Research is finding real benefits from the ancient therapy of skillful touch.

If that crick in your neck won’t go away or you’ve thrown your back out again, you’ve probably thought of getting a massage. You know from experience what a relief a quick back rub from a friend or partner can be for sore muscles, especially at the end of a long day.

But what if your medical problems are more serious than a simple muscle kink? Should you seek out a massage to ease the stress from your company’s downsizing? Would a massage improve your anorexic daughter’s body image, or help your premature infant to gain weight? Could it ease an asthmatic’s breathing difficulties, help an insomniac sleep, or improve an HIV patient’s immune function?

The answer to these questions appears to be an enthusiastic yes. Spurred by anecdotal evidence, recent scientific studies of massage therapy are finding real benefits from the power of touch, which is taking its place alongside a host of alternative medicines.

The Hippocratic Rub?
Massage, a systematic manual application of pressure and movement to soft tissue, has a very long history. Rubdowns were considered a valuable medical tool as far back as the 5th century BC. The Greek physician Hippocrates wrote at the time that his colleagues should be well experienced “in rubbing . . . for rubbing can bind a joint that is too loose, and loosen a joint that is too rigid.”

Farther back on the evolutionary tree, chimpanzees, which share roughly 99.5% of the same DNA with humans, spend up to half their waking hours clustered in groups grooming each other. Mothers bond with their babies and adults form lasting attachments with each other through hours of massaging skin, picking fur, and scratching backs.

Laboratory animals that are touch-deprived have decreased levels of growth hormone and higher levels of stress hormones. Restoring touch, even by stroking the animals with a wet paintbrush, normalizes those animals’ hormone levels.

But in our own modern “rat race”society, have we humans lost the need for touch? Not at all, according to pediatric psychologist Tiffany Field of the Touch Research Institute. Field, who does most of her research at the University of Miami, says humans can suffer health setbacks without touch and gain health benefits with touch. Her studies show that, in addition to relieving a sore back, massage can relieve anxiety, depression, tension, and stress; help with headache, chronic pain, and digestive disorders; and encourage healing of almost any area in the body by promoting the flow of blood and lymphatic fluids, stimulating nerves, and loosening muscles and connective tissue to keep them elastic.

Some of Field’s most dramatic findings have been among children. In a landmark study of premature infants, her team showed that preemies given a 15-minute massage three times a day for 10 days while they were still in an incubator gained 47% more weight and were hospitalized for six fewer days than babies who weren’t massaged (1). Another study performed by Field’s group and published in 1998 showed that asthmatic children who were given a daily 20-minute bedtime massage had fewer asthma attacks and had better peak airflow than children who weren’t massaged (2). The benefits also extended in this case to the massage-givers: If the nightly rubdowns were performed by the parents, Field found that they suffered less anxiety over their children’s health.

Other researchers are finding that many seemingly dissimilar conditions can be improved through massage. From constipation to carpal tunnel syndrome, sports injuries to stress, and anorexia to arthritis, many human ills have been shown to improve with human touch.

Styles: Swedish et al.
The simple backrub has proliferated in recent years to hundreds of different massage styles. These days, massage therapy can encompass anything from an on-the-job chair massage at the workplace to being stroked with hot stones at an upscale spa. So, how do you know which massage style is best for you?

Most styles used in the United States are a variation on the Swedish technique developed in the late 19th century by Per Henrik Ling, a Swedish gymnast. A Swedish massage involves slow, rhythmic, gliding strokes on the skin, usually in the direction of the heart (for example, from wrist to shoulder). There’s also a good bit of kneading and rolling of muscle groups, and steady friction against the skin. Sometimes, therapists will drum against broad areas of the back with their hands or quickly jostle select muscle groups for a brief period of time. These techniques generally require the use of lotions or oils to prevent discomfort or skin irritation. Many practitioners prefer aromatic essential oils; according to their proponents, different oils can have additional therapeutic effects on the person being massaged. For example, citrus oil is reputed to flush out toxins, sandalwood to ease stress.

Deep-tissue massages use Swedish techniques, but with more pressure on the muscles and connective tissue to release chronic patterns of tension. Sports massages target specific muscle groups that are relevant to a subject’s particular sport.

Some massage techniques rely on ancient medical theories such as traditional Chinese medicine. For example, Shiatsu (“finger pressure”) massage was developed in Japan from Chinese roots. Thai massage has more religious overtones, having been developed by Buddhist monks in ancient Siam. Both involve pressing and stretching along special points of the body’s “meridians”, or invisible channels of energy. In acupressure massage, a technique like acupuncture without the needles, a therapist also presses points on the body thought to influence certain types of disease.

Getting to It
Unless you live in a very small town, choosing the right massage therapist out of the vast array of different providers can be a challenge. How do you choose the best therapist for you?

In 30 states and the District of Columbia, massage therapy is treated as a certified medical specialty, much like chiropractic care. Therapists are required to spend up to 500 hours in classroom training and take written and performance tests.

Some health insurance plans now cover massage as a physical therapy; depending on your plan, a recommendation for a certified therapist could be obtained from your primary care physician or directly from your insurance company. If massage is not covered in your insurance plan, finding a therapist might be solely up to you. Ask a friend for recommendations or visit the American Massage Therapy Association (AMTA) website (www.amtamassage.org). The AMTA is one of the largest massage therapy professional organizations in North America.

If insurance doesn’t cover the therapy and you’re paying for sessions yourself, be aware of prices. Depending on where you live, an hour-long session can cost as little as $30 and as much as $150. Practitioners in wealthier areas of the country, as well as resorts, usually charge more than those in a neighborhood or small-town spa. Gratuities are customary and are usually 10–20%.

Although most forms of therapeutic massage are best performed with the subject wearing little or no clothing, the experience is not meant to be sensual. If you are nervous about nudity, you should probably choose a style that can be done with a clothed subject, such as shiatsu. Many spas separate therapists and clients according to gender, but many others do not. If you will feel more comfortable with a therapist of your own sex, make sure you request that when you make an appointment.

Keep an open dialogue during your session—if you feel your therapist is pressing too hard or not hard enough, let him or her know. Try to avoid too much conversation, however. You’ll get the most benefit if you concentrate on the soothing sensations of your therapist’s touch.

Massage therapy shouldn’t be used in some cases—in theory, for example, massage can cause some cancer tumors to metastasize or could damage an inflamed area. Also, alert your therapist to any known allergies to oils, especially nut oils, some of which are used as lubricants during therapy. Ask your doctor if you are in doubt about having massage therapy, and keep in mind that massage isn’t capable of curing a serious condition; it should be used as a complementary therapy only.

But once you go for it, relax and enjoy your session!

References

1. Field et al. Pediatrics 1986, 77 (5), 654–658.
2. Field et al. J. Pediatrics 1998, 132 (5), 854–858.

Christen L. Brownlee is an associate editor of Today’s Chemist at Work. Send your comments or questions regarding this article to tcaw@acs.org or the Editorial Office, 1155 16th St N.W., Washington, DC 20036.