Massage Therapy

Purported Benefits, Side Effects & More
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Massage Therapy

Purported Benefits, Side Effects & More
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Massage Therapy

Common Names

  • Swedish massage
  • Reflexology
  • Myofascial release
  • Neuromuscular therapy
  • Shiatsu
  • Manual lymphatic drainage
  • Reiki

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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 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.

What are the potential uses and benefits?
  • 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.
  • Fatigue
    Studies show that massage can reduce fatigue in cancer patients.
  • Cancer-related symptoms
    Clinical trials support the use of massage for pain, fatigue, anxiety, and other mood disturbances associated with cancer and its treatment. It can also improve shortness of breath and sleep quality.
What else do I need to know?

What Is It:

Massage is an ancient technique that involves manual manipulation of muscles and soft tissues of the body. It increases circulation, promotes relaxation, and has important emotional and psychological benefits. Commonly practiced forms include Swedish massage, reflexology, reiki, neuromuscular therapy, myofascial release, shiatsu, tui na, and manual lymphatic drainage, or MLD.

Massage therapy can help reduce

  • Anxiety, depression
  • Pain
  • Fatigue

It can also help improve

  • Sleep
  • Well-being
  • Coping

Cancer guidelines recommend massage therapy for depression and mood disorders, and as part of management for cancer pain, fatigue, and during palliative care. Further, a newly released guideline from the Society for Integrative Oncology and ASCO recommends massage for short-term pain relief and enhanced coping for individuals living with advanced cancer.

Patients should speak with their doctor and see a qualified massage therapist who has experience working with cancer patients.

Is It Safe:

Massage is generally safe when provided by a qualified massage therapist. Patients should speak with their doctor and see a therapist with experience in this population.

Massage should be avoided in areas with

  • Tumor involvement
  • Recent radiotherapy and surgery
  • Implanted devices like a hepatic infusion pump or wound vacuum
  • Suspected abdominal obstructions or intestinal inflammation, or with irritable bowel syndrome.

In these cases, therapists should use alternate sites for massage.

Abdominal massage should be avoided in those who are pregnant.

Who Can Provide this Service:

In the US, therapists are licensed within each state by meeting specific education, exam, and experience requirements. There is also a voluntary national board certification, and specialty or advanced certifications for particular modalities or for experience with certain populations, such as cancer patients.

Where Can I Get Treatment:

NCI-designated cancer centers may offer massage therapy, yoga, acupuncture, and meditation, usually through referrals from the healthcare team or by accessing supportive care services.

The Integrative Medicine Service at MSK offers several forms of massage therapy to support recovery and wellbeing.

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For Healthcare Professionals

Clinical Summary

Massage is an ancient technique that involves manipulation of muscles and soft tissues of the body. It increases circulation, promotes relaxation, and has important emotional and psychological benefits. Commonly practiced forms include Swedish massage, reflexology, reiki, neuromuscular therapy, myofascial release, shiatsu, tui na, and manual lymphatic drainage, or MLD.

Massage therapy can help reduce

  • Anxiety, depression
  • Pain
  • Fatigue

It can also help improve

  • Sleep
  • Well-being
  • Coping

Oncology guidelines recommend massage therapy
Current oncology guidelines recommend massage therapy for depression and mood disorders (44) (45), and as part of management for cancer pain, fatigue, and during palliative care (54). Further, a newly released guideline from the Society for Integrative Oncology and ASCO recommends massage for short-term pain relief and enhanced coping in patients living with advanced cancer (58).

Clinical trials are continuing to evaluate massage therapy for patients with cancer.

The Integrative Medicine Service at MSK offers massage therapy and other integrative therapies to support the recovery and wellbeing of cancer patients.

Improved psychological symptoms and functioning
In cancer patients, studies show that massage can help alleviate stress, anxiety, depression, nausea, pain, fatigue, and insomnia (1) (2) (3) (4) (7) (8) (9) (12) (13) (14) (15) (16) (21) (22) (23) (40) (41) (53) (55) (59), and decrease pain medication use (59). It can also improve pain and mood in palliative care patients (56) (57) (58), those undergoing surgery and procedural interventions (20) (25) (26) (27) (28) (29) (30) (31) (52), and reduce anxiety and improve sleep in family caregivers (24).

