Why have so many cultures made massage part of their lifestyle? Because massage works. It works as a social tool: between friends, between parents and children, between lovers. It works as a medical method: despite the basic hostility of the medical community to any ‘alternative’ treatment, doctors have come to accept the benefits of massage for relaxation, for improving the circulation, and for treating certain medical conditions. It works for maximizing the performance of athletes and sportsmen, as the development of sports massage has shown. It works for the young and the old, in professional and personal settings.
Massage is pleasant. Hardly a revelation, but it’s important to remember this when we delving into the medical literature, or into heated debates over the benefits of massage. The good feeling that you get after a massage is hard to test and quantify, but no less real for that.
Since it is so difficult to conduct controlled studies of something as personal and subjective as wellbeing, clinical studies will commonly flatten the experience of patients down to something that they can attach a number to. Thus we get indexes of factors like ‘anxiety’ and ‘depression’ which give us some information, but scarcely capture the entirety of the benefits of massage.
In any case, massage therapy does, it seems, reduce anxiety and depression. It also has some effect on the experience of pain. It can’t necessarily reduce the immediate feeling of pain, but over the course of a series of massages patients report lower overall pain.
Medical studies have found that massage therapy does help patients in many ways1. Studies haven’t been able to reproduce all the benefits claimed by massage and bodywork practitioners, but they have shown enough to conclude that massage isn’t entirely useless.
The placebo effect
The most important, and least controversial, benefit, is the placebo effect. This refers to the fact that if you are receiving treatment, you are more likely to get better even if the treatment does nothing to you. This form of ‘mind over body’ health improvement (your health improves because you think your health is improving) is powerful, and has been demonstrated in clinical trials. It is particularly significant in areas such as pain relief, where the symptoms experienced are a blend of the physical and psychological.
So, any form of treatment in which the patient believes can benefit them. But massage probably has advantages beyond this. When we feel pain, our instinct is to touch the affected part of the body and this seems to bring at least a minimal level of relief. If touch can relieve pain in this context, then why not also in massage.
Slightly different again from the psychological effects are the neurological effects. This refers to the effect massage has on the low-level nervous system. Depending on the form of massage used, it can make the nervous system either more or less excitable, leading to greater or lesser responses to stimuli. This can be measured by testing !Ã¢â‚¬ÂHoffman’s signÃ¢â‚¬Â – the reflex motion of the thumb when a fingernail is flicked.
Mechanical pressure on muscles increases the flexibility of those muscles, and decreases their stiffness. This is a purely mechanical effect, dependent on the physical structure of the muscles.
The lymphatic system
Your body drains waste away from muscles and other tissue through the lymphatic system. This is far from perfect, and when it slows down your body can be left feeling (and looking) puffy and unpleasant. This tends to happen overnight, when the entire lymphatic system slows down, and it is also worsened by poor diet.
Fortunately, the circulation of lymph can be improved by manual manipulation that is, by massage.
Of the physical effects of massage, perhaps the clearest are on the circulatory system. When you touch, squeeze or press any part of your body, you increase the circulation to that area. Massage takes this effect, and systematically applies it. As a result, massage is a good way to deal with minor problems of the circulatory system.
Meanwhile, massage will be having other effects on the central circulatory system, reducing blood pressure and heart rate. Why this happens isn’t fully understood, but i seems to be a reaction to changing levels of hormones circulating in the body.
Massage can measurably alter the levels of certain hormones circulating in the body. Cortisol, known as a ‘stress hormone’, is reduced by a massage. Meanwhile a good massage raises the levels of dopamine and seratonin circulating around the body. Dopamine and seratonin make you feel good they relax your heart, they reduce your sensitivity to pain, and they reduce blood pressure.
In the longer term, low levels of dopamine and seratonin are associated with depression. That doesn’t mean massage can cure depression, but it does highlight the link between having a backrub and feeling good.
So, here is one mechanism by which massage makes you feel good. It isn’t clear why massage has these effects on the hormones, but that doesn’t stop it being a good thing.