main effects were noted for time for diastolic blood pressure, respiration, total Profile of Mood States score and pain perception in both groups.
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Olney, C.M. (2005).The effect of therapeutic back massage in hypertensive persons: a preliminary study. Biol Res Nurs, 7, 98-105.
METHOD: This study tested the effects of a regularly applied back massage on the BP of patients with clinically diagnosed hypertension. A 10-min back massage was given to the experimental group, three times a week for 10 sessions. The control group relaxed in the same environment for 10 min, three times a week for 10 sessions. RESULTS: Systolic BP decreased over time, as did the diastolic BP.
Boone, T. & Cooper, R. (1995). The effect of massage on oxygen consumption at rest. American Journal of Chinese Medicine, 23, 37-41.
METHOD: This study determined the effect of massage on oxygen consumption at rest. Ten healthy, adult males volunteered to serve as subjects. During the Control Session, each subject was placed in the supine position on a massage table to remain motionless for 30 minutes. During the Treatment Session, each subject received a 30-minute sports massage of the lower extremities. Oxygen consumption was measured. RESULTS: The subjects’ oxygen consumption did not change with the massage. Also, there were no significant differences in heart rate, stroke volume, cardiac output, and arteriovenous oxygen difference during the massage. These findings indicate that massaging the lower extremities results in neither an increase nor a decrease in the subjects’ expenditure of energy at rest.
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Boone, T., Tanner, M., & Radosevich, A. (2001). Effects of a 10-minute back rub on cardiovascular responses in healthy subjects. American Journal of Chinese Medicine. 29, 47-52
METHODS: This study determined the cardiovascular responses to a 10-minute back rub. Twelve healthy, college-age males and females volunteered to participate as subjects. The subjects were assessed for 10 minutes on a massage table lying on one side. During the treatment period, a back rub was administered. Oxygen consumption and cardiac output were measured. RESULTS: The central and peripheral components of oxygen consumption were changed and cardiac output decreased. These results indicate that the back rub was effective in inducing relaxation.
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Delaney, J.P., Leong, K.S., Watkins, A., & Brodie, D. (2002). The short-term effects of myofascial trigger point massage therapy on cardiac autonomic tone in healthy subjects. Journal of Advanced Nursing, 37, 364-71.
METHOD: This study investigated the effects of myofascial trigger-point massage therapy to the head, neck and shoulder areas on cardiac autonomic tone. A 5-minute cardiac interbeat interval recording, systolic and diastolic blood pressure and subjective self-evaluations of muscle tension and emotional state were taken before and after intervention. RESULTS: Following myofascial trigger-point massage therapy there was a significant decrease in heart rate, systolic blood pressure and diastolic blood pressure. Analysis of heart rate variability revealed a significant increase in parasympathetic activity following myofascial trigger-point massage therapy. Additionally both muscle tension and emotional state showed significant improvement.
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Lewis, P., Nichols, E., Mackey, G., Fadol, A., Sloane, L., Villagomez, E., & Liehr, P. (1997). The effect of turning and backrub on mixed venous oxygen saturation in critically ill patients. American Journal of Critical Care, 6, 132-140.
METHOD: A repeated-measures design was used to examine the effect of a change in body position (right or left lateral) and timing of backrub (immediate or delayed) on mixed venous oxygen saturation in 57 surgical ICU patients. Mixed venous oxygen saturation was recorded at 1-minute intervals for 5 minutes in each of three periods: baseline, after turning, and after backrub. Subjects were randomly assigned to body position and timing of backrub. Subjects in the immediate-backrub group were turned and given a 1-minute backrub. Mixed venous oxygen saturation was measured at 1-minute intervals for 5 minutes at two points: after the backrub and then with the patient lying on his side. For subjects in the delayed-backrub group, saturation was measured at 1-minute intervals for 5 minutes at two different points: after the subject was turned to his side and after the backrub. RESULTS: Both position and timing of backrub had significant effects on mixed venous oxygen saturation across conditions over time. Subjects positioned on their left side had a significantly greater decrease in saturation when the backrub was started. At the end of the backrub, saturation was significantly lower in subjects lying on their left side than in subjects lying on their right side. The pattern of change differed according to the timing of the backrub, and return to baseline levels of saturation after intervention differed according to body position. Two consecutive interventions (change in body position and backrub) caused a greater decrease in mixed venous oxygen saturation than the two interventions separated by a 5-minute equilibration period. Turning to the left side decreased oxygen saturation more than turning to the ride side did. Oxygen saturation returned to clinically acceptable ranges within 5 minutes of the intervention.
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McNamara, M.E., Burnham, D.C., Smith, C., & Carroll, D.L. (2003). The effects of back massage before diagnostic cardiac catheterization. Altern Ther Health Med., 9, 50-7.
