Massage Therapy
Massage therapy is a practice that dates back thousands of years. There are many types of massage therapy; all involve manipulating the muscles and other soft tissues of the body. In the United States, massage treatment is sometimes part of conventional medicine. 1In other instances, it is part of complementary and alternative medicine (CAM).2 This Backgrounder provides a general overview of massage therapy used as CAM and suggests some resources you can use to learn more.
Key Points
- People use healing massage therapy as CAM for a variety of health-related purposes, from treating specific diseases and conditions to general wellness.
- Scientists do not fully know what changes occur in the body during massage, whether they influence health, and, if so, how. The National Center for Complementary and Alternative Medicine (NCCAM) is sponsoring studies to answer these questions and identify the purposes for which massage may be most helpful.
- There appear to be few risks to massage therapy programs if it is used appropriately and provided by a trained massage professional.
- Tell your health care providers about any CAM therapy you are considering or using, including massage therapy. This helps to ensure safe and coordinated care.
The term massage therapy (also called massage, for short; massage also refers to an individual treatment session) covers a group of practices and techniques. There are over 80 types of massage therapy. In all of them, therapists press, rub, and otherwise manipulate the muscles and other soft tissues of the body, often varying pressure and movement. They most often use their hands and fingers, but may use their forearms, elbows, or feet. Typically, the intent is to relax the soft tissues, increase delivery of blood and oxygen to the massaged areas, warm them, and decrease pain.
A few popular examples of this therapy are as follows:
- In Swedish massage, the therapist uses long strokes, kneading, and friction on the muscles and moves the joints to aid flexibility.
- A therapist giving a deep tissue massage uses patterns of strokes and deep finger pressure on parts of the body where muscles are tight or knotted, focusing on layers of muscle deep under the skin.
- In trigger point massage (also called pressure point massage), the therapist uses a variety of strokes but applies deeper, more focused pressure on myofascial trigger points--"knots" that can form in the muscles, are painful when pressed, and cause symptoms elsewhere in the body as well.
- In shiatsu massage, the therapist applies varying, rhythmic pressure from the fingers on parts of the body that are believed to be important for the flow of a vital energy called qi.
In the United States, therapeutic massage therapy first became popular and was promoted for a variety of health purposes starting in the mid-1800s. In the 1930s and 1940s, however, massage fell out of favor, mostly because of scientific and technological advances in medical treatments. Interest in massage revived in the 1970s, especially among athletes.
More recently, a 2002 national survey on Americans' use of CAM (published in 2004) found that 5 percent of the 31,000 participants had used massage therapy in the preceding 12 months, and 9.3 percent had ever used it. According to recent reviews, people use massage for a wide variety of health-related intents: for example, to relieve pain (often from musculoskeletal conditions, but from other conditions as well); rehabilitate sports injuries; reduce stress; increase relaxation; address feelings of anxiety and depression; and aid general wellness.
Who Provides Massage Therapy
A person who professionally provides massage therapy is most often called a massage therapist, although there are some other health care providers (such as chiropractors) who also have massage training. This Backgrounder mainly uses the term massage therapist. Most massage therapists learn and practice more than one type of massage.
To learn massage, most therapists attend a school or training program, with a much smaller number training instead with an experienced practitioner. Many students are already licensed as another type of health care provider, such as a nurse.
There are about 1,300 massage therapy schools, college programs, and training programs in the United States. The course of study typically covers subjects such as anatomy and physiology (structure and function of the body); kinesiology (motion and body mechanics); therapeutic evaluation; massage techniques; first aid; business, ethical, and legal issues; and hands-on practice of techniques. These educational programs vary in many respects, such as length, quality, and whether they are accredited. Many require 500 hours of training, which is the same number of hours that many states require for certification. Some therapists also pursue specialty or advanced training.
At the end of 2004, 33 states and the District of Columbia had passed laws regulating massage therapy--for example, requiring that massage therapists graduate from an approved school or training program and pass the national certification exam in their field in order to practice. Cities and counties may have laws that apply as well. Professional organizations of massage therapists have not agreed upon the standards for recognizing that a massage therapist is properly and adequately trained.
What Massage Therapists Do in Treating Patients
Massage therapists work in a variety of settings, including private offices, hospitals, other clinical settings, nursing homes, studios, and sport and fitness facilities. Some also travel to patients' homes or workplaces to provide a massage.
Massage therapy treatments usually last for 30 to 60 minutes; less often, they are as short as 15 minutes or as long as 1.5 to 2 hours. For some conditions (especially chronic ones), therapists often advise a series of appointments. Therapists usually try to provide an environment that is as calm and soothing as possible (for example, by using dim lighting, soft music, and fragrances).
At the first appointment, a massage therapist will discuss your symptoms, medical history, the results you (and your health care provider, if applicable) desire, and possibly other factors such as your work and levels of stress. She will likely perform some evaluations through touch. If she finds nothing that would make a massage inadvisable, she will proceed with the massage. At any time, you can bring up questions or concerns.
During health massage treatment, you will lie on a special padded table or sit on a stool or chair. You might be fully clothed (for example, for a "chair massage") or partially or fully undressed (in which case you will be covered by a sheet or towel; only the parts of your body that the therapist is currently massaging are exposed). Oil or powder helps reduce friction on the skin. The therapist may use other aids, such as ice, heat, fragrances, or machines. He may also provide recommendations for self-care, such as drinking fluids, learning better movement, and developing an awareness of your body.
Why People Use Massage Therapy
In the 2002 national survey on Americans' use of CAM, respondents who used a CAM therapy could choose from five reasons for using the therapy. The results for massage were as follows:
- They believed that massage combined with conventional medicine would help: 60 percent
- They thought massage would be interesting to try: 44 percent
- They believed that conventional medical treatments would not help: 34 percent
- Body massage was suggested by a conventional medical professional: 33 percent
- They thought that conventional medicine was too expensive: 13 percent