Preliminary data for other symptoms
Other studies suggest massage may prevent chemotherapy-induced peripheral neuropathy (46), reduce neurological complications (2), or decrease pain after lymph node dissection (5), but data on whether it can prevent lymphedema are mixed (6) (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.

Contraindications

Massage is generally safe when provided by a qualified massage therapist. Patients should speak with their doctor and see a therapist with experience in this population.

Massage should be avoided in areas with

  • Tumor involvement
  • Recent radiotherapy and surgery
  • Implanted devices like a hepatic infusion pump or wound vacuum
  • Suspected abdominal obstructions or intestinal inflammation, or with irritable bowel syndrome (39).

In these cases, therapists should use alternate sites for massage.

Abdominal massage should be avoided in those who are pregnant.

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 warfarin therapy with persistent abdominal pain and vomiting (39). Although the particular massage was not described, abdominal massage is more typical with 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. Hematoma and 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 US, therapists are licensed within each state by meeting specific education, exam, and experience requirements. There is also a voluntary national board certification, and specialty or advanced certifications for particular modalities or for experience with certain populations, such as cancer patients.

NCI-designated cancer centers may offer massage therapy, yoga, acupuncture, and meditation, usually through referrals from the healthcare team or by accessing supportive care services.

The Integrative Medicine Service at MSK offers several forms of massage therapy to support recovery and wellbeing.