METHOD: The purpose of this study was to measure the effects of a 20-minute back massage on the physiological and psychological human responses of patients admitted for a diagnostic cardiac catheterization. RESULTS: There was a significant reduction in systolic blood pressure in the treatment group. In addition, main effects were noted for time for diastolic blood pressure, respiration, total Profile of Mood States score and pain perception in both groups.
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Carpal Tunnel Syndrome
Field, T., Diego, M., Cullen, C., Hartshorn, K., Gruskin, A., Hernandez-Reif, M., & Sunshine, W. (2004). Carpal tunnel syndrome symptoms are lessened following massage therapy. Journal of Bodywork and Movement Therapies, 8, 9-14.
METHOD: The objective of this study was to determine the effectiveness of massage therapy for relieving the symptoms of Carpal Tunnel Syndrome (CTS). Sixteen adults with CTS symptoms were randomized to a 4-week massage therapy or control group. Participants in the massage therapy group were taught a self-massage routine that was done daily at home. They were also massaged once a week by a therapist. The participants’ diagnosis was based on a nerve conduction velocity test, the Phalen test, and the Tinel sign test performed by a physician. The participants were also given the State Trait Anxiety Inventory (STAI), the Profile of Mood States (POMS), a visual analog scale for pain and a test of grip strength. RESULTS: Participants in the massage therapy group improved on median peak latency and grip strength. They also experienced lower levels of perceived pain, anxiety, and depressed mood.
Chronic Fatigue Syndrome
Field, T, Sunshine, W., Hernandez-Reif, M., Quintino, O., Schanberg, S., Kuhn, C., & Burman, I. (1997). Chronic fatigue syndrome: massage therapy effects on depression and somatic symptoms in chronic fatigue syndrome. Journal of Chronic Fatigue Syndrome, 3, 43-51.
METHOD: Twenty chronic fatigue syndrome subjects were randomly assigned to a massage therapy or a SHAM TENS (transcutaneous electrical stimulation) control group. RESULTS: Immediately following the massage therapy versus SHAM TENS on the first and last days of the study the massage therapy group had lower depression and anxiety scores and lower cortisol levels. Longer-term effects (last day versus first day) suggested that the massage therapy versus the SHAM TENS group had lower depression, emotional distress and somatic symptom scores, more hours of sleep and lower epinephrine and cortisol levels.
Depression
Field, T., Morrow, C., Valdeon, C., Larson, S., Kuhn, C., & Schanberg, S.(1992). Massage reduces depression and anxiety in child and adolescent psychiatric patients. Journal of the American Academy of Child & Adolescent Psychiatry, 31, 125-131.
METHOD: A 30-minute back massage was given daily for a 5-day period to 52 hospitalized depressed and adjustment disorder children and adolescents. RESULTS: Compared with a control group who viewed relaxing videotapes, the massaged subjects were less depressed and anxious and had lower saliva cortisol levels after the massage. In addition, nurses rated the subjects as being less anxious and more cooperative on the last day of the study, and nighttime sleep increased over this period. Finally, urinary cortisol and norepinephrine levels decreased, but only for the depressed subjects.
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Field, T., Grizzle, N., Scafidi, F., & Schanberg, S. (1996). Massage and relaxation therapies’ effects on depressed adolescent mothers. Adolescence, 31, 903-911.
METHOD: Thirty-two depressed adolescent mothers received ten 30-minute sessions of massage therapy or relaxation therapy over a five-week period. Subjects were randomly assigned to each group. RESULTS: Although both groups reported lower anxiety following their first and last therapy sessions, only the massage therapy group showed behavioral and stress hormone changes including a decrease in anxious behavior, pulse, and salivary cortisol levels. A decrease in urine cortisol levels suggested lower stress following the five-week period for the massage therapy group.
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Onozawa, K., Glover, V., Adams, D., Modi, N., & Kumar, R.C. (2001). Infant massage improves mother-infant interaction for mothers with postnatal depression. Journal of Affective Disorders, 63(1-3).
METHOD: Thirty-four primiparous depressed mothers at 4 weeks postpartum were randomly assigned either to an infant massage class and a support group (massage group) or to a support group (control group). Each group attended five weekly sessions. RESULTS: The depression scores fell in both groups. However, improvement of mother-infant interactions was seen only in the massage group.
Diabetes
Field, T., Hernandez-Reif, M., LaGreca A., Shaw, K., Schanberg, S., & Kuhn, C. (1997). Massage therapy lowers blood glucose levels in children with Diabetes Mellitus. Diabetes Spectrum ,10, 237-239.
METHOD: Twenty diabetic children were randomly assigned to a touch therapy or relaxation therapy group. The children’s parents were taught one or the other therapy and were asked to provide them for 20 minutes before bedtime each night for 30 days. RESULTS: The immediate effects of the touch therapy were reduced parent anxiety and depressed mood and reduced child anxiety, fidgetiness and depressed affect. Over the 30 day period compliance on insulin and food regulation improved and blood glucose levels decreased from 159 to within the normal range (121).
