A study of the effects of massage therapy on HIV patients found that those who received a massage five times a week for one month had higher numbers of natural killer (NK) cells, which were also more potent. They also had less anxiety and lower serotonin (stress hormone) levels.13
A third study involved giving massage therapy to fifty-two hospitalized depressed and adjustment disordered children and adolescents. A separate comparison group viewed relaxation videotapes. Those receiving the massage therapy were less depressed and anxious and had lower saliva cortisol levels, which is an indicator of less depression.14
Following is a list of other applications of massage therapy currently being studied at TRI:
- Newborns of cocaine-addicted mothers
- HlV-exposed newborns
- Infants of depressed mothers
- Infant colic
- Infant sleep disorders
- Infants with cancer
- Preschool children
- Neglected children
- Abused children
- Autistic children
- Posttraumatic stress disorder after Hurricane Andrew
- Pediatric skin disorders
- Juvenile rheumatoid arthritis
- Depressed teenage mothers
- Teenage mothers' childbirth labor
- Eating disorders
- Job performance/stress
- HIV and improved immune function
- Spinal cord injuries
- Fibromyalgia syndrome
- Rape and spouse abuse
- Couples' sex therapy
- Volunteer foster grandparents
- Chronic fatigue syndrome
Little research has been conducted on the various forms of bodywork. One exception is Rolfing, for which several studies have found interesting effects.
In one controlled study, forty-eight participants were randomly assigned to either the experimental group (Rolfing) or a control group (no Rolfing). A significant decrease in anxiety was found in those who received the treatment over a five-week period. The researchers explained these findings in terms of the theory that the Rolfing caused a release of emotional tension that had been stored up in the muscles, which in turn resulted in lower anxiety scores on a psychological test of state anxiety.15
Other studies of Rolfing have found improvements in muscular efficiency,16 reductions in anxiety,17 decrease in pelvic tilt, and increase in vagal tone (amplitude of respiratory sinus arrhythmia, a heart rate function that corresponds with reduced stress in the body).18
Strengths and Limitations
Massage therapy and bodywork obviously have a very broad, diverse range of applications. Essentially, they can support any health condition that would benefit from greater blood circulation and the release of tension. Psychological conditions also are affected beneficially, as the physiological changes that occur with these kinds of intervention help harmonize and rebalance the nervous and hormonal systems.
There is great potential in using massage to reduce cumulative traumatic disorders in the workplace. For example, chicken cutters in chicken processing plants often develop carpal tunnel problems. Several companies in the chicken processing industry in Virginia have developed worksite massage programs that have shown impressive reductions in these problems. The most frequently used techniques include cross-fiber, deep tissue, and Swedish, concentrated on those muscle groups that are chronically stressed in the work (hands, arms, shoulders, and back). The programs also teach self-massage techniques and the results include better morale and reduced absenteeism.
Contraindications to massage or bodywork are few and may include transmittable skin diseases, unhealed wounds, postoperative conditions, and blood clots. In many cases, of course, such therapy can avoid problem areas in the body, assuming the practitioner is aware of the condition.
Many people wonder about whether massage or bodywork could cause a cancer to metastasize. According to Elliot Greene, "This is an area where research is needed to define the risk. Practitioners are generally taught to err on the side of conservatism. For example, massage is not recommended for someone immediately after chemotherapy or radiation treatment.
"Physiologically, it is not easy to metastasize a tumor from simple pressure and studies have shown that the body has a number of layers of defenses to prevent that from happening simply from touch. It is known, however, that certain kinds of chemotherapies in particular make the tissue fragile for a couple of days and massage immediately after such therapies might irritate the tissues. If there was any danger of metastasizing, it would be more likely to happen closer to the treatment. A conservative response would be to use much lighter forms of massage."19
In fact, massage therapy is increasingly being incorporated into complementary cancer therapy programs. At the Cancer Support and Education Center in Menlo Park, California, it has been an integral part of a program that resulted in significant improvement in quality of life, even for patients with metastatic disease.20
The ability of massage to reduce anxiety, depression, and stress is a logical counter to the strain a cancer patient must deal with in facing a life-threatening condition and traumatic treatment.