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. 2011 Sep;19(9):1303-11.
  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 Jul;19(7):650-6.
  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.
  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.
  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.
  17. Perlman AI, Ali A, Njike VY, et al. Massage therapy for osteoarthritis of the knee: a randomized dose-finding trial. PLoS One. 2012;7(2):e30248.
  18. Sherman KJ, Cook AJ, Wellman RD, et al. Five-week outcomes from a dosing trial of therapeutic massage for chronic neck pain. Ann Fam Med. 2014 Mar-Apr;12(2):112-20.
  19. Givi M. Durability of effect of massage therapy on blood pressure. Int J Prev Med. 2013 May;4(5):511-6.
  20. Braun LA, Stanguts C, Casanelia L, et al. Massage therapy for cardiac surgery patients—a randomized trial. J Thorac Cardiovasc Surg. 2012 Dec;144(6):1453-9.
  21. Dion LJ, Engen DJ, Lemaine V, et al. Massage therapy alone and in combination with meditation for breast cancer patients undergoing autologous tissue reconstruction: A randomized pilot study. Complement Ther Clin Pract. May 2016;23:82-87.
  22. Wang TJ, Wang HM, Yang TS, et al. The effect of abdominal massage in reducing malignant ascites symptoms. Res Nurs Health. Feb 2015;38(1):51-59.
  23. Jacobs S, Mowbray C, Cates LM, et al. Pilot Study of Massage to Improve Sleep and Fatigue in Hospitalized Adolescents With Cancer. Pediatr Blood Cancer. May 2016;63(5):880-886.
  24. Pinar R, Afsar F. Back Massage to Decrease State Anxiety, Cortisol Level, Blood Prsessure, Heart Rate and Increase Sleep Quality in Family Caregivers of Patients with Cancer: A Randomised Controlled Trial. Asian Pac J Cancer Prev. 2015;16(18):8127-8133.
  25. Miller J, Dunion A, Dunn N, et al. Effect of a Brief Massage on Pain, Anxiety, and Satisfaction With Pain Management in Postoperative Orthopaedic Patients. Orthop Nurs. Jul-Aug 2015;34(4):227-234.
  26. Khorsand A, Tadayonfar MA, Badiee S, et al. Evaluation of the Effect of Reflexology on Pain Control and Analgesic Consumption After Appendectomy. J Altern Complement Med. Dec 2015;21(12):774-780.
  27. Dreyer NE, Cutshall SM, Huebner M, et al. Effect of massage therapy on pain, anxiety, relaxation, and tension after colorectal surgery: A randomized study. Complement Ther Clin Pract. Aug 2015;21(3):154-159.
  28. Peng S, Ying B, Chen Y, et al. Effects of massage on the anxiety of patients receiving percutaneous coronary intervention. Psychiatr Danub. Mar 2015;27(1):44-49.
  29. Mei L, Miao X, Chen H, et al. Effectiveness of Chinese Hand Massage on Anxiety Among Patients Awaiting Coronary Angiography: A Randomized Controlled Trial. J Cardiovasc Nurs. Mar/Apr 2017;32(2):196-203.
  30. Mobini-Bidgoli M, Taghadosi M, Gilasi H, et al. The effect of hand reflexology on anxiety in patients undergoing coronary angiography: A single-blind randomized controlled trial. Complement Ther Clin Pract. May 2017;27:31-36.
  31. Saatsaz S, Rezaei R, Alipour A, et al. Massage as adjuvant therapy in the management of post-cesarean pain and anxiety: A randomized clinical trial. Complement Ther Clin Pract. Aug 2016;24:92-98.
  32. Moraska AF, Schmiege SJ, Mann JD, et al. Responsiveness of Myofascial Trigger Points to Single and Multiple Trigger Point Release Massages: A Randomized, Placebo Controlled Trial. Am J Phys Med Rehabil. Sep 2017;96(9):639-645.
  33. Seyyed-Rasooli A, Salehi F, Mohammadpoorasl A, et al. Comparing the effects of aromatherapy massage and inhalation aromatherapy on anxiety and pain in burn patients: A single-blind randomized clinical trial. Burns. Dec 2016;42(8):1774-1780.
  34. Gregory R, Gilles C, Aude A, et al. Effects of massage therapy on anxiety, depression, hyperventilation and quality of life in HIV infected patients: A randomized controlled trial. Complement Ther Med. Jun 2017;32:109-114.
  35. Moghimi-Hanjani S, Mehdizadeh-Tourzani Z, Shoghi M. The Effect of Foot Reflexology on Anxiety, Pain, and Outcomes of the Labor in Primigravida Women. Acta Med Iran. Aug 2015;53(8):507-511.
  36. Eguchi E, Funakubo N, Tomooka K, et al. The Effects of Aroma Foot Massage on Blood Pressure and Anxiety in Japanese Community-Dwelling Men and Women: A Crossover Randomized Controlled Trial. PLoS One. 2016;11(3):e0151712.
  37. Lee YM, Yeun YR. Effects of Combined Foot Massage and Cognitive Behavioral Therapy on the Stress Response in Middle-Aged Women. J Altern Complement Med. Jun 2017;23(6):445-450.