Elderly
Field, T., Hernandez-Reif, M., Quintino, O., Schanberg, S. & Kuhn, C. (1998). Elder retired volunteers benefit from giving massage therapy to infants. Journal of Applied Gerontology, 17, 229-239.
METHOD: This exploratory within-subjects study compared the effects of elder volunteers giving massage to infants versus receiving massage themselves. Three times a week for 3 weeks, 10 elder volunteers received massage sessions. For another 3 weeks, three times per week, the same elderly volunteers massaged infants at a nursery school. RESULTS: Immediately after the first-and last-day sessions of giving massages, the elder retired volunteers had less anxiety and depression and lower stress hormone (salivary cortisol) levels. Over the 3-week period, depression and catecholamines (norepinephrine and epinephrine) decreased and lifestyle and health improved. These effects were not as strong for the 3-week period when they received massage, possibly because the elder retired volunteers initially felt awkward about being massaged and because they derived more satisfaction from massaging the infants.
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Hartshorn, K., Delage, J., Field, T., & Olds, L. (2001). Senior citizens benefit from movement therapy. Journal of Bodywork and Movement Therapies, 5, 1-5.
METHOD: Sixteen senior citizens participated in four, 50-minute movement therapy sessions over a 2-week period and were compared to 16 senior citizens who belonged to a wait list control group who received the movement sessions only after the end of the study. RESULTS: The movement therapy participants improved in their functional motion on the Tinetti scale, and specifically on the gait scale, their leg strength increased, and their leg pain significantly decreased.
Endorphins
Day, J. A., Mason, R. R., & Chesrown, S. E. (1987). Effect of massage on serum level of beta-endorphin and beta-lipotropin in healthy adults. Physical Therapy ,67, 926-930.
METHOD: The effect of massage was evaluated on the levels of endogenous opiates in peripheral venous blood. The results were based on findings from 21 healthy, adult volunteers. The volunteers were assigned randomly to either the Control Group (n = 11) that rested but received no massage or the Experimental Group (n = 10) that received a 30-minute complete back massage. RESULTS: No significant pretreatment or posttreatment difference was found in blood beta-endorphin or beta-lipotropin levels between the groups. The results indicate that massage did not change the measured serum levels of beta-endorphin or beta-lipotropin in these healthy subjects without pain.
Exercise
Brooks, C.P., Woodruff, L.D., Wright, L.L. & Donatelli, R. (2005). The immediate effects of manual massage on power-grip performance after maximal exercise in healthy adults. J Altern Complement Med, 11, 1093-101.
METHOD: This study assessed the effects of using manual massage to improve power-grip performance immediately after maximal exercise in healthy adults. Fifty-two volunteer massage-school clients, staff, faculty, and students participated. Subjects randomly received either a 5-minute forearm/hand massage of effleurage and friction (to either the dominant hand or nondominant hand side), 5 minutes of passive shoulder and elbow range of motion, or 5 minutes of nonintervention rest. RESULTS: After 3 minutes of isometric exercise, power grip was consistently fatigued to at least 60% of baseline, with recovery occurring over the next 5 minutes. Massage had a greater effect than no massage or than placebo on grip performance after fatigue, especially in the nondominant-hand group.
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Drust, B., Atkinson, G., Gregson, W., French, D. & Binningsley, D. (2003). The effects of massage on intra muscular temperature in the vastus lateralis in humans. Int J Sports Med, 24, 395-9.
METHOD: The aim of the current investigation was to evaluate the effect of different durations of massage, and ultrasound treatment, on the temperature of the vastus lateralis muscle in males. Deep effleurage massage of the vastus lateralis was performed on seven healthy males for 5, 10 and 15 min periods. A 5-min period of ultrasound at 45 KHz was also completed by all subjects. Intra muscular temperature (at 1.5, 2.5 and 3.5 cm) and thigh skin temperature were assessed pre and post treatment. Heart rate was monitored continuously throughout all conditions. RESULTS: Pre treatment intra muscular temperature increased as depth of measurement increased. Changes in muscle temperature at 1.5 and 2.5 cm were significantly greater following massage than ultrasound. No significant differences between massage treatments and ultrasound were noted when intra muscular temperature was measured at 3.5 cm. Massage also significantly increased both heart rate and thigh skin temperature compared to ultrasound. Increases in intra muscular temperature, heart rate and thigh skin temperature were the same irrespective of massage duration. These data suggest that massage and ultrasound have only limited effects on deep muscle temperature.
