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What is massage?
Massage is a "hands-on" therapy in which muscles
and other soft tissues of the body are manipulated to improve
health and well-being. Varieties of massage range from gentle
stroking and kneading of muscles and other soft tissues to
deeper manual techniques. Massage has been practiced as a
healing therapy for centuries in nearly every culture around the
world. It helps relieve muscle tension, reduce stress, and evoke
feelings of calmness. Although massage affects the body as a
whole, it particularly influences the activity of the
musculoskeletal, circulatory, lymphatic, and nervous systems.
What is the history of Massage?
The use of massage for healing purposes dates back 4,000
years in Chinese medical literature and continues to be an
important aspect of Traditional Chinese Medicine (TCM) today. A
contemporary form of massage known as Swedish massage was
introduced to the United States in the 1850s. By the end of the
19th century, a significant number of American
doctors were practicing this manual technique and the nation's
first massage therapy clinics opened its doors to the public.
In the early 20th century, the rise of technology
and prescription drugs began to overshadow massage therapy. For
the next several decades, massage remained dormant and only a
few therapists continued to practice the "ancient"
technique. During the 1970s, however, both the general public as
well as the medical profession began to take notice of
alternative medicine and mind-body therapies, which thrust
massage therapy back into the limelight. Today, there are more
than 125,000 massage therapists practicing in the United States
and their numbers are growing rapidly to keep up with the more
than 80 million massage therapy appointments made every year.
Are there many types of massage?
There are nearly 100 different massage and body work
techniques. Each technique is uniquely designed to achieve a
specific goal. The most common types practiced in the United
States include:
 | Aromatherapy massage: Essential oils from plants
are massaged into the skin in order to enhance the healing
and relaxing effects of massage. Essential oils are believed
to have a powerful effect on mood by stimulating two
structures deep in the brain known to store emotions and
memory. (See the Aromatherapy monograph for more details)
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| Craniosacral massage: Gentle pressure is applied to
the head and spine to correct imbalances and restore the
flow of cerebrospinal fluid in these areas.
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| Lymphatic massage: Light, rhythmic strokes are used
to improve the flow of lymph (colorless fluid that helps
fight infection and disease) throughout the body. One of the
most popular forms of lymphatic massage, Manual Lymphatic
Drainage (MLD), focuses on draining excess lymph. MLD is
commonly used after surgery (such as a mastectomy for breast
cancer) to reduce swelling.
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| Myofascial release: Gentle pressure and body
positioning are used to relax and stretch the muscles,
fascia (connective tissue), and related structures. Both
physical therapists and massage therapists who are
appropriately trained use this technique.
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| On-site/chair massage: Popular in offices and other
public places, on-site massage therapists use a portable
chair to deliver brief, upper body massages to fully-clothed
people.
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| Polarity therapy: A form of energy healing,
polarity therapists stimulate and balance the flow of energy
within the body to enhance health and well-being.
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| Reflexology: Specialized thumb and finger
techniques are applied to the hands and/or feet.
Reflexologists believe that these areas contain "reflex
points" or direct connections to specific organs and
structures throughout the body.
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| Rolfing: Pressure is applied to the fascia
(connective tissue) to stretch it, lengthen it, and make it
more flexible. This goal of this technique is to realign the
body so that it conserves energy, releases tension, and
functions better.
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| Shiatsu: Gentle finger and hand pressure are
applied to specific points on the body to relieve pain and
enhance the flow of energy (known as qi) through the
body's energy pathways (called meridians). Shiatsu is widely
used in Traditional Chinese Medicine (TCM).
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| Sports massage: Often used on professional athletes
and other active individuals, sports massage can enhance
performance and prevent and treat sports-related injuries.
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| Swedish massage: A variety of strokes and pressure
techniques are used to enhance the flow of blood to the
heart, remove waste products from the tissues, stretch
ligaments and tendons, and ease physical and emotional
tension.
