In the first ever study of massage as a stand-alone treatment for anxiety, researchers uncovered significant benefits.

The research, published in the Journal of Clinical Psychiatry, compared twice-weekly Swedish massage to light touch over a six-week period for people with generalised anxiety disorder GAD. Therapy sessions lasted 45 minutes and improvements in anxiety were assessed by both the patients and their practitioners.

Swedish massage therapy – a traditional form of deep-tissue massage – appeared to be the most effective in reducing anxiety, the researchers found.

In contrast, light touch therapy – the practice of gently placing hands on different parts of someone’s body to ‘release energy’ – didn’t show as significant an effect on the participants’ anxiety levels.

Rapid results

Researchers found as early as session five that those who received Swedish massage showed greater improvement of anxiety symptoms than those who received light touch. There was also a decrease in depression symptoms among those who received massage.

People with GAD experience constant anxiety, with fearful and worrisome thoughts clouding their mind at all hours of the day – often for weeks or months on end.

These thoughts are often difficult to escape and can leave GAD sufferers feeling drained, fatigued, or  with long-term stomach pain or muscle tension.

GAD is typically treated with antidepressants or anti-anxiety medications, as well as psychotherapy and cognitive behavioural therapy. This latest evidence suggests that there may be another way to treat this condition.

“These findings are significant and if replicated in a larger study will have important ramifications for patients and providers,” said Dr. Mark Hyman Rapaport, chair of Emory University’s Department of Psychiatry and Behavioral Sciences.

Therapeutic benefits

Past research has come to similar conclusions about massage benefits. In one 2010 study massage was found to boost the immune system, and other evidence suggests that it can also improve sleep quality. Both sleep and immune function also play a role in mental health.

In addition, touch and intimacy are also important in human emotional, physical, and mental well-being. Studies show that frequent physical contact – hugs, caresses, massages, or kisses – can help boost immunity, decrease heart rate and blood pressure, and overall improve emotional well-being.

Australian researchers studied a group of 140 people aged 60 and older who had been diagnosed with chronic low-back pain lasting more than 12 months. They were divided into two groups: one receiving Swedish massage with ginger oil and one receiving traditional Thai massage.

Both forms of massage were provided by trained therapists during 30-minute sessions that took place twice a week for five weeks. The traditional Thai massage was applied through the clothing with no oil. The Swedish massage was applied to the skin using aromatic ginger oil, which consisted of 2% essential ginger oil with jojoba oil.

The results, published in the journal Complementary Therapies in Medicine  showed that  both types of massage produced significant immediate, short- and long-term improvements in low back pain. However, Swedish massage was found to be the more effective of the two in terms of improvement of pain and disability, according to recent research.

A potent anti-inflammatory

Massage has been shown to be a good way to relieve chronic pain.

Likewise ginger has been used as an anti-inflammatory and anti-rheumatic for musculoskeletal pain.

Studies indicate that its anti-inflammatory benefits come from its compounds called gingerols . The studies suggest that gingerols work by inhibiting CO-X2, which is a pro-inflammatory enzyme.

Previous studies have suggested that taking ginger as an oral supplement can be effective in relieving knee pain and neck pain. There is also evidence that a few tablespoons of grated ginger can help relieve muscle pain caused by exercise.

But until now, no study has examined the use of ginger for back pain.

Researchers at the University of Alberta have been studying the traditional Japanese massage practice as a means of breaking a familiar and vicious cycle whereby pain keeps a person awake, and loss of sleep increases sensitivity to pain.

The research team’s findings were published in the Journal of Integrative Medicine.

Finding results that work

The pilot study was an attempt to explore low-cost, unintimidating alternatives to drugs to help people with chronic pain fall asleep, noting medication is seldom recommended for long-term use.

Not only does sleep deprivation lower a person’s pain threshold, it also affects their health, from increased risk of obesity, diabetes, cardiovascular disease and traffic accidents. So finding a solution that works was crucial.

For this study, occupational therapy and physical therapy students were taught the basic shiatsu techniques and in turn trained participants to give massage to themselves.

For patients suffering from chronic pain due to low-back and other musculoskeletal injuries, the only thing that matters is finding results that work, said lead researcher Cary Brown, an associate professor of occupational therapy in the Faculty of Rehabilitation Medicine, University of Alberta.

Results showed that those who self-administered shiatsu reported falling asleep faster – sometimes even while administering treatment – and slept longer after two weeks and eight weeks of treatment, compared with sleep patterns at the beginning of the study.

Focussing on something else

Brown notes there’s a difference between people with pain passively going to a therapist versus taking control of their sleep problem in the form of self-administering hand shiatsu, which requires more mental effort.

Hand shiatsu, when self-administered, takes some concentration because our minds cannot focus on two demands at one time, she says, making it less likely that negative thoughts would interfere with sleep.

