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Massage Therapy: An Introduction

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Massage therapy has a long history in cultures around the world. Today, people use many different types of massage therapy for a variety of health-related purposes. In the United States, massage therapy is often considered part of complementary and alternative medicine (CAM), although it does have some conventional uses. This fact sheet provides a general overview of massage therapy and suggests sources for additional information.

seated massage
© Bob Stockfield

Key Points

History of Massage

Massage therapy dates back thousands of years. References to massage appear in writings from ancient China, Japan, India, Arabic nations, Egypt, Greece (Hippocrates defined medicine as "the art of rubbing"), and Rome.

Massage became widely used in Europe during the Renaissance. In the 1850s, two American physicians who had studied in Sweden introduced massage therapy in the United States, where it became popular and was promoted for a variety of health purposes. With scientific and technological advances in medical treatment during the 1930s and 1940s, massage fell out of favor in the United States. Interest in massage revived in the 1970s, especially among athletes.

Use of Massage Therapy in the United States

According to the 2007 National Health Interview Survey, which included a comprehensive survey of CAM use by Americans, an estimated 18 million U.S. adults and 700,000 children had received massage therapy in the previous year.

People use massage for a variety of health-related purposes, including to relieve pain, rehabilitate sports injuries, reduce stress, increase relaxation, address anxiety and depression, and aid general wellness.

Defining Massage Therapy

The term "massage therapy" encompasses many different techniques (see box for examples). In general, therapists press, rub, and otherwise manipulate the muscles and other soft tissues of the body. They most often use their hands and fingers, but may use their forearms, elbows, or feet.

Types of Massage Therapy: A Few Examples

In Swedish massage, the therapist uses long strokes, kneading, deep circular movements, vibration, and tapping. Sports massage is similar to Swedish massage, adapted specifically to the needs of athletes. Among the many other examples are deep tissue massage; trigger point massage, which focuses on myofascial trigger points—muscle "knots" that are painful when pressed and can cause symptoms elsewhere in the body; and reflexology, which applies pressure to the feet (or sometimes the hands or ears), to promote relaxation or healing in other parts of the body.

The Practice of Massage Therapy

Massage therapists work in a variety of settings, including private offices, hospitals, nursing homes, studios, and sport and fitness facilities. Some also travel to patients' homes or workplaces. They usually try to provide a calm, soothing environment.

Therapists usually ask new patients about symptoms, medical history, and desired results. They may also perform an evaluation through touch, to locate painful or tense areas and determine how much pressure to apply.

Typically, the patient lies on a table, either in loose-fitting clothing or undressed (covered with a sheet, except for the area being massaged). The therapist may use oil or lotion to reduce friction on the skin. Sometimes, people receive massage therapy while sitting in a chair. A massage session may be fairly brief, but may also last an hour or even longer.

Research Status

Although scientific research on massage therapy—whether it works and, if so, how—is limited, there is evidence that massage may benefit some patients. Conclusions generally cannot yet be drawn about its effectiveness for specific health conditions.

According to one analysis, however, research supports the general conclusion that massage therapy is effective. The studies included in the analysis suggest that a single session of massage therapy can reduce "state anxiety" (a reaction to a particular situation), blood pressure, and heart rate, and multiple sessions can reduce "trait anxiety" (general anxiety-proneness), depression, and pain. In addition, recent studies suggest that massage may benefit certain conditions, for example:

There are numerous theories about how massage therapy may affect the body. For example, the "gate control theory" suggests that massage may provide stimulation that helps to block pain signals sent to the brain. Other examples include theories suggesting that massage might stimulate the release of certain chemicals in the body, such as serotonin or endorphins, or cause beneficial mechanical changes in the body. However, additional studies are needed to test the various theories.

seated massage
© Bob Stockfield

Safety

Massage therapy appears to have few serious risks—if it is performed by a properly trained therapist and if appropriate cautions are followed. The number of serious injuries reported is very small. Side effects of massage therapy may include temporary pain or discomfort, bruising, swelling, and a sensitivity or allergy to massage oils.

Cautions about massage therapy include the following:

Training, Licensing, and Certification

There are approximately 1,500 massage therapy schools and training programs in the United States. In addition to hands-on practice of massage techniques, students generally learn about the body and how it works, business practices, and ethics. Massage training programs generally are approved by a state board. Some may also be accredited by an independent agency, such as the Commission on Massage Therapy Accreditation (COMTA).

As of 2007, 38 states and the District of Columbia had laws regulating massage therapy. In some states, regulation is by town ordinance.

The National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) certifies practitioners who pass a national examination. Increasingly, states that license massage therapists require them to have a minimum of 500 hours of training at an accredited institution, pass the NCBTMB exam, meet specific continuing education requirements, and carry malpractice insurance.

In addition to massage therapists, health care providers such as chiropractors and physical therapists may have training in massage.

Licenses and Certifications

Some common licenses or certifications for massage therapists include:

LMT
Licensed Massage Therapist
LMP
Licensed Massage Practitioner
CMT
Certified Massage Therapist
NCTMB
Has met the credentialing requirements (including passing an exam) of the National Certification Board for Therapeutic Massage and Bodywork, for practicing therapeutic massage and bodywork
NCTM
Has met the credentialing requirements (including passing an exam) of the National Certification Board for Therapeutic Massage and Bodywork, for practicing therapeutic massage

If You Are Thinking About Using Massage Therapy

NCCAM-Funded Research on Massage Therapy

Recent NCCAM-sponsored studies have been investigating:

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References

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For More Information

NCCAM Clearinghouse

The NCCAM Clearinghouse provides information on CAM and NCCAM, including publications and searches of Federal databases of scientific and medical literature. The Clearinghouse does not provide medical advice, treatment recommendations, or referrals to practitioners.

Toll-free in the U.S.: 1-888-644-6226
TTY (for deaf and hard-of-hearing callers): 1-866-464-3615
Web site: nccam.nih.gov
E-mail:

PubMed®

A service of the National Library of Medicine (NLM), PubMed contains publication information and (in most cases) brief summaries of articles from scientific and medical journals. CAM on PubMed, developed jointly by NCCAM and NLM, is a subset of the PubMed system and focuses on the topic of CAM.

Web site: www.ncbi.nlm.nih.gov/sites/entrez
CAM on PubMed: nccam.nih.gov/research/camonpubmed/

Acknowledgments

NCCAM thanks the following people for their technical expertise and review of the content update of this publication: Karen Sherman, Ph.D., M.P.H., Center for Health Studies, Group Health Cooperative; Jeanette Ezzo, Ms.T., M.P.H., Ph.D., JPS Enterprises; and Partap Khalsa, D.C., Ph.D., NCCAM.

This publication is not copyrighted and is in the public domain. Duplication is encouraged.

NCCAM has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your primary health care provider. We encourage you to discuss any decisions about treatment or care with your health care provider. The mention of any product, service, or therapy is not an endorsement by NCCAM.

NCCAM Publication No. D327
Created: September 2006
Updated: June 2009

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