Medical Massage Researches

Effectiveness of soft tissue massage in the Treatment of Shoulder Pain.

Australian Journal Physiotherapy. 2003;49(4):275 (Van den Dolder PA, Roberts DL)

The purpose of this single blinded randomised 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 or to a control group that received no treatment while on the waiting list for two weeks. 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). The treatment group showed significant improvements in range of motion compared with the control group for abduction (mean 42.2 degrees, 95% CI 24.1 to 60.4 degrees), flexion (mean 22.6 degrees, 95% CI 12.4 to 32.8 degrees) and hand-behind-back (mean 11.0 cm improvement, 95% CI 6.3 to 15.6 cm). Massage reduced pain as reported on the descriptive section of the SFMPQ by a mean of 4.9 points (95% CI 2.5 to 7.2 points) and on the visual analogue scale by an average of 26.5 mm (95% CI 5.3 to 47.6 mm), and it improved reported function on the PSFDM by a mean of 8.6 points (95% CI 4.9 to 12.3 points). We conclude that soft tissue massage around the shoulder is effective in improving range of motion, pain and function in patients with shoulder pain.

A review of the evidence for the effectiveness, safety, and cost of acupuncture, massage therapy, and spinal manipulation for back pain.

Annals Internal Medicine. 2003 Jun 3;138(11):898-906. (Cherkin DC, Sherman KJ, Deyo RA, Shekelle PG)

BACKGROUND: Few treatments for back pain are supported by strong scientific evidence. Conventional treatments, although widely used, have had limited success. Dissatisfied patients have, therefore, turned to complementary and alternative medical therapies and providers for care for back pain. PURPOSE: To provide a rigorous and balanced summary of the best available evidence about the effectiveness, safety, and costs of the most popular complementary and alternative medical therapies used to treat back pain. DATA SOURCES: MEDLINE, EMBASE, and the Cochrane Controlled Trials Register. STUDY SELECTION: Systematic reviews of randomized, controlled trials (RCTs) that were published since 1995 and that evaluated acupuncture, massage therapy, or spinal manipulation for nonspecific back pain and RCTs published since the reviews were conducted. DATA EXTRACTION: Two authors independently extracted data from the reviews (including number of RCTs, type of back pain, quality assessment, and conclusions) and original articles (including type of pain, comparison treatments, sample size, outcomes, follow-up intervals, loss to follow-up, and authors’ conclusions). DATA SYNTHESIS: Because the quality of the 20 RCTs that evaluated acupuncture was generally poor, the effectiveness of acupuncture for treating acute or chronic back pain is unclear. The three RCTs that evaluated massage reported that this therapy is effective for subacute and chronic back pain. A meta-regression analysis of the results of 26 RCTs evaluating spinal manipulation for acute and chronic back pain reported that spinal manipulation was superior to sham therapies and therapies judged to have no evidence of a benefit but was not superior to effective conventional treatments. CONCLUSIONS: Initial studies have found massage to be effective for persistent back pain. Spinal manipulation has small clinical benefits that are equivalent to those of other commonly used therapies. The effectiveness of acupuncture remains unclear. All of these treatments seem to be relatively safe. Preliminary evidence suggests that massage, but not acupuncture or spinal manipulation, may reduce the costs of care after an initial course of therapy.

Massage therapy for osteoarthritis of the knee: a randomized controlled trial.

Journal Orthopedic Sports Physical Therapy. 1984;6(3):168-72. (Perlman AI, Sabina A, Williams AL, Njike VY, Katz DL.)

BACKGROUND: Massage therapy is an attractive treatment option for osteoarthritis (OA), but its efficacy is uncertain. We conducted a randomized, controlled trial of massage therapy for OA of the knee. METHODS: Sixty-eight adults with radiographically confirmed OA of the knee were assigned either to treatment (twice-weekly sessions of standard Swedish massage in weeks 1-4 and once-weekly sessions in weeks 5-8) or to control (delayed intervention). Primary outcomes were changes in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and functional scores and the visual analog scale of pain assessment. The sample provided 80% statistical power to detect a 20-point difference between groups in the change from baseline on the WOMAC and visual analog scale, with a 2-tailed alpha of .05. RESULTS: The group receiving massage therapy demonstrated significant improvements in the mean (SD) WOMAC global scores (-17.44 [23.61] mm; P < .001), pain (-18.36 [23.28]; P < .001), stiffness (-16.63 [28.82] mm; P < .001), and physical function domains (-17.27 [24.36] mm; P < .001) and in the visual analog scale of pain assessment (-19.38 [28.16] mm; P < .001), range of motion in degrees (3.57 [13.61]; P = .03), and time to walk 50 ft (15 m) in seconds (-1.77 [2.73]; P < .01). Findings were unchanged in multivariable models controlling for demographic factors. CONCLUSIONS: Massage therapy seems to be efficacious in the treatment of OA of the knee. Further study of cost effectiveness and duration of treatment effect is clearly warranted.

