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Other common
name(s): Swedish massage, sports massage, deep tissue
massage, myotherapy, massage therapy, therapeutic massage,
neuromuscular therapy, trigger point massage, trigger point therapy
Scientific/medical
name(s): none
Description
Massage involves manipulation, rubbing, and kneading of the
muscles and soft tissue to enhance function of those tissues and
promote relaxation.
Overview
Studies of massage for cancer patients suggest massage can
decrease stress, anxiety, depression, pain, and fatigue. Many health
care professionals recognize massage as a useful, noninvasive addition
to standard medical treatment. Therapeutic massage is most often given
by trained massage therapists. Caregivers can also be trained in safe
massage techniques.
How is it promoted for use?
Massage is recommended by some health care professionals as a
complementary therapy. Supporters believe massage can help reduce
stress, anxiety, and pain in people who have serious illnesses such as
cancer. It is also known to help relax muscles. Many people find that
massage brings a temporary feeling of well-being and relaxation.
Massage is also used to relieve pain and stiffness, increase mobility,
rehabilitate injured muscles, and reduce the pain of headaches and
backaches.
Some practitioners claim massage raises the body's production
of endorphins (chemicals believed to improve overall mood) and flushes
the waste product lactic acid out of muscles. Proponents also claim
massage promotes recovery from fatigue produced by excessive exercise,
breaks up scar tissue, loosens mucus in the lungs, promotes sinus
drainage, and helps arthritis, colds, and constipation.
Proponents claim a type of massage called myotherapy can
reduce 95% of all muscle-related pain and, in some cases, can take the
place of pain-relieving drugs. They say the techniques used in
myotherapy relax muscles and improve muscle strength, flexibility, and
coordination; relieve pain; reduce the need for pain medications;
increase blood circulation; improve stamina and sleep patterns; and
correct posture imbalances.
What does it involve?
There are many types of massage, including Swedish massage,
sports massage, neuromuscular therapy, myotherapy, and others (see our
documents Acupressure, Shiatsu, and Other
Asian Bodywork, and Myofascial
Release). Swedish massage is one of the most common types of
massage used in the United States today, although most massage
therapists combine a number of different styles and techniques.
In all forms of massage, therapists use their hands (and
sometimes forearms, elbows, and massage tools) to manipulate the body's
soft tissue. Massage strokes can vary from light and shallow to firm
and deep and from slow steady pressure to quick tapping. The type of
massage stroke will depend on the health and needs of the individual
and the training and style of the massage therapist. During active
treatment for cancer, special considerations may apply.
Swedish massage uses several techniques to apply pressure to
muscles in order to relax them and encourage circulation. Deep tissue
massage focuses on deep layers of muscle tissue and connective tissue
with the goal of releasing chronic tension or tightness. Sports massage
is used in different ways depending on the sport, but the overall goals
are to reduce fatigue and improve mobility.
Myotherapy and neuromuscular therapy focus on finding trigger
points and use techniques such as deep pressure to reduce them. Trigger
points are abnormally sensitive, highly irritable knots of tight muscle
tissue that may cause pain or limit range of motion. These types of
massage are also called trigger point therapies.
Massage usually takes place on a massage table. The client may
wear minimal clothing and is covered by a sheet, light blanket, or
towel. Oils or lotions are often used to keep friction from irritating
the skin. Typical massage therapy sessions last from thirty minutes to
one hour. Massage therapists often play soothing music and use dim
lighting to increase relaxation and comfort.
Some massages take place with the client fully clothed and
seated on a massage chair. Chair massage focuses on the head, neck,
shoulders, back, arms, and hands. These massages tend to last fifteen
to thirty minutes.
Many hospitals and cancer centers now offer massage to cancer
patients. When provided to patients undergoing inpatient procedures,
these massages generally last a shorter time.
What is the history behind it?
Massage has been used in many ancient cultures, including
those of China, India, Persia, Arabia, Greece, and Egypt. Chinese texts
dating back to 2700 BC recommended massage and other types of body
movements as treatments for paralysis, chills, and fever. Hippocrates,
known as the father of western medicine, recommended massage for sports
and war injuries.
