Medical Evidence for Bowen Massage
There is insufficient medical evidence to support the effectiveness of Bowen massage for improving morbidity, mortality, or quality of life outcomes. According to high-quality guidelines, massage therapy in general is conditionally recommended against for various conditions, and specific evidence for Bowen massage is limited to small, low-quality studies.
Evidence from Clinical Guidelines
Recommendations Against Massage Therapy
The 2020 American College of Rheumatology/Arthritis Foundation guidelines conditionally recommend against massage therapy for patients with knee and/or hip osteoarthritis 1. These guidelines specifically note that:
- Studies addressing massage have suffered from high risk of bias
- Included small numbers of patients
- Have not demonstrated benefit for osteoarthritis-specific outcomes 1
Similarly, manual therapy with exercise is conditionally recommended against over exercise alone in patients with knee and/or hip OA 1.
Limited Evidence for Other Massage Types
While some guidelines acknowledge potential benefits of massage in specific contexts, such as for cancer patients, these benefits are typically described as short-term and limited to:
- Pain reduction
- Relaxation promotion
- Mood improvement 1
However, even in these contexts, the evidence is not strong enough for broad recommendations.
Specific Evidence for Bowen Massage
Limited Research Base
The available research on Bowen massage specifically is extremely limited:
- A 2011 systematic review found only 15 articles meeting inclusion criteria (only 1 randomized clinical trial) 2
- Most evidence consists of case studies and small, methodologically weak trials
- Over half of the studies (53%) reported pain reduction, but the quality of evidence was poor 2
Recent Research
A 2020 double-blind, randomized controlled trial on Bowen Therapy for chronic pain found:
- Short-term reduction in pain compared to sham therapy (1 week post-intervention)
- No differences between groups at final follow-up (6 weeks)
- No improvement in function measures
- Uncertain mechanisms of action 3
This suggests any benefits may be temporary and limited to pain reduction only, with no long-term improvements in function or quality of life.
Case Reports and Small Studies
Several small studies and case reports have reported positive outcomes:
- A case report of a migraineur showed cessation of migraine and neck pain after Bowen therapy 4
- A small qualitative study of 20 participants with frozen shoulder reported subjective improvements 5
However, these studies have significant limitations:
- Small sample sizes
- Lack of control groups
- Potential for placebo effect
- Self-reported outcomes
- Publication bias
Potential Mechanisms and Risks
The mechanisms behind Bowen massage remain uncertain, though one study suggested possible sympathoexcitation 3.
Risks appear minimal, similar to other massage therapies, but may include:
- Increased pain intensity (reported in 1.5% to 25% of participants in massage studies) 6
- Potential bruising for individuals on anticoagulation therapy 1
- Caution needed for those with certain medical conditions or implanted devices 1
Conclusion for Clinical Practice
When considering the totality of evidence:
- High-quality guidelines conditionally recommend against massage therapy for conditions like osteoarthritis
- Specific evidence for Bowen massage is limited to small studies with significant methodological limitations
- Any benefits appear to be short-term and primarily related to pain reduction rather than functional improvement
- Other evidence-based approaches should be prioritized for most conditions
For patients seeking non-pharmacological pain management options, clinicians should consider treatments with stronger evidence bases before recommending Bowen massage.