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Hemmings, B., Smith, M., Graydon, J. & Dyson, R. (2000). Effects of massage on physiological restoration, perceived recovery, and repeated sports performance. Br J Sports Med, 34, 109-14
METHODS: Eight amateur boxers completed two performances on a boxing ergometer on two occasions in a counterbalanced design. Boxers initially completed performance 1, after which they received a massage or passive rest intervention. Each boxer then gave perceived recovery ratings before completing a second performance, which was a repeated simulation of the first. Heart rates and blood lactate and glucose levels were also assessed before, during, and after all performances. RESULTS: A repeated measures analysis of variance showed no significant group differences for either performance, although a main effect was found showing a decrement in punching force from performance 1 to performance 2 . The massage intervention significantly increased perceptions of recovery compared with the passive rest intervention. Blood lactate concentration after the second performance was significantly higher following massage.
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Hilbert, J.E., Sforzo, G.A. & Swensen, T. (2003). The effects of massage on delayed onset muscle soreness. Br J Sports Med, 37, 72-5.
METHODS: Eighteen volunteers were randomly assigned to either a massage or control group. Delayed onset muscle soreness was induced with six sets of eight maximal eccentric contractions of the right hamstring, which were followed 2 h later by 20 min of massage or sham massage (control). Peak torque and mood were assessed at 2, 6, 24, and 48 h postexercise. Range of motion (ROM) and intensity and unpleasantness of soreness were assessed at 6, 24, and 48 h postexercise. Neutrophil count was assessed at 6 and 24 h postexercise. RESULTS: Intensity of soreness was significantly lower in the massage group relative to the control group at 48 h postexercise.
Mori, H., Ohsawa, H., Tanaka, T.H., Taniwaki, E., Leisman, G. & Nishijo, K. (2004). Effect of massage on blood flow and muscle fatigue following isometric lumbar exercise. Med Sci Monit, 10, 173-8.
METHODS: Twenty-nine healthy male subjects participated in two experimental sessions (massage and rest conditions). Subjects lay prone on the table and were instructed to extend their trunks until the inferior portion of their rib cage no longer rested on the table. Subjects held this position for 90 seconds (Load I). Subjects then either received massage on the lumbar region or rested for 5 minutes, then repeated the same load (Load II). Skin blood flow (SBF), muscle blood volume (MBV), skin temperature (ST), and subjects’ subjective feelings of fatigue were evaluated using Visual Analogue Scale (VAS). RESULTS: An increase of MBV between pre- and post-load II periods was higher after massage than after rest. An increase of SBF at pre- and post-load II was observed only under massage condition. An increase of SBF between post-load I and pre-load II periods was higher after massage than after rest. An increase of ST between post-load I and post-load II periods was greater after massage than after rest. The VAS score was lower with massage than with rest in the post-treatment period.
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Rinder, A.N. & Sutherland, C.J. (1995). An investigation of the effects of massage on quadriceps performance after exercise fatigue. Complement Ther Nurs Midwifery, 1, 99-102.
METHODS: Thirteen males and 7 females completed their maximum number of leg extensions against a half maximum load. In a randomised, crossover study they were exercised to fatigue using an ergonometer, ski-squats and leg extensions followed either by a 6 min massage or rest after which they again completed their maximum number of leg extensions against half maximum load. The process was repeated a few days later with the alternative condition (rest or massage). RESULTS: Massage after exercise fatigue significantly improved quadriceps performance compared to rest.
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Robertson, A., Watt, J.M. & Galloway, S.D. (2004). Effects of leg massage on recovery from high intensity cycling exercise. Br J Sports Med, 4 ,173-6.
METHODS: Nine male games players participated. They attended the laboratory on two occasions one week apart and at the same time of day. Dietary intake and activity were replicated for the two preceding days on each occasion. After baseline measurement of heart rate and blood lactate concentration, subjects performed a standardised warm up on the cycle ergometer. This was followed by six standardised 30 second high intensity exercise bouts, interspersed with 30 seconds of active recovery. After five minutes of active recovery and either 20 minutes of leg massage or supine passive rest, subjects performed a second standardised warm up and a 30 second Wingate test. Capillary blood samples were drawn at intervals, and heart rate, peak power, mean power, and fatigue index were recorded. RESULTS: Significantly lower fatigue index was observed in the massage trial.
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Rodenburg, J. B., Steenbeek, D., Schiereck, P., & Bar, P. R. (1994). Warm-up, stretching and massage diminish harmful effects of eccentric exercise. International Journal of Sports Medicine. 15, 414-419.
METHOD: The combination of a warm-up, stretching exercises and massage were assessed for their effects on subjective scores for delayed onset muscle soreness (DOMS) and functional and biochemical measures. Fifty people, randomly assigned to a treatment and a control group, exercised with the forearm flexors for 30 min. The treatment group also performed a warm-up and stretching protocol followed by forearm exercise and massage. RESULTS: The median values at the five post-exercise time points differed significantly for DOMS measured when the arm was extended. Significant effects for treatment were found on the maximal force, the flexion angle of the elbow and the creatine kinase activity in blood.