Evaluating mindfulness-based stress reduction and massage for the management of chronic pain.

Complementary Therapy Medicine. 2007 Sep;15(3):157-63. Epub 2007 Feb 20. (Plews-Ogan M, Owens JE, Goodman M, Wolfe P, Schorling J.)

BACKGROUND: Mindfulness-based stress reduction (MBSR) and massage may be useful adjunctive therapies for chronic musculoskeletal pain. OBJECTIVE: To evaluate the feasibility of studying MBSR and massage for the management of chronic pain and estimate their effects on pain and mood. DESIGN: Randomized trial comparing MBSR or massage with standard care. PARTICIPANTS: Thirty patients with chronic musculoskeletal pain. MEASUREMENTS: Pain was assessed with 0 to 10 numeric rating scales. Physical and mental health status was measured with the SF-12. RESULTS: The study completion rate was 76.7%. At week 8, the massage group had average difference scores for pain unpleasantness of 2.9 and mental health status of 13.6 compared with 0.13 (P<.05) and 3.9 (P<.04), respectively, for the standard care group. These differences were no longer significant at week 12. There were no significant differences in the pain outcomes for the MBSR group. At week 12, the mean change in mental health status for the MBSR group was 10.2 compared with -1.7 in the standard care group (P<.04). CONCLUSIONS: It is feasible to study MBSR and massage in patients with chronic musculoskeletal pain. Mindfulness-based stress reduction may be more effective and longer-lasting for mood improvement while massage may be more effective for reducing pain.

The effects of massage in patients with chronic tension headache.

American Journal Public Health. 2002 Oct;92(10):1657-61.(Puustjärvi K, Airaksinen O, Pöntinen PJ)

21 female patients suffering from chronic tension headache received 10 sessions of upper body massage consisting of deep tissue techniques in addition to softer techniques in the beginning. When found, trigger points were carefully and forcefully massaged. The range of cervical movements, surface ENMG on mm. frontalis and trapezius, visual analogue scale (VAS) and Finnish Pain Questionnaire (FPQ), and the incidence of neck pain during a two week period before and after the treatment, and at 3 and 6 months during the follow-up period together with Beck depression inventory were taken for evaluation and follow-up. The range of movement in all directions increased, and FPQ, VAS and the number of days with neck pain decreased significantly. There was a significant change in ENMG on the frontalis muscle whereas changes in trapezius remained insignificant. Beck inventory showed an improvement after the treatment. This study confirmed clinical and physiological effects of massage.

A randomized, controlled trial of massage therapy as a treatment for migraine.

BACKGROUND: Migraine is a distressing disorder that is often triggered by stress and poor sleep. Only one randomized controlled trial (RCT) has assessed the effects of massage therapy on migraine experiences, which yielded some promising findings. PURPOSE: An RCT was designed to replicate and extend the earlier findings using a larger sample, additional stress-related indicators, and assessments past the final session to identify longer-term effects of massage therapy on stress and migraine experiences. METHODS: Migraine sufferers (N = 47) who were randomly assigned to massage or control conditions completed daily assessments of migraine experiences and sleep patterns for 13 weeks. Massage participants attended weekly massage sessions during Weeks 5 to 10. State anxiety, heart rates, and salivary cortisol were assessed before and after the sessions. Perceived stress and coping efficacy were assessed at Weeks 4, 10, and 13. RESULTS: Compared to control participants, massage participants exhibited greater improvements in migraine frequency and sleep quality during the intervention weeks and the 3 follow-up weeks. Trends for beneficial effects of massage therapy on perceived stress and coping efficacy were observed. During sessions, massage induced decreases in state anxiety, heart rate, and cortisol. CONCLUSIONS: The findings provide preliminary support for the utility of massage therapy as a nonpharmacologic treatment for individuals suffering from migraines.