The Practitioner/Patient Relationship
Hands-on therapies naturally foster a kind of intimacy between the practitioner and patient. In many of the approaches, the recipient partially or fully disrobes and lies on a table (though they are draped with a sheet and are never fully exposed), which further contributes to the intimacy and vulnerability that may be felt when using this tradition. Normal boundaries of social interaction are crossed. Hence there is a special need for sensitivity and regard for the client on the part of the practitioner that matches and perhaps even exceeds that of many doctor-patient relationships.
There is a wide range of attitudes among practitioners about how they view their role. Some think of themselves as healers or therapists, working with the whole person through the body. Certain approaches (e.g., the Rosen Method) are explicitly focused on engaging the person on the emotional level and working with emotional issues in the context of the body with subtle verbal suggestions. Others may take a more mechanistic approach toward working with the body. They may not wish to engage the client on the emotional level at all but rather concentrate on physical techniques. Some see themselves as facilitators, some as educators.
There is wide variation among practitioners, even within the specific approaches, as to how much verbal exchange takes place and the degree to which the practitioner is available for emotional or psychological support. Finally, some approaches require a series of sessions over a period of time (e.g., Rolfing, Hellerwork), which naturally fosters a therapeutic relationship and requires communication, instruction, and feedback. On the other hand, many European or Western forms of massage are complete in themselves as one session and do not really require any communication between practitioner and client. It is not unusual to experience an entire massage without a word being spoken.
A Doctor's Story
A patient was brought to our intensive care unit from another hospital emergency room, where he had been given a hundred milligrams of Thorazine (an antipsychotic drug) intramuscularly. Thorazine has a faster and greater effect when injected than when taken orally, but it also has a greater chance of lowering the blood pressure. This man had been given a very high dosage—and they hadn't noticed that he was drunk. You never mix alcohol and major antipsychotics because they are additive in effect.
When the patient arrived, the medication was just taking effect. He went under before the eyes of the admitting personnel, becoming less responsive and groggy, then turning gray. When I arrived, the pulse was so weak that I couldn't feel it and the blood pressure was 40/0, which indicates a coronary arrest with the imminent danger of croaking. By the time we got him into a room, he was totally unresponsive and just whitish gray, like a person looks just before dying due to lack of oxygen.
I put my knuckle into his sternum and dug in hard to elicit a pain reflex and stimulate adrenaline release, which sometimes can revive a person. Nothing. I didn't have the necessary medical equipment to do some of the things that Western medicine can do because this was a psychiatric unit. Here I was, looking at a guy who was going to have a cardiac arrest at any moment. I could stand by and watch him die or I could do something—anything. I suddenly remembered . . . a primary revival point and the most important one for loss of consciousness. So I pulled the patient's shoes off and, without explaining to the nurses what I was doing, proceeded to put my thumbs almost through his feet at these points.
It took about two minutes, three at the most. He started moving around a bit at first and then moaning a little. By the end of those few minutes, he had sat up in his chair and was talking to us. He had a strong pulse and a blood pressure of 90/40. There was an amazed look on the nurses' faces as they asked what I had done. I said I had worked with the acupressure points to mobilize reserve energy. I don't know if that made any sense to them, but they were amazed and happy that the patient was alive. Meanwhile, by the way, a priority code ambulance—with sirens and lights and the whole bit—was on its way to pick up a supposedly dying patient.21
Evaluating Personal Results
The subjective experience of the client is generally the most important way of evaluating personal results. However, sometimes the change process naturally causes temporary discomfort, which needs to be accepted, so that expectations of feeling good may not always be appropriate.
Practitioners of the various methods can often also give the client feedback based on what they feel through their hands and what they see with their eyes.
Some modalities, particularly those of structural/functional/movement integration, use visual feedback in the form of having clients look at themselves in mirrors or even taking "before and after" photographs. The photographic record is particularly common in Rolfing and Hellerwork as a way of following progress over time.
Some of the movement integration therapies also use videotape to help observe changes in function, posture, and range of motion.
Relationship to Other Forms of Medicine
These modalities tend to be highly complementary to all other medical traditions. They can enhance the effectiveness of other forms of treatment by inducing relaxation, promoting circulation, and their other common benefits. They can also help patients tolerate more invasive approaches and handle the side effects of other treatments.
About The Author
William Collinge, PhD, MPH is a consultant, author, speaker and researcher in the field of integrative health care. He has served as a scientific review panelist for the National Institutes of Health in mind/body medicine, complementary therapies, and health care services; and for the Congressionally Directed Medical Research Programs on breast cancer, prostate cancer, and......more