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Smith, L. L., Keating, M. N., Holbert, D., Spratt, D. J., McCammon, M. R., Smith, S. S., and Israel, R. G. (1994). The effects of athletic massage on delayed onset muscle soreness, creatine kinase, and neutrophil count: a preliminary report. Journal of Orthopaedic & Sports Physical Therapy, 19, 93-99.
METHOD: It was hypothesized that athletic massage administered 2 hours after eccentric exercise would disrupt an initial crucial event in acute inflammation, the accumulation of neutrophils. This would result in a diminished inflammatory response and a concomitant reduction in delayed onset muscle soreness (DOMS) and serum creatine kinase (CK). Untrained males were randomly assigned to a massage or control group. All performed five sets of isokinetic eccentric exercise of the elbow flexors and extensors. Two hours after exercise, massage subjects received a 30-minute athletic massage; control subjects rested. Delayed onset muscle soreness and CK were assessed before exercise and at 8, 24, 48, 72, 96, and 120 hours after exercise. Circulating neutrophils were assessed before and immediately after exercise, and at 30-minute intervals for 8 hours; cortisol was assessed before and immediately after exercise, and at 30-minute intervals for 8 hours; CK was assessed at similar times. RESULTS: A trend analysis revealed a significant treatment by time interaction effect for 1) DOMS, with the massage group reporting reduced levels; 2) CK, with the massage group displaying reduced levels; 3) neutrophils, with the massage group displaying a prolonged elevation; and 4) cortisol, with the massage group showing a diminished diurnal reduction. The results of this study suggest that sports massage will reduce DOMS and CK when administered 2 hours after the termination of eccentric exercise. This may be due to a reduced emigration of neutrophils and/or higher levels of serum cortisol.
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Viitasalo, J. T., Niemela, K., Kaappola, R., Korjus, T., Levola, M., Mononen, H. V., Rusko, H. K., and Takala, T. E. (1995). Warm underwater water-jet massage improves recovery from intense physical exercise. European Journal of Applied Physiology & Occupational Physiology, 71, 431-438.
METHOD: The effects of warm underwater water-jet massage on neuromuscular functioning, selected biochemical parameters (serum creatine kinase, lactic dehydrogenase, serum carbonic anhydrase, myoglobin, urine urea and creatinine) and muscle soreness were studied among 14 junior track and field athletes. Each subject spent, in a randomized order, two identical training weeks engaged in five strength/power training sessions lasting 3 days. RESULTS: The training weeks differed from each other only in respect to underwater water-jet massage treatments. These were used three times (20 min each) during the treatment week and not used during the control week. During the treatment week continuous jumping power decreased and ground contact time increased significantly less (P < 0.05) and serum myoglobin increased more than during the control week. It is suggested that underwater water-jet massage in connection with intense strength/power training increases the release of proteins from muscle tissue into the blood and enhances the maintenance of neuro-muscular performance capacity.
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Zainuddin, Z., Newton, M., Sacco, P. & Nosaka, K. (2005). Effects of massage on delayed-onset muscle soreness, swelling, and recovery of muscle function. J Athl Train, 40, 174-80.
METHOD: This study tested the hypothesis that massage applied after eccentric exercise would effectively alleviate delayed-onset muscle soreness (DOMS) without affecting muscle function. We used an arm-to-arm comparison model with 2 independent variables (control and massage) and 6 dependent variables (maximal isometric and isokinetic voluntary strength, range of motion, upper arm circumference, plasma creatine kinase activity, and muscle soreness). A 2-way repeated-measures analysis of variance and paired t-tests were used to examine differences in changes of the dependent variable over time between control and massage conditions. Ten healthy subjects with no history of upper arm injury and no experience in resistance training, performed 10 sets of 6 maximal isokinetic eccentric actions of the elbow flexors with each arm on a dynamometer, separated by 2 weeks. One arm received 10 minutes of massage 3 hours after eccentric exercise; the contralateral arm received no treatment. RESULTS: Delayed-onset muscle soreness was significantly less for the massage condition for peak soreness in extending the elbow joint and palpating the brachioradialis muscle. Soreness while flexing the elbow joint and palpating the brachialis muscle was also less with massage. Massage treatment had significant effects on plasma creatine kinase activity, with a significantly lower peak value at 4 days postexercise , and upper arm circumference, with a significantly smaller increase than the control at 3 and 4 days postexercise.
Facial Massage
Yamada, Y., Hatayama, T., Hirata, T., Maruyama, K., et al.(1986). A psychological effect of facial estherapy. Tohoku Psychologica Folia, 45, 6-16.
METHOD: Changes in emotion, level of arousal, and facial skin state were assessed in 24 female undergraduates by the use of 3 types of checklists. RESULTS: Two adjective checklists indicated that on items of both general deactivation and deactivation-sleep factors, many subjective rating scores were heightened after the facial esthetic massage and most subjects in the experimental group showed that the subjective state of their faces was much improved.
