While getting a massage might feel great, scientists have found that there isn't strong evidence that they actually help with pain.
Analyzing the results of more than 100 studies, researchers discovered that only a few of the studies found that massages help reduce pain, according to a new paper in thejournal JAMA Network Open.
Out of 129 studies published between 2018 and 2023, only 41 actually used a formal method to test how strong the evidence of pain relief was. Of 17 of those studies, which covered 13 health conditions, none found strong evidence.
Only seven conclusions were rated as moderate-certainty evidence, indicating beneficial associations between massage therapy and pain relief. All other conclusions were rated as low- or very low-certainty evidence.
"This study found that despite a large number of randomized clinical trials, systematic reviews of massage therapy for painful adult health conditions rated a minority of conclusions as moderate-certainty evidence and that conclusions with moderate- or high-certainty evidence that massage therapy was superior to other active therapies were rare," the authors wrote in the paper.
Massage helps increase blood flow to tissues, which can improve the delivery of oxygen and nutrients while removing waste products like lactic acid. It also enhances the lymphatic system, aiding in the removal of toxins and reducing swelling. Techniques like kneading and stroking help to relieve muscle tension by breaking down adhesions and scar tissue in muscle fibers, and can also improve flexibility and range of motion by loosening tight muscles and tendons.
"Included studies were systematic reviews of massage therapy for pain in adult health conditions that formally rated the certainty, quality, or strength of evidence for conclusions," the authors wrote. "Studies of sports massage therapy, osteopathy, dry cupping or dry needling, and internal massage therapy [e.g., for pelvic floor pain] were ineligible, as were self-administered massage therapy techniques, such as foam rolling."
The conditions reviewed across the various papers included cancer-related pain, back pain, chronic neck pain, fibromyalgia, labor pain, mechanical neck pain, myofascial pain, palliative care needs, plantar fasciitis, post-breast cancer surgery pain, post-cesarean pain, postpartum pain and postoperative pain.
The paper revealed that most systematic reviews concluded that the certainty of the evidence was low or very low, highlighting a significant need for high-quality randomized clinical trials to strengthen the evidence for the effectiveness of massage therapy in pain management. The findings suggest that massage therapy is generally beneficial for pain relief, but more rigorous studies are necessary to establish its superiority over other active treatments.
"Although this systematic review found that the number of conclusions about the effectiveness of massage therapy that were judged to have at least moderate certainty of evidence was greater now than in 2018, it was still small relative to the need," the researchers wrote.
"More high-quality randomized clinical trials are needed to provide a stronger evidence base to assess the effect of massage therapy on pain. For painful conditions that do not have at least moderate-certainty evidence supporting use of massage therapy, new studies that address limitations of existing research are needed.
"The field of massage therapy would be best advanced by educating the wider research community with clearer definitions of massage therapy and whether it is appropriate to include multiple modalities in the same systematic review."
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