Swedish massage, one of the most common forms of massage used
today in the United States, is usually attributed to the nineteenth
century Swedish physician Per Henrik Ling. A number of writings from
the late 1800s discuss techniques that have been incorporated into what
we call Swedish massage.
Trigger point therapy was developed as a result of the work of
Janet Travell, MD, and colleagues in the 1940s. Travell developed a
technique called trigger point injections, in which pain-relieving
drugs are injected directly into the tender area of painful muscles.
Later therapists noted that external pressure could help relieve
trigger point pain without injections. Neuromuscular techniques emerged
during the last half-century in Europe and North America.
In 1992, massage therapists set up the National Certification
Board for Therapeutic Massage and Bodywork so that their qualifications
could be standardized and officially recognized. A person who completes
required training and passes the Board's exam can say that he or she is
Nationally Certified in Therapeutic Massage and Bodywork (NCTMB). In
2005, the board created a new level of certification, which allows a
person to call himself or herself Nationally Certified in Therapeutic
Massage (NCTM). The newer title requires the same basic knowledge as
the NCTMB certification, but the person is tested on fewer types of
massage. Both credentials must be renewed every four years through
continuing education and practice. The massage therapists' certifying
board is recognized by the National Commission for Certifying Agencies.
In addition, massage therapists have asked state legislatures
to require licensing so that untrained people cannot call themselves
massage therapists. According to the U.S. Department of Labor,
thirty-eight states and the District of Columbia now regulate massage
therapists. Certification and licensure make it easier to find a
professional massage therapist.
What is the evidence?
While massage appears promising for symptom management and
improving quality of life, available scientific evidence does not
support claims that massage slows or reverses the growth or spread of
cancer. A growing number of health care professionals recognize massage
as a useful addition to conventional medical treatment. In a 1999
publication, the National Cancer Institute found that about half of
their cancer centers offered massage as an adjunctive therapy to cancer
treatment. Some studies of massage for cancer patients suggest that it
can decrease stress, anxiety, depression, pain, and fatigue. These
potential benefits hold great promise for people who have cancer, who
often must deal with the stresses of a serious illness in addition to
unpleasant side effects of conventional medical treatment. While some
evidence from research studies with cancer patients supports the use of
massage for short-term symptom relief, additional research is needed to
find out if there are measurable, long-term physical or psychological
benefits.
Meanwhile, most patients do indeed seem to feel better after
massage, which may result in substantial relief. A 2005 review of
research reported that massage therapy has been shown to reduce pain
and anxiety in randomized controlled trials. Large, well-controlled
studies are still needed to determine the long-term health benefits of
massage.
Are there any possible problems or
complications?
People with rheumatoid arthritis, cancer that has spread to
the bone, spine injuries, osteoporosis, or other bone diseases that
could be worsened by physical manipulation should avoid physical
manipulation or deep pressure. Manipulation of a bone in an area of
cancer metastasis could result in a bone fracture. Also, people who
have had radiation may find even light touch on the treatment area to
be uncomfortable. People with cancer and chronic conditions such as
arthritis and heart disease should consult their physicians before
undergoing any type of therapy that involves manipulation of joints and
muscles. It is important that massage be given by trained massage
therapists and that the massage therapist know about your cancer and
its treatment. Generally, gentle massage and bodywork can be adapted to
meet the needs of cancer patients.
People who have had radiation may find even light touch on the
treatment area to be uncomfortable. A few people have allergic
reactions to lotions or oils used during massage, and this may be more
common among patients receiving radiation treatment.
Another concern for people who have cancer is that tissue
manipulation in the area of a tumor might increase the risk that cancer
cells will travel to other parts of the body. It may be prudent for
cancer patients to avoid massage near tumors and lumps that could be
cancerous until this question is clearly answered.
Patients with low blood platelet counts (a common side effect
of chemotherapy) or who are taking blood-thinning medication such as
warfarin (Coumadin) may be susceptible to easy bruising and should ask
their doctor whether massage is safe for them.