Headache
Foster, K.A., Liskin, J., Cen, S., Abbott, A., Armisen, V., Globe, D., Knox, L., Mitchell, M., Shtir, C., & Azen, S. (2004). The Trager approach in the treatment of chronic headache: a pilot study. Altern Ther Health Med., 10, 40-6.
METHOD: Thirty-three volunteers with a self-reported history of chronic headache and with at least one headache per week for at least 6 months received Trager massage. RESULTS: Participants randomized to Trager massage demonstrated a significant decrease in the frequency of headaches, improvement in head quality of life and a 44% decrease in medication usage.
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Hernandez-Reif, M., Field, T., Dieter, J., Swerdlow. & Diego, M., (1998). Migraine Headaches are Reduced by Massage Therapy. International Journal of Neuroscience, 96, 1-11.
METHOD: Twenty-six adults with migraine headaches were randomly assigned to a massage therapy group, which received twice-weekly 30-minute massages for five consecutive weeks or a wait-list control group. RESULTS: The massage group reported fewer distress symptoms, less pain, more headache free days, fewer sleep disturbances and taking fewer analgesics. They also showed increased serotonin levels.
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Quinn, C., Chandler, C., & Moraska, A. (2002). Massage therapy and frequency of chronic tension headaches. American Journal of Public Health, 92, 1657-1661.
METHOD: This study examined the effects of massage therapy on chronic, nonmigraine headache. Four chronic tension headache sufferers (aged 18-55 yrs) received structured massage therapy treatment directed toward the neck and shoulder muscles during a 4-wk period. RESULTS: Massage therapy reduced the number of weekly headaches. Headache frequency was significantly reduced within the initial week of massage treatment, and continued for the remainder of the study. A trend toward reduction in average duration of each headache event between the baseline period and the treatment period was also observed.
Job Stress
Katz, J., Wowk, A., Culp, D., & Wakeling, H. (1999). Pain and tension are reduced among hospital nurses after on-site massage treatments: a pilot study. Journal of Perianesthesia Nursing, 14, 128-133.
METHOD: The aims of this pilot study were (1) to evaluate the feasibility of carrying out a series of eight 15-minute workplace-based massage treatments, and (2) to determine whether massage therapy reduced pain and stress experienced by nursing staff at a large teaching hospital. Twelve hospital staff (10 registered nurses and 2 nonmedical ward staff) working in a large tertiary care center volunteered to participate. Participants received up to eight, workplace-based, 15-minute Swedish massage treatments provided by registered massage therapists. Pain, tension, relaxation, and the Profile of Mood States were measured before and after each massage session. RESULTS: Pain intensity and tension levels were significantly lower after massage. In addition, relaxation levels and overall mood state improved significantly after treatments.
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Cady, S. H., & Jones, G. E. (1997). Massage therapy as a workplace intervention for reduction of stress. Perceptual & Motor Skills, 84, 157-158.
METHOD: The effectiveness of a 15-min. on-site massage while seated in a chair was evaluated for reducing stress as indicated by blood pressure. 52 employed participants’ blood pressures were measured before and after a 15-min. massage at work. RESULTS: Analyses showed a significant reduction in participants’ systolic and diastolic blood pressure after receiving the massage.
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Field, T., Ironson, G., Scafidi, F., Nawrocki, T., Goncalves, A., Burman, I., Pickens, J., Fox, N., Schanberg, S., & Kuhn, C. (1996). Massage therapy reduces anxiety and enhances EEG pattern of alertness and math computations. International Journal of Neuroscience, 86, 197-205.
METHOD: Twenty-six adults were given a chair massage and 24 control group adults were asked to relax in the massage chair for 15 minutes, two times per week for five weeks. On the first and last days of the study they were monitored for EEG before, during and after the sessions. In addition, before and after the sessions they performed math computations, they completed POMS Depression and State Anxiety Scales and they provided a saliva sample for cortisol. At the beginning of the sessions they completed Life Events, Job Stress and Chronic POMS Depression Scales. RESULTS: Analyses revealed the following: 1) frontal delta power increased for both groups, suggesting relaxation; 2) the massage group showed decreased frontal alpha and beta power (suggesting enhanced alertness), while the control group showed increased alpha and beta power; 3) the massage group showed increased speed and accuracy on math computations while the control group did not change; 4) anxiety levels were lower following the massage but not the control sessions, although mood state was less depressed following both the massage and control sessions; 5) salivary cortisol levels were lower following the massage but not the control sessions but only on the first day; and 6) at the end of the 5 week period depression scores were lower for both groups but the job stress score was lower only for the massage group.