“One of the barriers to falling asleep for people who have pain is they worry about what’s going to happen and while you’re laying there you’re thinking about all these negative things, it occupies your attention.” Brown says.

While she cautions it’s impossible to draw strong conclusions about the pilot given the small sample size, Brown believes the results are promising enough to warrant further study.

To find out US researchers randomised 228 patients with chronic neck pain into five different groups receiving various doses of massage over a five-week period. What they found was that the benefits increased in line the the ‘dose’.

Specifically, they found that, in terms of achieving a clinically meaningful improvement in neck dysfunction or pain, patients who received 30-minute treatments two or three times weekly were not significantly better than those in a control group who were put on a waiting list for treatment.

But patients who received 60-minute treatments two or three times weekly showed significant improvement in neck dysfunction and pain intensity compared to the control group.

Compared with the control group these patients were three times more likely to have clinically meaningful improvement in neck function if they received 60 minutes of massage twice a week and five times more likely if they received 60 minutes of massage three times a week.

Writing in the Annals of Family Medicine, the authors conclude patients who receive massage treatment for chronic neck pain may not be getting the full benefits if they only have a few short sessions of therapy. They add “Clinicians recommending massage and researchers studying this therapy should ensure that patients receive a likely effective dose of treatment.”

There is increasing interest in using complementary and alternative treatments to manage behavioural and psychological symptoms of dementia such as agitation, aggression and depressed mood.

In this small study which involved patients in five long-term care facilities in Brisbane, Australia,  researchers sought to compare the effect of foot massage (intervention) and quiet presence (control) on agitation and mood in people with dementia.

In all 55 long-term care residents aged 74-103 years, with moderate to severe dementia and a history of agitated behaviour participated.  The patients were randomised to one of two groups: a 10-min foot massage or quiet presence (control), every weekday for 3 weeks.

At the end of that period both groups experienced an increase in agitation, though the increase was greater in the quiet presence group than it was in the foot massage group. In addition those receiving the foot massage were also more alert as compared to those in the quiet presence group whose alertness declined.

The authors say that more research is needed to understand specific conditions under which massage might promote relaxation and improve mood for people with dementia.

Good for care nurses too

The study builds on a previous pilot study by the same team and provides further evidence to help assess whether foot massage is, indeed, a low cost, low risk, non-pharmacological and easily applied procedure that produces tangible positive psychological and physiological effects.

In addition, the researchers have produced previous research to show that caregivers working with people who have dementia also benefit from a 10-minute foot massage administered during their shifts.  

Noting that massage has been shown to reduce stress in many different types of individuals including among nurses, the researchers found those who received massages had lower diastolic blood pressure and lower levels of anxiety than those who did not receive the treatment. The researchers described “significant differences” between the two groups’ blood pressure and anxiety measurements, and said a larger study is called for to build on the “promising” findings.

Researchers at McMasters University in Ontario say this simple drug-free therapy can help not just bone-weary athletes but those with inflammation-related chronic conditions, such as arthritis or muscular dystrophy.

Massage is well accepted as a therapy for relieving muscle tension and pain. But for this small study, in the journal  Science Translational Medicine, the scientists delved deeper into its effects on the body. They found that massage also triggers biochemical sensors that can send inflammation-reducing signals to muscle cells.

In addition, massage signals muscle to build more mitochondria – the power centres of our cells – which play an important role in healing.

Healing at a cellular level

“The main thing, and what is novel about our study, is that no one has ever looked inside the muscle to see what is happening with massage,  no one looked at the biochemical effects or what might be going on in the muscle itself,” said Justin Crane, one of the authors of the study.

“We have shown the muscle senses that it is being stretched and this appears to reduce the cells’ inflammatory response,” he said. “As a consequence, massage may be beneficial for recovery from injury.”

Reduced inflammation

Crane claims the study was unique in that it took a manual therapy, like massage, and test the effect using a muscle biopsy to show massage reduces inflammation, an underlying factor in many chronic diseases.

To do this the researchers followed 11 men in their twenties.

On their first visit, the men’s exercise capacity was assessed. Two weeks later, the men cycled on a bicycle for more than 70 minutes, to a point of exhaustion when they couldn’t cycle any more. They then rested for 10 minutes.

While resting, a massage therapist lightly applied massage oil to both legs, and then performed massage for 10 minutes on one leg using a variety of techniques commonly used in rehabilitation.

Muscle biopsies were done on both legs (quadriceps) and repeated 2.5 hours later. Researchers found reduced inflammation in the massaged leg. Surprisingly, though, in this study massage did not appear to clear lactic acid from the muscle.

A potent therapy

Crane admits being surprised that just 10 minutes of massage had such a profound effect. “I didn’t think that little bit of massage could produce that remarkable of a change, especially since the exercise was so robust. Seventy minutes of exercise compared to 10 of massage, it is clearly potent.”

The results hint that massage therapy blunts muscle pain by the same biological mechanisms as most pain medications and could be an effective alternative.