It is important for people who have cancer to let their
medical care provider know they are receiving massage. Massage should
be provided by a trained professional with expertise in working safely
with people with cancer and with cancer survivors. Family members and
other caregivers can be instructed in certain massage techniques as
well.
Relying on this treatment alone and delaying or avoiding
conventional medical care for cancer may have serious health
consequences.
Additional Resources
More information from your American Cancer
Society
The following information on complementary and alternative
therapies may also be helpful to you. These materials may be found on
our Web site (www.cancer.org)
or ordered from our toll-free number (1-800-ACS-2345).
References
Ahles TA, Tope DM, Pinkson B, et al. Massage therapy for
patients undergoing autologous bone marrow transplantation. J Pain Symptom Manage.
1999;18:157-163.
Bass SS, Cox CE, Salud CJ, et al. The effects of postinjection
massage on the sensitivity of lymphatic mapping in breast cancer. J Am Coll Surg.
2001;192:9-16.
Calvert RN. Pages from history: swedish massage. Massage
Magazine Web site. Accessed at
http://www.massagemag.com/Magazine/2002/issue100/history100.php on June
2, 2008.
Cassileth B, Vickers AJ. Massage therapy for symptom control:
outcome study at a major cancer center. J Pain Symptom Manage.
2004; 28:244-249.
Corley MC, Ferriter J, Zeh J, Gifford C. Physiological and
psychological effects of back rubs. Appl Nurs Res.
1995;8:39-42.
Deng G, Cassileth BR. Integrative oncology: complementary
therapies for pain, anxiety, and mood disturbance. CA Cancer J Clin.
2005;55:109-116.
Fellowes D, Barnes K, Wilkinson S. Aromatherapy and massage
for symptom relief in patients with cancer. Cochrane Database Syst Rev.
2004;(2):CD002287.
Hernandez-Reif M, Ironson G, et al. Breast cancer patients
have improved immune and neuroedocrine functions following massage
therapy. J Psychoso Res.
2004;57:45-52.
Manipulation & body-based methods: massage &
related bodywork. Complementary/Integrative Medicine Education
Resources, The University of Texas M.D. Anderson Cancer Center Web
site. Accessed at
http://www.mdanderson.org/departments/CIMER/display.cfm?id=254B81AA-6D52-42D3-94DDF74AC23EFEC4&method=displayFull
on June 20, 2008.
Manipulative and body-based practices: an overview. National
Center for Complementary and Alternative Medicine Web site. Accessed at
http://nccam.nih.gov/health/backgrounds/manipulative.htm on June 13,
2007.
Massage therapy as CAM. National Center for Complementary and
Alternative Medicine Web site. Accessed at
http://nccam.nih.gov/health/massage/ on December 9, 2006.
Occupational Outlook Handbook, 2006–07 Edition.
Massage therapists. US Department of Labor, Bureau of Labor Statistics
Web site. Accessed at http://www.bls.gov/oco/ocos295.htm on April 2,
2007.
Post-White J, Kinney ME, Savik KS, Gau JB, Wilcox C, Lerner I.
Therapeutic massage and healing touch improve symptoms in cancer. Integr Cancer Ther.
2003;2:332-344.
Rosser RJ. Sentinel lymph nodes and postinjection massage: It
is premature to reject caution. J
Am Coll Surg. 2001;193:338-339.
Smith MC, Kemp J, Hemphill, Vojir CP. Outcomes of therapeutic
massage for hospitalized cancer patients. J Nurs Scholarsh.
2002;34:257-262.
Weinrich SP, Weinrich MC. The effect of massage on pain in
cancer patients. Appl
Nurs Res. 1990;3:140-145.
Note:
This
information may not cover all possible claims, uses, actions,
precautions, side effects or interactions. It is not intended as
medical advice, and should not be relied upon as a substitute for
consultation with your doctor, who is familiar with your medical
situation.
Last Medical Review: 11/01/2008
Last Revised: 11/01/2008
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