Field, T., Quintino, O., Henteleff, T., Wells-Keife, L., & Delvecchio-Feinberg, G. (1997). Job stress reduction therapies. Alternative Therapies in Health and Medicine, 3, 54-56.
METHOD: The immediate effects of brief massage therapy, music relaxation with visual imagery, muscle relaxation, and social support group sessions were assessed in 100 hospital employees at a major public hospital. RESULTS: Each of the groups reported decreases in anxiety, depression, fatigue, and confusion, as well as increased vigor following the sessions. That the groups did not differ on these variables suggests that these particular therapies, when applied for short periods of time, are equally effective for reducing stress among hospital employees.
Massage Therapists
Lee, A.C. & Kemper, K.J. (2000). Practice patterns of massage therapists. Journal of Alternative & Complementary Medicine, 6, 527-9.
METHODS: To describe the practice patterns of licensed massage therapists (LMTs). One hundred and twenty-six (126) massage practices were randomly selected from the Greater Boston Area yellow pages. RESULTS: Most respondents were Caucasian (95%) and female (80%). Their mean age was 41 years old. Half held a college degree; on average, practitioners received 1000 hours of training in massage therapy. The majority were in group practices (59%) and saw an average of 20 patients per week. The typical visit lasted 50-60 minutes; the cost was $60 and rarely covered by insurance (5%). Half of the respondents offered sliding scales to patients, but only 11% accepted Medicaid patients. Respondents reported less than 1 visit per week from pediatric and adolescent patients (<21 years old).
Nausea
Ming, J.L., Kuo, B.I., Lin, J.G., & Lin, L.C. (2002). The efficacy of acupressure to prevent nausea and vomiting in post-operative patients. J Adv Nurs., 39, 343-51.
METHOD: The aim of this study was to examine the effect of stimulating two acupressure points on prevention of post-operative nausea and vomiting. The Rhodes Index of Nausea, Vomiting and Retching questionnaire was used as a tool to measure incidence. To control the motion sickness variable, the subjects who underwent functional endoscopic sinus surgery under general anaesthesia were randomly assigned to a finger-pressing group, a wrist-band group, and a control group. The acupoints and treatment times were similar in the finger-pressing group and wrist-band pressing group, whereas only conversation was employed in the control group. RESULTS: Significant differences in the incidence of the post-operative nausea and vomiting were found between the acupressure, wrist-band, and control groups, with a reduction in the incidence rate of nausea from 73% to 43% and vomiting incidence rate from 90% to 43% in the acupressure group..
Pain
Hasson, D., Arnetz, B., Jelveus, L., & Edelstam, B. (2004). A randomized clinical trial of the treatment effects of massage compared to relaxation tape recordings on diffuse long-term pain. Psychother Psychosom., 73, 17-24.
METHOD: The purpose of this randomized clinical trial was to assess possible effects of massage as compared to listening to relaxation tapes on musculoskeletal pain. 129 patients suffering from long-term musculoskeletal pain were randomized to either a massage or relaxation group, and assessed before, during and after treatment. RESULTS: During treatment there was a significant improvement in self-rated health, mental energy, and muscle pain only in the massage group as compared to the relaxation group.
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Kubsch, S.M., Neveau, T., & Vandertie, K. (2000). Effect of cutaneous stimulation on pain reduction in emergency department patients. Complementary Therapies in Nursing & Midwifery, 6, 25-32.
METHODS: Tactile stimulation was used with 50 emergency department patients to relieve pain. Another objective was to determine the effect of tactile stimulation on blood pressure and heart rate. RESULTS: Following stimulation, subjects reported significantly reduced pain, and demonstrated reduced heart rate, and blood pressure readings.
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Lundeberg, T. (1984). Long-term results of vibratory stimulation as a pain relieving measure for chronic pain. Pain, 20, 13-23.
METHOD: 267 patients with chronic neurogenic or musculoskeletal pain were given vibratory stimulation for their pain. The patients were observed for 18 months or until they terminated the treatment. RESULTS: About half of the successfully relieved patients (59% of the total number of patients) reported more than 50% pain relief, as scored on a visual analogue and an adjective scale. Seventy-two percent of these patients reported increased social activity and greater than 50% reported reduced intake of analgesic drugs after 12 months of home treatment.
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Lundeberg, T., Abrahamsson, P., Bondesson, L., & Haker. E. (1987). Effect of vibratory stimulation on experimental and clinical pain. Scandinavian Journal of Rehabilitation Medicine, 20, 149-159.
