Massage

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Category: Complementary and Alternative Therapies

What is it?

Therapeutic massage is the holistic application of touch to affect the systems of the body including the muscular, skeletal, digestive, elimination, respiratory, circulatory, lymphatic, endocrine, emotional, mental and nervous systems. It involves manipulation of the soft tissues of the body with the hands for therapeutic, healing, and relaxing purposes.

How does it work?

Therapeutic massage can ease tension and reduce pain. Stress can cause constant muscular tension. This tension or tightness reduces the flow of blood and oxygen to the muscles and organs and also restricts nerve & lymph supply. This can lead to a buildup of toxins in the body which can lead to symptomatic feelings of fatigue, heaviness, aches and pains, tightness of muscles and stiffness. It is often applied through techniques such as rubbing or kneading the body part, usually with the hands, to stimulate circulation and make muscles or joints supple and relieve tension.

Is it effective?

Massage has been shown to reduce ‘stress hormones’ such as cortisol help the body release ‘happy hormones’ such as serotonin and dopamine. It has been shown to be effective in the treatment of anxiety and depression in cancer patients. However the use of massage for the treatment of PTSD has not been research adequately to give an effective measure.

Are there any disadvantages?

Most massage techniques have a low risk of adverse effects. If you have other underlying health issues massage may not be suitable. Generally, massage should be avoided if you suffer from congestive heart failure, kidney failure, infection of the superficial veins (called phlebitis) or soft tissue (called cellulitis) in the legs or elsewhere, blood clots in the legs, bleeding disorders, or contagious skin conditions. If you have cancer, you must check with your doctor before considering massage because you should not receive such treatments under certain circumstances. People with rheumatoid arthritis, a goiter (a thyroid disorder characterized by an enlarged thyroid), eczema and other skin lesions should not receive massage therapy during flare-ups. Experts also advise that people with osteoporosis, high fever, few platelets or white blood cells, and mental impairment, as well as those recovering from surgery may be better off avoiding massage.

Massage obviously involves close physical contact. To minimise the risks of unprofessional behaviour in this situation, patients should ensure that practitioners are registered with an appropriate regulatory body.

Where do you get it?

Massage Therapists are listed in the Yellow Pages. Other professionals such as Physiotherapists and Chiropractors may use massage as a component of their treatment. Qualified Massage Therapists should belong to a relevant professional association. While these strategies are pursued, it is also important that the person with PTSD is under the care of a certified health professional.

What are the evidence limitations?

There is currently no explicit evidence to support massage as an independent intervention for PTSD. Much of the evidence base is derived from lower levels of evidence such as expert opinion and clinical experiences. Therefore interpreting this evidence should be undertaken with caution.

Recommendations

Based on the current lack of high quality evidence, the use of massage for PTSD cannot be recommended based on the current research evidence. More research is required. It may be considered as an adjunct to other PTSD interventions, such as psychological and drug therapies.

Key References

Australian Centre for Posttraumatic Mental Health 2007, 'Australian guidelines for the treatment of adults with Acute Stress Disorder and Posttraumatic Stress Disorder. Practitioner Guide' National Health and Medical research Council, viewed 11 December 2008,.

Field, T, Hernandz-Reif, M, Schanberg, S & Kuhn, C 2005, 'Cortisol decreases and serotonin and dopamine increase following massage therapy', International Journal of Neuroscience, vol. 115, no. 101, pp. 1397-1413

Wilkinson, SM, Love, SB, Westcombe, AM, Gambles, MA, Burgess, CC, Cargill, A, Young, T, Maher, EJ & Ramirez, AJ 2007, 'Effectiveness of Aromatherapy Massage in the Management of Anxiety and Depression in Patients With Cancer: A Multicenter Randomized Controlled Trial', Journal of Clinical Oncology, Vol. 25, no. 5, pp. 532-539.

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