Natural Therapies & Massage

This section contains articles (from research, professional associations and others) about Natural Therapies.

 

Evidence Based Massage:   Low Back Pain  -  How your local Remedial Massage Therapist fits into the primary care paradigm

Article from Rebecca Barnett, Secretary, Association of Massage Therapists

Many recent studies demonstrate the efficacy of Remedial Massage Therapy in the treatment of chronic and sub-acute Low Back Pain (LBP).

In 2002, the Cochrane Collaboration published a review of massage with the objective of assessing the effects of massage therapy for non-specific LBP.1 Eight randomised trials were featured. The authors concluded that massage therapy appeared to be beneficial for patients with subacute and chronic non-specific LBP, especially when the treatment was combined with exercises and education, and delivered by a qualified Massage Therapist. The results of one high quality study showed that the benefits of Massage Therapy last as long as one year following the end of active treatment.2

In summarising the implications for practice, the authors of the Cochrane Review made the following observation: "Massage is beneficial for patients with subacute and chronic non-specific LBP in terms of improving symptoms and function. Massage therapy is costly, but it may save money in health care provider visits, pain medications and costs of back care services." 3

In a separate review comparing the effectiveness, safety and cost of acupuncture, massage therapy and spinal manipulation for back pain, researchers concluded that the preliminary evidence suggests that massage therapy, but not acupuncture or spinal manipulation, may reduce the costs of care after an initial course of therapy.4      This conclusion was based on analysis of 49 randomised, controlled trials.

Remedial Massage Therapy can be utilised as part of a multi-disciplinary approach to non-specific LBP and also as an effective standalone therapy where the precise soft tissue mechanisms and etiology are known. One frequent cause of LBP is the presence of active myofascial trigger points (TrPs) in the quadratus lumborum, multifidi, gluteus medius and psoas major muscles.5

Remedial Massage Therapists are trained to assess and treat TrPs using a variety of manual techniques, as well as addressing restrictions and shortening in the myofascia. Given the prevalence of connective tissue induration in muscle fibre, particularly in the lower multifidus triangle, the effect of soft tissue mobilisation in prevention and rehabilitation of LBP is significant.6       Your local Remedial Massage Therapist can work closely with the primary care team to ensure best practice outcomes for the low back pain patient.

1 Furlan AD, Brosseau L, Imamura M, Irvin E "Massage for low back pain". Cochrane Database Syst Rev 2002: CD001929    2 Cherkin DC, Eisenberg D, Sherman KJ, Barlow W, Kaptchuk TJ, Street J, et al. "Randomized trial comparing traditional Chinese medical acupuncture, therapeutic massage, and self-care education for chronic low back pain", Archives of Internal Medicine,  2001;161:1081–8.      3 Furlan et al 4 Cherkin DC, Sherman KJ, Deyo RA, Shekelle PG. (2002) "A review of the evidence for the effectiveness,safety, and cost of acupuncture, massage therapy, and spinal manipulation for back pain", Annals of Internal Medicine, 2003;138(11):898-906    5 Travell JG, Simons DG Myofascial Pain and Dysfunction: The TriggerPoint Manual. volume 2- the lower extremities Lippincott Williams Wilkins; 23-131 & 150-167    6 Williams, PE, Katanese, T, Lucey, EG and Goldspink, G, "The importance of stretch and contractile activity in the prevention of connective tissue accumulation in

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Evidence Based Massage:  Cancer    -    How your local Massage Therapist fits into the primary care paradigm

An article by Rebecca Barnett, Secretary, Association of Massage Therapists

Until relatively recently, common wisdom held that Massage Therapy was contraindicated for patients with cancer due to its circulatory enhancing effects. However, current studies have demonstrated substantial symptom relief and immune system benefits from massage.

The Memorial Sloan-Kettering Cancer Center in New York undertook a large and significant study. Over a 3-year period, 1290 cancer patients were treated with either Swedish Massage or foot massage. Symptom scores were reduced by approximately 50%, even for patients reporting high baseline scores. Outpatients of the Center improved about 10% more than inpatients.1     Outcomes from Swedish Massage were superior to those from foot massage.

The researchers concluded that massage therapy achieves major reductions in cancer patients’ pain, fatigue, nausea, anxiety and depression, and that Massage Therapy appears to be a non-invasive and inexpensive means of symptom control for patients with serious chronic illness.

In another study investigating immune and neuroendocrine function, 34 Stage 1 and 2 breast cancer patients were randomly assigned to either a massage group or a control group. The immediate massage therapy effects included reduced anxiety, depressed mood and anger. The longer-term massage effects included reduced depression and hostility, and increased urinary dopamine, serotonin values, NK cell number, and lymphocytes.2

The efficacy of Manual Lymphatic Drainage (MLD) in the treatment of lymphoedema is well documented. In one recent case study, researchers measured the effect of MLD on 3 lymphoedema patients and demonstrated a significant clinical effect on the total fluid levels in the massaged and affected lymphoedematous limbs. They also recorded a softening of the tissues of all of the major lymphatic territories.3

A recent meta-analysis encompassing 27 clinical trials of massage and meditation also suggests that there is substantial benefit in incorporating massage into the palliative care model. Results from 26 of the 27 trials showed significant improvements in symptoms such as anxiety, emotionaldistress, comfort, nausea and pain.4     Although variations in methodology raised some questions about the clinical significance of this review, the principal finding was that the trials of massage exhibited substantial benefit for the end-of-life patient.

Your local Massage Therapist can work in close co-operation with the primary care team to reduce the symptoms and distress associated with cancer. The emerging evidence suggests a pivotal role for the Massage Therapist in the management of both the physical and psychological effects of serious, life threatening illnesses.

1 B. Cassilethand A. Vickers, "Massage Therapy for Symptom Control: Outcome Study at a Major Cancer Center", Journal of Pain and SymptomManagement, Vol. 28 No. 3 September 2004 2 M. Hernandez-Reif, G. Ironson, T. Field, J. Hurley, G. Katz, M. Diegoa, S. Weiss, M. Fletcher, S. Schanberg, C. Kuhn, I. Burman, "Breast cancer patients have improved immune and neuroendocrine functions following massage therapy", Journal of Psychosomatic Research 57 (2004) 45–52 3 R. Harris, N. Piller, "Three case studies indicating the effectiveness of manual lymph drainage on patients with primary and secondary lymphoedema using objective measuring tools", Journal of Bodywork and Movement Therapies (2003) 7(4), 213-221 4 W. Lafferty, L. Downey, R. McCarty, L. Standish, D. Patrick, "Evaluating CAM treatment at the end of life: A review of clinical trials for massage and meditation", Complementary Therapies in Medicine (2006) 14, 100