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| Trigger point massage: Pressure is applied to
"trigger points" (tender areas where the muscles
have been damaged) to alleviate muscle spasms and pain. |
How does massage work?
When a practitioner massages soft tissue, electrical signals
are transmitted both to the local area and throughout the body.
These signals help heal damaged muscle, stimulate circulation,
clear waste products via the lymphatic system, boost the
activity of the immune system, reduce pain and tension, and
induce a calming effect. They may also enhance a general sense
of well-being by stimulating the release of endorphins (natural
pain-killers and mood elevators) and reducing levels of certain
stress hormones.
What happens during a massage therapy session?
At your first massage therapy session, the practitioner will
ask you about any symptoms you may have (like low back pain) and
will also ask questions about your medical history. The
practitioner may also initiate a discussion about what you
expect to achieve from the massage session.
The therapist leaves the room while you undress and lay down
on the massage table. A sheet is used as a drape during the
session and is moved only to expose the part of the body being
worked on at any given time. Massage oil or lotion is often used
to reduce friction between the practitioner's hands and your
skin. The room is kept warm and free of distractions. The
therapist may have soft music playing in the background and
frequently asks whether he or she is applying too much or too
little pressure.
The manner in which a practitioner massages your body depends
on the problem being treated. A massage session can last from 15
to 90 minutes and may include a schedule of follow-up visits,
depending on the severity of your situation.
What is massage good for?
In general, massage is believed to support healing, boost
energy, reduce recovery time after an injury, ease pain, and
enhance relaxation, mood, and well-being. In addition to being
of value for many musculoskeletal problems such as low back
pain, osteoarthritis, fibromyalgia, and sprains and strains,
massage may relieve depression in people with chronic fatigue
syndrome, ease chronic constipation (when the technique is
performed in the abdominal area), decrease swelling after a
mastectomy (removal of the breast), alleviate sleep disorders,
and improve self-image. In the workplace, massage has been shown
to melt away stress and enhance mental alertness.
Studies have found that massage relieves chronic back pain
more effectively than other treatments (including acupuncture
and conventional medical care for this condition with education
via books and videos) and, in many cases, costs less than other
treatments for this common health problem. In addition, mothers
and newborns also appear to benefit from massage. Mothers
trained to massage their infants often feel less depressed and
have a better emotional bond with their babies. Newborns who
receive massage from their mothers also tend to cry less, and
are more active, alert, and sociable. Premature babies who
receive massage therapy have been shown to gain weight faster
than preemies who do not receive this type of therapy. Infants
who receive massage regularly may also sleep better, be less
gassy or colicky, and have better body awareness as well as more
regular digestion.
Studies have also shown that massage may be an effective
treatment for young children and adolescents with a wide range
of health problems including the following:
| Autism: Autistic children, who usually don't like
being touched, show less autistic behavior and are more
social and attentive after receiving massage therapy from
their parents.
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| Atopic dermatitis/Eczema: Children with this scaly,
itchy skin problem seem to experience less redness, scaling,
and other symptoms if receiving massage between flares.
Massage should not be used when this skin condition is
actively inflamed.
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| Attention deficit hyperactivity disorder (ADHD): Massage may
improve mood in children with ADHD and help them feel less
fidgety and hyperactive.
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| Bulimia: Studies have shown that adolescents with
this eating disorder feel less depressed and anxious after
receiving massage therapy.
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| Cystic fibrosis: Massage may reduce anxiety and
improve respiration in children with this lung condition.
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| Diabetes: Massage may help regulate blood sugar
levels and reduce anxiety and depression in children with
diabetes.
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| HIV: In a small study, teenagers with the human
immunodeficiency virus (HIV) showed improved immune function
and diminished feelings of depression and anxiety after
receiving two massages per week for 12 weeks.
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| Rheumatoid arthritis: Children with juvenile
rheumatoid arthritis (JRA) have been shown to experience
less pain, morning stiffness, and anxiety as a result of
massage therapy. |
Are there any risks associated with massage?
