Research has revealed a lot about massage. Up until the mid-1980s, we had some ideas about what was happening under our hands, and we made best guesses based on tradition and observations about how to do our work safely. Mostly we did a good job at this, but we made some mistakes too.

As interest in this low-risk and highly popular intervention began to climb, the practice of massage got more attention from the research field. As a result, we discovered that some of the assumptions we made about our work were not accurate. This doesn’t mean massage isn’t effective, but now we can gather reliable information about how and for whom massage can be most helpful.
Research has allowed practitioners to target their skills. And because we can now test some of the traditional “common wisdom” about massage, we can abandon some of the myths we used to believe—and that still show up in some places that have not updated their information. For instance, research does not support the idea that massage “flushes toxins.” It is a fine idea, but not crucial, to drink water after your session. And we used to think that massage was dangerous for cancer patients, but research shows that skilled massage offers many benefits for this population. These and many more discoveries have changed the way we think about and use massage therapy.

Massage Benefits for Healthy People

Wellness, Relaxation, Revitalization, Improved Immune System Function

While most research is conducted in the context of illnesses or conditions, some studies have looked at bodywork for healthy people and concluded that massage therapy for wellness or for stress relief is consistently effective in a variety of ways. Even a simple hand massage appears to move healthy people into a relaxed state.1 A comparison of traditional Swedish massage and Thai massage found that Swedish massage produced stronger relaxation responses and improved sleep, while Thai massage led to a sense of energy and revitalization.2 Improvements in immune system function, along with reductions in stress-related hormones, have been found as well.3 More specific effects of massage for stress are covered in the context of some of the conditions listed below.

Massage Benefits for Athletes

Improved Strength, Speedy Recovery—Maybe

The research about massage for athletes is not always consistent; it seems to depend a lot on the sport in question and the type of athlete being studied. In general, massage appears to be a better choice after an event than before it.4 One study found that massage may improve strength in muscles damaged by overuse;5 another suggests that people who receive massage feel they recover from overexertion more quickly, so they can return to training sooner.6 A systematic review of several studies found that immune system recovery is supported by postexercise massage.7
All this said, it is important to point out that some studies have not found that massage therapy is effective in aiding athletic performance or speeding healing after exertion, so there is more to be discovered about this question.

Massage Benefits for People with Musculoskeletal Injuries

Noninvasive Options, Long-Lasting Results

Muscular aches and pains drive many clients to seek massage. Here is a synopsis of what the most current research says about this intervention:
Muscle and tendon injuries. Muscle and tendon injuries are usually related to overuse. Research has revealed that when these injuries persist, traditional anti-inflammatories are not effective, and physicians are encouraged to explore noninvasive options before recommending surgical repair. Fortunately, these injuries often respond well to manual therapies. Studies of tendon injuries in a violinist8 at the elbow,9 Achilles tendon,10 and knee11 show that skilled massage therapy can be a helpful contributor to successful muscle and tendon recovery.
Sprains. Sprains (torn ligaments) often respond well to massage therapy along with some movement therapy. Research has shown that stimulating nerves in the area of sprains can improve balance and stability, especially around the ankle.12
Plantar fasciitis. Many physicians recommend massage therapy, especially to the muscles of the lower leg, as part of treatment for plantar fasciitis.13 However, relatively little research has been done on this topic. One study compared massage and exercise to ultrasound and exercise, and found that massage led to longer-lasting relief for the participants,14 and a small systematic review found support for soft tissue mobilization to help patients with plantar fasciitis.15
Carpal tunnel syndrome (CTS). A systematic review combining findings from dozens of studies found that massage therapy was helpful for CTS symptoms.16 This supports similar conclusions of studies that found patients with CTS who received massage had significant decreases in symptom severity and improvements in strength and function of their hands and wrists—especially in comparison with other interventions.17

Massage Benefits for People with Cancer

Pain Relief, Less Anxiety, Better Sleep, and Much More

We used to think that because many types of massage claim to boost circulation (this is not strongly supported by research, by the way), and because cancer uses the blood and lymphatic systems to spread (it does, but it is an extremely complicated and multifactorial process), then massage therapy must be dangerous for any and all cancer patients. Research has revealed that carefully applied, highly skilled massage therapy for people with cancer may offer many benefits, including:
• Improved sleep, reduced fatigue18
• Reduced stress, anxiety, and depression19
• Less nausea and constipation20
• Improved immune system function21
• Improved quality of life22
The benefits of massage therapy are so well demonstrated in the research that massage and manual lymphatic drainage are recommended in clinical practice guidelines, specifically for women in treatment for breast cancer.23

Massage Benefits for People with Acute and Chronic Pain

A Safe and Effective Option

Massage therapy for pain in general has a strong evidence base, led by a massive systematic review comprising nearly 70 studies that found it compares well with several other interventions for pain and restored function, and that it has the added benefit of having a low risk of adverse events.24 Another systematic review found evidence in favor of massage, along with several other nonpharmacologic interventions, for chronic noncancer pain.25
Back and neck pain. The American College of Physicians recommends massage as an early option for acute and subacute low-back pain.26 This is supported by evidence in favor of massage alone, or massage plus exercise for back pain.27 Craniosacral therapy has also been seen to be helpful for chronic, uncomplicated low-back pain.28 And a systematic review of nonpharmacologic therapies for low-back pain recommends massage among other interventions.29
Similarly, manual therapy has robust evidence for clients with neck pain in a variety of settings, so it is often included in clinical practice guidelines for managing neck pain.30
Pain related to fibromyalgia. Research supports massage therapy for fibromyalgia, specifically for pain, anxiety, quality of life, and sleep.31 The best results were seen with long-term treatments, so this suggests that people with fibromyalgia commit to several weeks of regular massage to derive the most benefit.32
Headaches. Headaches, especially tension-type headaches and those related to neck pain and trigger points, appear to respond well to massage therapy. Researchers found that patients experienced lower levels of pain and reduced frequency.33 All these findings support a systematic review that found massage can be as effective as pharmacological interventions for tension-type headaches.34 Massage therapy is so consistently helpful that it is recommended in clinical guidelines for headache care.35
Pain in the context of opioids. Because massage therapy is demonstrably effective for many kinds of pain, and because it is a comparatively low-risk treatment option, it is generating a lot of interest in the context of reducing the need for opioid drugs. Several policy-making organizations, including The Joint Commission, The US Department of Health and Human Services, and the American Society of Interventional Pain Physicians, have published strategies that could include massage therapy as a part of pain management to reduce reliance on opioid drugs.36

Massage therapy research is an exciting field that helps the profession evolve and grow. There is so much more for us to learn and discover.

Editor’s note: This is a selection of excerpts from a much larger piece on the benefits of massage as demonstrated by research. If you work with a client population that is not included here or want to dive deeper into the research on the benefits of massage, be sure to read more in an upcoming issue of ABMP’s digital-only, consumer education magazine Body Sense. It will also be available online at www.massagetherapy.com.
Sources and citations for this research noted here will be available in the digital edition of this issue at www.massageandbodyworkdigital.com.

Author’s note: This content is offered as an evidence-informed summary of what we generally understand are some of the benefits of massage therapy. It is not an exhaustive literature review, which requires a different level of analysis of the cited studies.