  38. Lamas K, Hager C, Lindgren L, et al. Does touch massage facilitate recovery after stroke? A study protocol of a randomized controlled trial. BMC Complement Altern Med. Feb 04 2016;16:50.
  39. Chen HL, Wu CC, Lin AC. Small bowel intramural hematoma secondary to abdominal massage. Am J Emerg Med. Apr 2013;31(4):758.e753-754.
  40. Kinkead B, Schettler PJ, Larson ER, et al. Massage therapy decreases cancer-related fatigue: Results from a randomized early phase trial. Cancer. 2018 Feb 1;124(3):546-554.
  41. Donoyama N, Satoh T, Hamano T, et al. Effects of Anma therapy (Japanese massage) on health-related quality of life in gynecologic cancer survivors: A randomized controlled trial. PLoS One. 2018;13(5):e0196638.
  42. Pach D, Piper M, Lotz F, et al. Effectiveness and Cost-Effectiveness of Tuina for Chronic Neck Pain: A Randomized Controlled Trial Comparing Tuina with a No-Intervention Waiting List. J Altern Complement Med. Mar 2018;24(3):231-237.
  43. Xiong M, Li Y, Tang P, et al. Effectiveness of Aromatherapy Massage and Inhalation on Symptoms of Depression in Chinese Community-Dwelling Older Adults. J Altern Complement Med. Jul 2018;24(7):717-724.
  44. Lyman GH, Greenlee H, Bohlke K, et al. Integrative Therapies During and After Breast Cancer Treatment: ASCO Endorsement of the SIO Clinical Practice Guideline. J Clin Oncol. Sep 1 2018;36(25):2647-2655.
  45. Greenlee H, DuPont-Reyes MJ, Balneaves LG, et al. Clinical practice guidelines on the evidence-based use of integrative therapies during and after breast cancer treatment. CA Cancer J Clin. May 6 2017;67(3):194-232.
  46. Izgu N, Metin ZG, Karadas C, et al. Prevention of chemotherapy-induced peripheral neuropathy with classical massage in breast cancer patients receiving paclitaxel: An assessor-blinded randomized controlled trial. Eur J Oncol Nurs. Jun 2019;40:36-43.
  47. Devoogdt N, Geraerts I, Van Kampen M, et al. Manual lymph drainage may not have a preventive effect on the development of breast cancer-related lymphoedema in the long term: a randomised trial. J Physiother. Oct 2018;64(4):245-254.
  48. Son SH, Lee CH, Jung JH, et al. The Preventive Effect of Parotid Gland Massage on Salivary Gland Dysfunction During High-Dose Radioactive Iodine Therapy for Differentiated Thyroid Cancer: A Randomized Clinical Trial. Clin Nucl Med. Aug 2019;44(8):625-633.
  49. Larkin PJ, Cherny NI, La Carpia D, et al. Diagnosis, assessment and management of constipation in advanced cancer: ESMO Clinical Practice Guidelines. Ann Oncol. Oct 1 2018;29(Suppl 4):iv111-iv125.
  50. Perlman A, Fogerite SG, Glass O, et al. Efficacy and Safety of Massage for Osteoarthritis of the Knee: a Randomized Clinical Trial. J Gen Intern Med. Mar 2019;34(3):379-386.
  51. Sharma I, Joseph D, Kirton O. Traumatic complications of inpatient massage therapy: Case report and literature review. Trauma Case Rep. Dec 2018;18:1-4.
  52. Blackburn L, Hill C, Lindsey AL, et al. Effect of Foot Reflexology and Aromatherapy on Anxiety and Pain During Brachytherapy for Cervical Cancer. Oncol Nurs Forum. May 1 2021;48(3):265-276.
  53. Liou KT, Lynch KA, Nwodim O, et al. Comparison of Depressive Symptom Outcomes in Hospitalized Adult Cancer Patients Receiving Music Therapy or Massage Therapy. J Pain Symptom Manage. 2022 Feb;63(2):e155-e159.
  54. National Comprehensive Cancer Network. NCCN Guidelines: Supportive Care.
  55. Miladinia M, Voss JG, Molavynejad S, et al. Slow-Stroke Back Massage Compared With Music Therapy for Leukemia-Related Pain and Fatigue: A Randomized Controlled Trial. JCO Oncol Pract. Nov 2021;17(11):e1614-e1621.
  56. Kutner JS, Smith MC, Corbin L, et al. Massage therapy versus simple touch to improve pain and mood in patients with advanced cancer: a randomized trial. Ann Intern Med. Sep 16 2008;149(6):369-379.
  57. Havyer RD, Lapid MI, Dockter TJ, et al. Impact of Massage Therapy on the Quality of Life of Hospice Patients and Their Caregivers: A Pilot Study. J Palliat Care. Jan 2022;37(1):41-47.
  58. Mao JJ, Ismaila N, Bao T, et al. Integrative Medicine for Pain Management in Oncology: Society for Integrative Oncology-ASCO Guideline. J Clin Oncol. Sep 19 2022:Jco2201357.
  59. Epstein AS, Liou KT, Romero SAD, Baser RE, Wong G, Xiao H, Mo Z, Walker D, MacLeod J, Li Q, Barton-Burke M, Deng GE, Panageas KS, Farrar JT, Mao JJ. Acupuncture vs Massage for Pain in Patients Living With Advanced Cancer: The IMPACT Randomized Clinical Trial.  JAMA Netw Open. 2023 Nov 1;6(11):e2342482.
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