
Common Names
- Swedish massage
- Reflexology
- Myofascial release
- Neuromuscular therapy
- Shiatsu
- Manual lymphatic drainage
- Reiki
For Patients & Caregivers
Tell your healthcare providers about any dietary supplements you’re taking, such as herbs, vitamins, minerals, and natural or home remedies. This will help them manage your care and keep you safe.
What Is It
Massage is a modality used in many cultures to provide comfort and pain relief using therapeutic touch. There are many styles of massage including Swedish, reflexology, reiki, neuromuscular therapy, myofascial release, shiatsu, tui na, and manual lymphatic drainage, or MLD.
Swedish massage is the most common and consists of five basic strokes. Reflexology involves massaging specific areas on the hands or feet that correspond to other parts of the body. Reiki promotes the healing of physical and emotional ailments through gentle touch. Neuromuscular therapy uses pressure and friction to relieve areas of strain or trigger points. Myofascial release uses gentle sustained pressure to connective tissue to release muscular tightness and soreness. Shiatsu and tui na are techniques that started in Asia. They are used to stimulate energy and blood flow in acupuncture points and channels. MLD uses a light rhythmic technique that encourages the natural movement of lymph fluid throughout the body.
Clinical trials have shown that massage therapy helps reduce pain, anxiety, fatigue, and shortness of breath in cancer patients. It can ease the mind, improve sleep, reduce depression, and provide comfort to patients. It may also help children and caregivers. In addition, studies suggest that massage can reduce pain and anxiety related to medical procedures, including surgery.
Current oncology guidelines recommend using massage for depression and mood disorders. In addition, massage is increasingly used as a complementary therapy to provide relief from symptoms of cancer and other illnesses. However, patients should speak with their doctor and see a qualified massage therapist who understands their condition for treatment.
How It Works
Massage helps reduce muscle soreness, stiffness, and spasms. It also promotes relaxation and improves circulation, processes that can support recovery and healing. These effects can also reduce pain, anxiety, and depression. It may also help regulate breathing and improve sleep. Certain types of massage, such as reflexology, are better suited for hospital or clinic settings, or in weak and elderly patients.
Purported Uses
-
Pain
Several studies show massage can ease pain and can reduce use of pain medications. -
Anxiety
Studies show that massage can reduce anxiety, including anxiety related to medical procedures. This can also lead to improved mood and sleep. -
Depression
Studies show that massage can reduce depression and mood disturbances. Current oncology guidelines recommend using massage for depression and mood disorders. -
Cancer-related symptoms
Several clinical trials support use of massage in reducing pain, fatigue, anxiety, and other mood disturbances associated with cancer and its treatment. It can also improve shortness of breath and sleep quality. -
Arthritis
Studies have shown that massage helps relieve symptoms of arthritis. -
Lower blood pressure
Massage therapy may help to lower blood pressure and other measures such as heart rate. -
Headache
Massage can be helpful to relieve headaches.
Is It Safe
Massage is generally safe when provided by a qualified massage therapist. However, patients should speak with their doctor and see a qualified massage therapist who understands their condition for treatment. Abdominal massage should be avoided in:
- Patients with tumor involvement in abdominal areas.
- Patients who have received recent abdominal radiotherapy and surgery.
- Patients who have had placement of underlying devices such as hepatic infusion pump or wound vacuum.
- Those with suspected abdominal obstructions, intestinal inflammation, or irritable bowel syndrome.
- Women who are pregnant.
In these cases, therapists should use alternate sites for massage.
Who Can Provide this Service
In the United States, qualified therapists are licensed within each state by meeting specific education, exam, and experience requirements. There is also a voluntary national board certification, as well as specialty certifications for advanced training in various modalities. Certifications are also available for therapists who have had additional training and experience with certain populations, such as cancer patients.
Where Can I Get Treatment
A majority of NCI-designated cancer centers now offer massage, yoga, acupuncture, and meditation. This is usually through referrals from the healthcare team or by accessing their supportive care services. The Integrative Medicine Service at MSK offers many forms of massage therapy to support the recovery and wellbeing of cancer patients. In addition, the IMPACT trial at MSK is comparing the long-term effects of massage therapy versus acupuncture treatments for pain and related symptoms in patients with advanced cancers.
For Healthcare Professionals
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. The various forms of massage that are commonly practiced include Swedish massage, reflexology, reiki, neuromuscular therapy, myofascial release, shiatsu, tui na, and manual lymphatic drainage, or MLD.
Swedish massage is the most common and consists of five basic strokes and their variations. Reflexology involves massaging reflex points on the hands, feet, or ears that correspond to particular regions in the body. It is utilized frequently and effectively for nausea, constipation, and peripheral neuropathy in the acute setting. Reiki promotes the healing of physical and emotional ailments through gentle touch. Shiatsu and tui na originated in Japan and China, and involve manual stimulation of acupuncture points and meridians to ensure proper flow of energy and blood to facilitate healing. Neuromuscular therapy uses pressure and friction to relieve areas of strain or trigger points. Myofascial release applies gentle sustained pressure to connective tissue to release muscular tightness and soreness. MLD uses a light rhythmic technique that encourages the natural movement of lymph fluid throughout the body.