In general, massage is considered relatively safe. Pain or
other rare negative side effects are generally caused by an
extremely vigorous massage technique.
Women should be very cautious about receiving massages during
pregnancy. If you are pregnant, be sure to find a therapist
specifically trained to perform massages on pregnant women.
Even though massage is a useful technique to help regulate
blood sugar over time, if you have diabetes you should check
your blood sugar after a massage session because it may be too
low just following a treatment. Plus, if you have diabetes and
you are receiving massage on a regular basis, you should check
your blood sugar frequently to evaluate for any changes over
time.
Should anyone avoid massage?
Massage should be avoided by people with congestive heart
failure, kidney failure, infection of the superficial veins
(called phlebitis) or soft tissue (called cellulitis) in the
legs or elsewhere, blood clots in the legs, bleeding disorders,
and contagious skin conditions. If you have cancer, you must
check with your doctor before considering massage because you
should not receive such treatments under certain circumstances.
For example, sometimes massage can damage tissue that is fragile
from chemotherapy or radiation treatments. People with
rheumatoid arthritis, goiter (a thyroid disorder characterized
by an enlarged thyroid), eczema and other skin lesions should
not receive massage therapy during flare-ups. Experts also
advise that people with osteoporosis, high fever, few platelets
or white blood cells, and mental impairment, as well as those
recovering from surgery, may be better off avoiding massage.
Also, be sure to let your massage therapist know any medications
you are taking as the treatment may influence absorption or
activity of both oral and topical medications.
What is the future of massage?
More research is needed to determine how effective massage
therapy is, which health problems improve the most from this
technique, and whether it is more cost-effective than other
types of treatment. Although massage is usually offered in the
community by private practitioners, it is slowly being
integrated into a variety of healthcare settings, such as
hospice care facilities and hospitals.
How can I find a practitioner?
Certified massage therapists complete a training program of
500 or more hours, take national board exams, and are licensed
or registered in 29 states. To find a massage therapist in
your area, contact the American Massage Therapy Association
(AMTA), 820 Davis Street, Suite 100, Evanston, IL 60201;
847-864-0123; www.amtamassage.org.
Although the AMTA has a listing of massage therapists who
specialize in a variety of techniques, you may also use
different resources to locate practitioners who specialize in
the following techniques:
| Lymphatic massage: Massage therapists and physical
therapists with at least 500 hours of massage- or
physical-therapy training can become certified in lymphatic
massage by taking a 4-week training program. To find a
therapist who practices lymphatic massage, contact North
American Vodder Association of Lymphedema Therapists
(NAVALT), P.O. Box 861, Chesterfield, OH 44026;
419-729-3258.
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| Reflexology: The American Reflexology Certification
Board (ARCB) certifies reflexologists who undergo 100 hours
of training and pass an exam. To find a qualified
reflexologist, contact the ARCB, P.O. Box 620607, Littleton,
CO 80162; 303-933-6921.
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| Rolfing: Contact the Rolf Institute of Structural
Integration, P.O. Box 1868, Boulder, CO 80302-1868;
800-530-8875 or 303-449-5903; or www.rolf.org.
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| Shiatsu: Contact the American Oriental Bodywork
Therapy Association at 609-782-1616. |
Supporting Research
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The effects of shiatsu on lower back pain. J Holist Nurs. 2001;19(1):57-70.
Cherkin DC, Eisenberg D, Sherman KJ, et al. Randomized
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Field T, Ironson G, Scafidi F, et al. Massage therapy reduces
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Field T, Hernandez-Reif M, LaGreca A, Shaw K, Schanberg S,
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Field T, Hernandez-Reif M, Seligman S, et al. Juvenile
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| Review Date: December
2002 |
Reviewed By: Jacqueline
A. Hart, MD, Department of Internal Medicine, Newton-Wellesley
Hospital, Boston, Ma and Senior Medical Editor A.D.A.M., Inc.;
Elizabeth Wotton, ND, private practice, Sausalito, CA.
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