METHOD: The effect of vibratory stimulation on experimental pain of the skin overlying the right and left extensor carpi radialis longus muscle induced by electrical stimulation was studied in 16 healthy subjects and in 18 patients suffering from chronic epicondyalgia of the right elbow. RESULTS: In the healthy subjects there were no side differences whereas in the patients, the skin pain threshold over the painful right muscle was lower than that of the left unaffected side under resting conditions. After vibratory stimulation, the skin pain threshold increased bilaterally by 1.1-1.6 times the pre-stimulation threshold in the healthy subjects and by 1.2-2.3 times this threshold in the patients. In 8 of the healthy subjects there was an increase in peripheral blood flow during stimulation and in 8 there was a small decrease. In 13 patients the change in pain threshold was seen in phase with the local increase and decrease in peripheral blood flow. In all individuals, the pain thresholds were regained within 45 minutes of cessation of stimulation. This was in contrast to the general subjective pain in the patients; 12 patients reported that the relief of pain lasted for a period of 1-7 hours.
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Lundeberg, T., Abrahamsson, P., & Haker, E. (1987). Vibratory stimulation compared to placebo in alleviation of pain. Scandinavian Journal of Rehabilitation Medicine, 19, 153-158.
METHOD: The placebo effect of vibratory stimulation was studied in 72 patients with chronic pain syndromes in a double-blind crossover trial using a vibrator and a “placebo unit”. RESULTS: Pain alleviation was reported by 48% of the patients during vibratory stimulation compared with 34% for placebo treatment.
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Nixon, M., Teschendorff, J., Finney, J., & Karnilowicz, W. (1997). Expanding the nursing repertoire: The effect of massage on post-operative pain. Australian Journal of Advanced Nursing, 14, 21-26.
METHOD: A treatment group of 19 patients and a control group of 20 patients were compared on the impact of massage therapy on patients’ perceptions of post-operative pain. RESULTS: Controlling for age, the results indicated that massage produced a significant reduction in patients’ perceptions of pain over a 24 hour period.
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Piotrowski, M.M., Paterson, C., Mitchinson, A., Kim, H.M., Kirsh, M., Hinshaw, D.B. (2003). Massage as adjuvant therapy in the management of acute postoperative pain: a preliminary study in men. J Am Coll Surg., 197, 1037-46.
METHOD: This prospective randomized clinical trial compared pain relief after major operations in 202 patients who received one of three nursing interventions: massage, focused attention, or routine care. Interventions were performed twice daily starting 24 hours after the operation through postoperative day 7. Perceived pain was measured each morning. RESULTS: The rate of decline in the unpleasantness of postoperative pain was accelerated by massage. Use of opioid analgesics was not altered significantly by the interventions.
van den Dolder, P.A., & Roberts, D.L. (2003). A trial into the effectiveness of soft tissue massage in the treatment of shoulder pain. Aust J Physiother., 49, 183-8.
METHOD: The purpose of this single blinded randomized controlled trial was to investigate the effects of soft tissue massage on range of motion, reported pain and reported function in patients with shoulder pain. Twenty-nine patients referred to physiotherapy for shoulder pain were randomly assigned to a treatment group that received six treatments of soft tissue massage around the shoulder (n = 15) or to a control group that received no treatment while on the waiting list for two weeks (n = 14). Measurements were taken both before and after the experimental period by a blinded assessor. Active range of motion was measured for flexion, abduction and hand-behind-back movements. Pain was assessed with the Short Form McGill Pain Questionnaire (SFMPQ) and functional ability was assessed with the Patient Specific Functional Disability Measure (PSFDM). RESULTS: The treatment group showed significant improvements in range of motion compared with the control group for abduction, flexion and hand-behind-back. Massage reduced pain as reported on the descriptive section of the SFMPQ by a mean of 5 points and on the visual analogue scale by an average of 27 mm, and it improved reported function on the PSFDM by a mean of 9 points.
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Walach, H., Guthlin, C., & Konig, M. (2003). Efficacy of massage therapy in chronic pain: a pragmatic randomized trial. J Altern Complement Med., 9, 837-46.
METHOD: Classic massage was compared to standard medical care (SMC) in chronic pain conditions of back, neck, shoulders, head and limbs. Pain was rated at pretreatment, post-treatment, and 3 month follow-up, as well as pain adjective list, depression, anxiety, mood, and body concept. RESULTS: 29 patients were randomized, 19 to receive massage, 10 to SMC. Pain improved significantly in both groups, but only in the massage group was it still significantly improved at follow-up. Depression and anxiety were improved significantly by both treatments, yet only the massage group maintained at follow-up.
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Wang, H.L., & Keck, J.F. (2004). Foot and hand massage as an intervention for postoperative pain. Pain Manag Nurs., 5, 59-65.
METHOD: The purpose of this pretest-posttest design study was to investigate whether a 20-minute foot and hand massage (5 minutes to each extremity), which was provided 1 to 4 hours after a dose of pain medication, would reduce pain perception and sympathetic responses among postoperative patients. RESULTS: Participants reported decreases in pain intensity. Decreases in sympathetic responses to pain (i.e., heart rate and respiratory rate) were observed although blood pressure remained unchanged. The patients experienced moderate pain after they received pain medications.
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