Massage Therapy

Health Care Professional Information

Clinical Summary

Massage is an ancient technique that involves manual manipulation of muscles and soft tissues of the body. It increases circulation and promotes relaxation. In addition, it has important emotional and psychological benefits as well. The various forms of massage that are commonly practiced are Swedish massage, Shiatsu, Reflexology, and Tuina. Swedish massage is the most common and consists of five basic strokes and their variations. Reflexology involves massaging specific areas (reflex points) on the hands or feet that are believed to correspond to particular regions in the body. Shiatsu and Tuina are techniques that originated in Japan and China, and involve stimulation of acupuncture points and meridians to ensure proper flow of energy and blood to facilitate healing.

Clinical studies show that massage can alleviate symptoms such as stress/anxiety, nausea, insomnia, pain, fatigue, and depression (1) (3) (7) (8) (9) (12) in cancer patients, and reduce psychological and neurological complications associated with bone marrow transplantation (2). Reflexology (foot massage) was found to alleviate pain and nausea (4), and to reduce anxiety in cancer patients (14) (15) (16). It also reduced symptoms of dyspnea and fatigue in advanced-stage breast cancer patients (13). Preliminary data indicate that post-operative arm massage can decrease pain and discomfort after lymph node dissection (5). Manual lymphatic drainage or MLD, which involves specialized light rhythmic massage, reduced lymphedema (6) and prevented secondary lymphedema (10) in breast cancer patients. But further research is needed. Massage therapy is effective in treating chronic back pain (11).

Massage is generally safe and being increasingly used as a complementary therapy to provide relief from certain symptoms of cancer and other illnesses. However, patients suffering from cancer, heart disease or arthritis should consult a qualified massage therapist for treatment.

Purported Uses
  • Cancer-related symptoms
  • Headache
  • Pain
Literature Summary and Critique

Listing M, Reisshauer A, Krohn M, et al. Massage therapy reduces physical discomfort and improves mood disturbances in women with breast cancer. Psychooncology. 2009 Dec;18(12):1290-9.
Eighty-six women with primary breast cancer were randomized to receive bi-weekly 30-minute massages (in the back and head-neck areas) or routine care for five weeks. Patients were administered standard questionnaires at baseline (T1), at the end of the study period (T2), and at a 11-week follow-up (T3). Researchers observed a significant reduction in physical discomfort at T2 and T3, and mood disturbances at T2. There was also a reduction in fatigue levels. However, the sample size differed between the intervention and the control groups due to high nonparticipation rate in the control group. Future studies should address this.

Cassileth BR and Vickers AJ. Massage therapy for symptom control: Outcome study at major cancer center. J Pain Symptom Manage 2004;28(3):244-249.
This study included 1,290 cancer patients over a 3-year period. Patients received massage in 20-minute (for inpatients) or 60-minute (for outpatients) sessions. The variations of massage administered were Swedish massage, light-touch massage and reflexology (foot massage). Researchers observed that massage significantly improved pain, nausea, fatigue, depression, and anxiety in the patients with benefits lasting longer (up to 48 hours) in outpatients compared to inpatients. They also found that Swedish and light-touch massages were more effective than reflexology. Since massage is noninvasive and inexpensive, it can be used to alleviate several symptoms associated with cancer.

