From the Guidelines
Regular massages can be a medically necessary component of treatment for certain musculoskeletal issues, as they have been shown to improve pain outcomes when used in conjunction with standard treatment. This is supported by the most recent and highest quality study, which recommends massage as part of a comprehensive treatment plan for conditions like chronic back pain, fibromyalgia, sports injuries, and muscle tension headaches 1.
Key Points to Consider
- Massage therapy can be used to improve pain outcomes in patients undergoing musculoskeletal extremity/pelvis surgery, with a moderate strength of recommendation 1.
- The specific massage technique depends on the condition being treated, such as deep tissue massage for chronic muscle tension, myofascial release for fascial restrictions, or trigger point therapy for specific pain points.
- Massages work by increasing blood circulation to injured tissues, reducing muscle tension, breaking up scar tissue, and releasing endorphins that naturally reduce pain.
- For best results, massage therapy should be combined with other treatments like physical therapy, appropriate exercise, and sometimes medication.
- Patients should ensure their massage therapist is licensed and informed about their specific condition to provide appropriate treatment.
Treatment Plan
A typical therapeutic massage regimen might involve 30-60 minute sessions once or twice weekly for 4-6 weeks, followed by maintenance sessions as needed. However, the exact treatment plan should be tailored to the individual patient's needs and preferences, taking into account the severity of their condition and their response to treatment. As noted in earlier studies, massage has been shown to be moderately effective in improving short-term pain and function compared to other interventions, such as manipulation, exercise therapy, relaxation therapy, acupuncture, or physiotherapy 1.
Conclusion Not Applicable - Further Discussion
It is essential to note that while massage therapy can be beneficial, it should not be used as a replacement for other evidence-based treatments. Instead, it should be used in conjunction with other therapies to provide comprehensive care. As recommended by the American College of Physicians, patients with musculoskeletal pain should be treated with a multimodal approach, including nonpharmacologic therapies like massage, as well as pharmacologic treatments and lifestyle modifications 1.
From the Research
Musculoskeletal System Issues and Massage Therapy
- Massage therapy has been studied as a potential treatment for musculoskeletal system issues, with some evidence suggesting its effectiveness in reducing pain and improving function 2, 3, 4.
- A systematic review of 17 studies found that massage therapy as a self-management strategy can be beneficial for symptom management of musculoskeletal pain and chronic conditions, with significant improvement in outcome measures such as chronic neck and back pain, stress or anxiety, fatigue, quality of sleep, and health-related quality of life 2.
- Another study found that massage therapy yields a small improvement in low back pain, hip and knee osteoarthritis, and fibromyalgia, and can be used as part of a multimodal treatment approach for chronic musculoskeletal pain 3.
Effectiveness of Massage Therapy for Specific Conditions
- Low-to-moderate-level evidence suggests that massage reduces pain in the short term compared to no treatment in people with shoulder pain and osteoarthritis of the knee, but not in those with low back pain or neck pain 4.
- Massage therapy has also been found to improve function in the short term compared to no treatment in people with low back pain, knee arthritis or shoulder pain 4.
- An evidence map of 49 systematic reviews found that high-quality reviews concluded that there was low strength of evidence of potential benefits of massage for various types of pain, including cancer pain, low back pain, and neck pain 5.
Mechanisms of Massage Therapy
- Massage can produce mechanical pressure, which is expected to increase muscle compliance resulting in increased range of joint motion, decreased passive stiffness and decreased active stiffness (biomechanical mechanisms) 6.
- Mechanical pressure might help to increase blood flow by increasing the arteriolar pressure, as well as increasing muscle temperature from rubbing, and can also affect neural excitability and hormonal levels (neurological and physiological mechanisms) 6.
- Changes in parasympathetic activity and hormonal levels following massage can result in a relaxation response, which can help to reduce anxiety and improve mood state (psychological mechanisms) 6.