In cancer patients, clinical studies show that massage can alleviate symptoms such as stress, anxiety, depression, nausea, pain, fatigue, and insomnia (1) (3) (7) (8) (9) (12) (41), and reduce neurological complications (2). In breast cancer patients, Swedish massage relieved persistent fatigue (40), and massage therapy alone or in combination with meditation appeared to help reduce postoperative stress (21). A preliminary study of Swedish massage prior to each paclitaxel infusion suggests it may help reduce or prevent chemotherapy-induced peripheral neuropathic pain, and improve nerve conduction and quality of life (46). Other preliminary data indicate that postoperative arm massage can decrease pain and discomfort after lymph node dissection (5) and that MLD may reduce lymphedema (6), but studies on whether it can prevent lymphedema are mixed (10) (47). A small study evaluating a parotid gland massage technique taught to patients suggests it may help reduce radiation burden to salivary glands from I therapy (48), but additional studies are needed.
Studies indicate that reflexology can alleviate pain and nausea (4) and reduce anxiety (14) (15) (16), dyspnea, and fatigue in cancer patients (13). Some studies show that massage and reflexology sessions have benefit and clinical utility, particularly for pain or anxiety associated with surgery and procedural interventions (20) (25) (26) (27) (28) (29) (30) (31) (52). Gentle abdominal massage was found to improve depression, anxiety, wellbeing, and perceived abdominal bloating in cancer patients with malignant ascites (22). In addition, clinical practice guidelines from the European Society for Medical Oncology (ESMO) determined there is some evidence abdominal massage may reduce GI symptoms and improve bowel efficiency, although the studies assessed were in noncancer populations (49).
In a retrospective study comparing a single first-time session of either music therapy or massage therapy for adult cancer inpatients, both interventions reduced depressive symptoms, although music therapy was associated with greater reductions (53).
Massage has also shown some benefits for pediatric cancer patients and caregivers. In a study of hospitalized adolescents with cancer, massage was well received with trends towards increased nighttime and overall sleep (23). In family caregivers of patients with cancer, it reduced anxiety, cortisol levels, blood pressure, and pulse rate, and improved sleep quality (24).
Massage therapy is also effective in treating chronic back pain (11), knee osteoarthritis (17) (50), neck pain (18) (42), headaches (32), and to reduce blood pressure (19). Both aromatherapy massage and inhalation aromatherapy reduced anxiety and pain in burn patients (33). In HIV patients, massage improved pain, anxiety, and hyperventilation (34). Reflexology reduced anxiety, labor pain, and duration among first-time mothers (35). Self-care massage improved mental health and blood pressure (36) and reduced stress (37) in some populations.
Clinical trials are evaluating massage therapy for conditions such as peripheral neuropathy, preoperatively for breast surgery patients, and combined with music therapy for hospice patients. A trial is also underway to determine whether massage can facilitate stroke recovery (38). And the IMPACT trial at MSK is comparing the long-term effects of massage therapy versus acupuncture treatments for pain and related symptoms in patients with advanced cancer.
Current oncology guidelines recommend using massage for depression and mood disorders (44) (45). Massage is generally safe and 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. The Integrative Medicine Service at MSK offers many of these therapies to support the recovery and wellbeing of cancer patients.
Contraindications
Avoid abdominal massage in:
- Patients with tumor involvement in abdominal areas.
- Patients who have received recent abdominal radiotherapy and surgery.
- Patients who have had placement of underlying devices such as hepatic infusion pump or wound vacuum.
- Those with suspected abdominal obstructions, intestinal inflammation, or irritable bowel syndrome (39).
- Women who are pregnant.
In these cases, therapists should use alternate sites for massage.
Adverse Reactions
Massage is generally safe when provided by a qualified massage therapist.
Case report (rare)
Small bowel intramural hemorrhage secondary to anticoagulant therapy after abdominal massage: In a 68-year-old man on long-term warfarin therapy; presented to ER with persistent abdominal pain and vomiting, and no bowel movement since onset (39). Although the particular massage was not described, abdominal massage is more typically part of eastern massage modalities such as shiatsu and tui na and may vary in pressure and intensity.
Hematoma: In a 69-year-old woman admitted for pneumonia who had multiple comorbidities and complained of pain in the right thigh. She requested an inpatient massage, which appeared to worsen symptoms. The hematoma along with calcified vessels were identified on CT scan and the patient required transfusions and an external compression wrap. Range of motion and pain resolved gradually. The authors suggest vascular status screening when selecting therapeutic massage techniques for patients (51).
Practitioners and Treatments
In the United States, qualified therapists are licensed within each state by meeting specific education, exam, and experience requirements. There is also national board certification, which is voluntary, as well as specialty certification for advanced education and training in a particular modality. Certifications are also available for therapists who have had additional training and experience with certain populations, such as cancer patients.
A majority of NCI-designated cancer centers now offer massage, yoga, acupuncture, and meditation. This is usually through referrals from the healthcare team or by accessing their supportive care services. The Integrative Medicine Service at MSK offers many forms of massage therapy to support the recovery and wellbeing of cancer patients. In addition, the IMPACT trial at MSK is comparing the long-term effects of massage therapy versus acupuncture treatments for pain and related symptoms in patients with advanced cancer.