References
  1. Cassileth BR and Vickers AJ. Massage therapy for symptom control: outcome study at a major cancer center. J Pain Symptom Manage 2004; 28(3):244-249.
  2. Smith MC, et al. Outcomes of touch therapies during bone marrow transplant. Altern Ther Health Med 2003; 9(1):40-49.
  3. Soden K, et al. A randomized controlled trial of aromatherapy massage in a hospice setting. Palliat Med 2004; 18(2):87-92.
  4. Grealish L, Lomasney A, Whiteman B. Foot massage. A nursing intervention to modify the distressing symptoms of pain and nausea in patients hospitalized with cancer. Cancer Nurs. 2000 Jun;23(3):237-43.
  5. Forchuk C, et al. Postoperative arm massage: a support for women with lymph node dissection. Cancer Nurs 2004; 27(1):25-33.
  6. Williams AF, et al. A randomized controlled crossover study of manual lymphatic drainage therapy in women with breast cancer-related lymphoedema. Eur J Cancer Care (Engl) 2002; 11(4):254-261.
  7. Listing M, Reisshauer A, Krohn M, et al. Massage therapy reduces physical discomfort and improves mood disturbances in women with breast cancer. Psychooncology. 2009 Dec;18(12):1290-9.
  8. Noto Y, Kitajima M, Kudo M, Okudera K, Hirota K. Leg massage therapy promotes psychological relaxation and reinforces the first-line host defense in cancer patients. J Anesth. 2010 Dec;24(6):827-31.
  9. Krohn M, Listing M, Tjahjono G, et al. Depression, mood, stress, and Th1/Th2 immune balance in primary breast cancer patients undergoing classical massage therapy. Support Care Cancer. 2010 Jul 20.
  10. Torres Lacomba M, Yuste Sánchez MJ, Zapico Goñi A, et al. Effectiveness of early physiotherapy to prevent lymphoedema after surgery for breast cancer: randomised, single blinded, clinical trial. BMJ. 2010 Jan 12;340:b5396.
  11. Cherkin DC, Sherman KJ, Kahn J, et al. A comparison of the effects of 2 types of massage and usual care on chronic low back pain: a randomized, controlled trial. Ann Intern Med. 2011 Jul 5;155(1):1-9.
  12. Toth M, Marcantonio ER, Davis RB, et al. Massage Therapy for Patients with Metastatic Cancer: A Pilot Randomized Controlled Trial. J Altern Complement Med. 2013 Jan 31.
  13. Wyatt G, Sikorskii A, Rahbar MH, et al. Health-related quality-of-life outcomes: a reflexology trial with patients with advanced-stage breast cancer. Oncol Nurs Forum. 2012 Nov;39(6):568-77. doi: 10.1188/12.ONF.568-577.
  14. Quattrin R, Zanini A, Buchini S, et al. Use of reflexology foot massage to reduce anxiety in hospitalized cancer patients in chemotherapy treatment: methodology and outcomes. J Nurs Manag. 2006 Mar;14(2):96-105.
  15. Sharp DM, Walker MB, Chaturvedi A, et al. A randomised, controlled trial of the psychological effects of reflexology in early breast cancer. Eur J Cancer. 2010 Jan;46(2):312-22. doi: 10.1016/j.ejca.2009.10.006.
  16. Stephenson NL, Swanson M, Dalton J, et al. Partner-delivered reflexology: effects on cancer pain and anxiety. Oncol Nurs Forum. 2007 Jan;34(1):127-32.

Consumer Information

How It Works

Bottom line: Massage is effective in reducing some symptoms associated with cancer.

Massage helps reduce muscle soreness, stiffness, spasms, and promotes relaxation. The various forms of massage that are commonly practiced are Swedish massage, Shiatsu, Reflexology, and Tuina. Swedish massage is the most common and consists of five basic strokes and their variations. Reflexology involves massaging specific areas on the hands or feet that are believed to correspond to particular regions in the body. Shiatsu and Tuina are techniques that originated in Japan and China. They are used to stimulate acupuncture points and meridians to ensure proper energy and blood flow to facilitate healing.
Clinical trials have shown that massage therapy helps reduce pain, mood disturbance, and fatigue in cancer patients undergoing chemotherapy. It can reduce psychological and neurological complications and provide comfort to patients undergoing bone marrow transplantation. Massage also improves sleep and reduces depression in patients with advanced cancer.

Although massage is being increasingly used as a complementary therapy for various illnesses, patients suffering from cancer, heart disease, or arthritis should consult a qualified massage therapist for treatment.

Purported Uses
  • Pain
    Several studies show effectiveness of massage in reducing pain.
  • Headache
    Massage helps relieve headaches.
  • Cancer-related symptoms
    Several clinical trials support use of massage in reducing pain, fatigue, and mood disturbances associated with cancer and its treatment.
Research Evidence

Cancer-related symptoms:
A major study including 1,290 cancer patients was conducted over a 3-year period to assess the benefits of massage in reducing cancer symptoms. Swedish massage, light-touch, or foot massages were given to patients in 20 minute (for inpatients) or 60 minute (for outpatients) sessions. Researchers found that Swedish and light-touch massages were more effective than foot massage in relieving pain, nausea, fatigue, depression, and anxiety. Outpatients reported longer lasting benefits from massage therapy compared to inpatients. Researchers suggest that massage is safe and can be used to reduce some symptoms caused by cancer.

Another study included 230 patients with cancer receiving chemotherapy. Patients received 4 weekly 45-minute sessions of therapeutic massage, healing touch, caring presence, or standard care alone. Patients who received massage and healing touch had lowered anxiety, fatigue, and mood disturbance compared to those in the caring presence group. Massage and healing touch appear to have short-term benefits in cancer patients, although more studies should be conducted to assess the long-term effects.

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