Massage therapy has been used in many forms for centuries to treat musculoskeletal pain. In our current society, neck pain is the second-most common complaint treated by most forms of complementary therapists.
However, despite masses of anecdotal evidence, research has failed to demonstrate the efficacy of massage therapy when it comes to treating such conditions. The reason given for this lack of supporting evidence will often depend on who you talk to.
Those who do not support massage as a viable treatment option will argue that the research doesn't lie and massage has no long-lasting beneficial effects. On the other hand, massage therapists will argue the lack of good quality research and their firsthand experiences of the wide and varied benefits.
So, who is right? Well, a new piece of research could answer the question once and for all.
The latest research
Previous articles, published in 2009 and 2011, demonstrated mild benefits of massage for both neck and lower back pain. But following this, a Cochrane review published in 2012 failed to draw any conclusions due to the large variation in type of massage used, treatment frequency and duration and a lack of long-term follow-up data.
The most recent piece of research to weigh in on the debate was published in the Annals of Family Medicine. Karen Sherman and her colleagues, who have been studying the effects of massage therapy for some time, led the study.
In order to answer some of the questions raised in the Cochrane review, Sherman and her group of researchers designed a study to compare the duration and frequency of massage therapy, in a bid to find the ideal "dosage." The study split 228 participants with chronic nonspecific neck pain into six groups.
Two groups received 30-minute massage treatments either once or twice a week for four weeks. Three groups received 60-minute massage treatments once, twice or three times a week, also for four weeks. The final group was a control group that received no treatment during the four-week period. Assessment of neck disability and pain scales were taken at baseline and at five weeks.
The results showed that those receiving 30-minute massage treatments (either once or twice a week) did not show a significant improvement compared with those in the control group. In contrast, those receiving multiple 60-minute treatments a week demonstrated a considerable improvement in both dysfunction and pain scales when compared to the control group.
The authors believe that multiple, longer treatment sessions are effective in treating neck-pain conditions and recommend that both massage therapists and further research studies should ensure that patients receive a higher dose, which is more likely to produce results.
Controversy prevails
While this piece of research does demonstrate that high doses of massage therapy can be effective in improving symptoms of chronic neck pain conditions, there will still be many cynics and rightly so.
The reason for this is twofold. Firstly, there is still a lack of long-term follow-up data to show that any improvements can be sustained. In my 10 years of experience as a massage therapist, when massage is used alone, the short-term benefits are often not transferred into the long term.
For me, the reason for this is that improving muscular condition in most cases does not solve the underlying issue that caused the muscular pain in the first place. Problems such as poor posture, muscle imbalance, spinal misalignment, facet joint disease, disc herniation and spinal stenosis amongst others may all be to blame for the increased muscle tension, fascial restrictions and trigger points that so often develop in the neck musculature and increase symptoms considerably.
And so, while massage therapy may help to relieve these problems in the short term, invariably they will only return once treatment ceases, until the definitive cause is addressed. For this reason, massage should be used in conjunction with other forms of treatment (such as exercise rehabilitation, manipulation, etc.) in order to get the best results and not as a standalone therapy.
The second issue is one of affordability and availability. This study states that in order to see considerable improvements, massage therapy should be of a longer duration and applied more frequently than in previous research. While this is fantastic news for the massage therapist, it comes at a cost to the patient or healthcare provider. Few people can afford to shell out for such regular and lengthy appointments on a private basis.
One step forward
While the latest research is beneficial and can be used to support the use of regular massage therapy, it also raises further questions and demonstrates the need for further investigation into the long-term effects and the use of combined treatment methods. The need for public and private healthcare companies to offer such treatment is a debate for another day.
