From the Guidelines
Massage therapy may work through mechanisms such as increased blood flow, but there is no evidence to support increased opioid release or increasing muscle tone as underlying effects. According to the study 1, massage therapy offers a promising area for future research with multiple studies demonstrating a benefit in pain alleviation. However, these studies demonstrate no benefit in terms of opioid reduction. Some of the key points to consider when evaluating the effects of massage therapy include:
- Increased blood flow may be a mechanism by which massage therapy exerts its effects, promoting better oxygen and nutrient delivery while removing metabolic waste products.
- There is no evidence to support the idea that massage therapy increases opioid release, as studies have shown no benefit in terms of opioid reduction.
- Increasing muscle tone is not mentioned as a mechanism of massage effects, and in fact, massage often helps reduce muscle tension rather than increase tone. The overall safety profile of massage therapy appears favorable, although this may be offset by increased costs and training requirements in the hospital setting 1.
From the Research
Mechanisms Underlying the Effects of Massage
- Increased blood flow: There is no direct evidence in the provided studies to support the claim that massage increases blood flow as a mechanism underlying its effects 2, 3, 4, 5, 6.
- Increased opioid release: The study by 2 investigated the effect of massage on pain in opioid-dependent patients, but it did not find a significant overall effect of massage on pain reduction or opioid release.
- Increasing muscle tone: None of the provided studies directly address the mechanism of increasing muscle tone as a result of massage 2, 3, 4, 5, 6.
- All of the above: Since there is limited direct evidence to support any of these mechanisms, it is not possible to conclude that all of the above are correct based on the provided studies.
Nonpharmacological Interventions for Pain Management
- Massage therapy is mentioned as a nonpharmacological intervention for pain management in several studies 3, 4, 5, 6.
- The study by 4 identified massage as one of the nonpharmacological interventions for acute pain management in patients with opioid tolerance or opioid abuse.
- The study by 6 reviewed the evidence base for nonpharmacologic therapies, including massage therapy, effective in postsurgical pain with opioid sparing, acute non-surgical pain, cancer pain, and chronic pain.