I have been massaging professionally for about 7 years now and many people come to me requesting a deep tissue massage for pain relief. Last week, one person who came to me said “I know that I feel less pain after massage but does massage really reduce pain and anyway how does it do that?” Good question I thought. So here is an attempt to answer her question by looking at the latest research.
There are many studies which show how massage reduces stress hormones and lowers blood pressure and anxiety, but what about massage decreasing pain. Pain is a difficult thing to grasp. You feel it intensely and there are so many dimensions of pain; emotional, psychological and physiological and even social.
First let’s look at what muscular pain is. Muscular pain is complex. Usually it is a message for us to listen to. “Don’t continue doing that says the muscle or I am going to tear” it might be saying. Some pain is inflammation, some is not. Some muscular pain are what is known to massage therapists as trigger points. That is, those pesky points of intense senstivity where the muscle fibres have adhered together or ‘knotted’ and then block blood flow and oxygen to the area. Muscular pain may be caused by lifestyle issues, shortening of a muscle, chills, sleeping positions, muscular fatigue, muscular trauma, muscular exertion, stress, lack of acyivity, muscular atrophy and bad nutritional habits.
Let’s look at some recent research on muscular pain and massage therapy and see if indeed massage does reduce pain. I found 5 recent studies. In one study (Cherkin et al., 2011), it was found that those who were massaged once a week for 10 weeks suffered less back pain even up to 6 months after the massages had been executed. They were better able to perform normal daily tasks, were more active and used less medication than the group who was not massaged. In another study looking at people who have pain from osteoarthritis of the knee (Perlman et al., 2011), it was found that massage significantly lessened their pain. Similarly, in a study looking at people with rheumatoid arthritis (Field et al., 2013), it also was found that massage lessened pain. In a study of people with fibromyalgia (Castro-Sánchez, et al., 2011), it was found that massage improved not only pain but “anxiety levels, quality of sleep, pain, and quality of life” and this continued for 1 month after the treatment had finished. They also found that even after 6 months, the group who was massaged still had better quality of sleep. In another study of hospitalized patients (Adams, White & Beckett, 2010), it was found that massage resulted in a “significant reduction in pain levels”, and they were also able to confirm“the interrelatedness of pain, relaxation, sleep, emotions, recovery, and finally, the healing process”. They concluded that “[m]assage therapy can provide pain relief and relaxation, can support a patient’s emotional well-being and recovery, and can ultimately aid in the healing process.” In a study of cancer patients (Toth, et al., 2013), it was found that massage improved pain and sleep quality even one week after having received a massage. So we see the research shows that massage definitely does reduce pain.
But how does massage reduce pain? Well there are probably many reasons and it is not at all well understood. And this is probably due to the complexity of the nature and origins of pain. As stated above in the results of one research study, pain is very intertwined with other elements such as emotions, relaxation and so on. In 2 studies which looked at massage and the mechanism of pain, it was found that massage works to reduce the inflammation, heat and pain in the area (like anti-inflammatory drugs), but unlike drugs, which can inhibit the healing process of the body and the muscles, they suggest that massage actually triggers biochemical processes which promotes healing and recovery of the muscle tissues (Crane et al, 2012; Best, Gharaibeh & Huard, 2013).
Having shown all of this research, there are always problems which can be found with research; sample sizes, methods, conlusions drawn and so on. Despite these physical and physiological effects that these research studies suggest, massage does affect the autonomic nervous system. Research shows that massage decrease stress hormones (cortisol), and increase serotonin and dopamine (Field, Diego & Hernadez-Reif, 2007) making that feel good factor that massage is famous for. And because pain is complex and affected by so many factors, pain can definitely decrease with massage.
So an answer to the question is that massage can reduce pain, it can help muscular tissue to heal, promotes relaxation, reduces anxiety, reduces stress and makes you feel good. Why would you even wait another day to get your next massage?
Adams, R., White, B. & Beckett, C., (2010) The Effects of Massage Therapy on Pain Management in the Acute Care Setting. Int J Ther Massage Bodywork. 3(1): 4–11. Published online Mar 17, 2010. PMCID: PMC3091428
Best, T.M., , Gharaibeh, B. & Huard, J., (2013). Republished: Stem cells, angiogenesis and muscle healing: a potential role in massage therapies? Postgrad Med J 89:666-670 doi:10.1136/postgradmedj-2012-091685rep
Castro-Sánchez, A.M., Matarán-Peñarrocha, G.A., Granero-Molina, J., Aguilera-Manrique, G., Quesada-Rubio, J.M., Moreno-Lorenzo, C. (2011). Benefits of massage-myofascial release therapy on pain, anxiety, quality of sleep, depression, and quality of life in patients with fibromyalgia. Evid Based Complement Alternat Med. 2011:561753.
Cherkin, D.C., Sherman, K.J., Kahn, J., Wellman, R., Cook, A.J., Johnson, E., Erro, J., Delaney, K. & Deyo R.A. (2011). A Comparison of the Effects of 2 Types of Massage and Usual Care on Chronic Low Back Pain. A Randomized, Controlled Trial. Annals of Internal Medicine. 155, 1-9
Crane, J.D.,Ogborn, D.I., Cupido, C., Melov, S., Hubbard, A. Bourgeois, J.M. & Tarnopolsky, M. A. (2012). Massage Therapy Attenuates Inflammatory Signaling After Exercise-Induced Muscle Damage. Sci Transl Med 4: 119, p. 119ra13 DOI: 10.1126/scitranslmed.3002882
Field T., Diego M., Delgado J., Garcia D. & Funk CG., (2013) Rheumatoid Arthritis in Upper Limbs Benefits from Moderate Pressure Massage Therapy. Complementary Therapies in Clinical Practice. 19(2):101-3. doi: 10.1016/j.ctcp.2012.12.001
Field, T., Diego, M. & Hernandez-Reif, M. (2007). Massage therapy research. Developmental Review 27. 75–89
Perlman, A.I., Ather, A., Njike, V.N., Hom, D., Davidi, A., Gould-Fogerite, S., Milak, C.,& Katz, D.L. (2012). Massage therapy for osteoarthritis of the knee: a randomized dose-finding trial. PLoS One. 7(2):e30248.
Toth M., Marcantonio E.R., Davis R.B., Walton T., Kahn J.R. & Phillips R.S. (2013) Massage therapy for patients with metastatic cancer: a pilot randomized controlled trial. J Altern Complement Med. 19(7):650-6. doi: 10.1089/acm.2012.0466. Epub 2013 Jan 31.