08 Aug 1HP Article Reviews: Benefits Effect of Massage Therapy on Gaming Pains?
Soft tissue mobilization, commonly referred to as massage, is often a patient’s favorite part of physical therapy. It’s largely a passive intervention and can provide immediate relief of symptoms. However, its efficacy as a long-term solution (as opposed to a short-term pain reliever) has been debated. If you’re a gamer and this is too much science for you – we have another article about massaging and gaming injuries
Bervoets et al. reviewed 26 randomized controlled trials involving 2565 participants in order to compare the benefits of massage therapy, no treatment, and active treatments including therapeutic exercise. These studies assessed patients with chronic low back pain, shoulder pain, fibromyalgia, knee osteoarthritis, neck pain, chronic patellar tendinopathy, carpal tunnel syndrome, hand osteoarthritis, and generalized “chronic musculoskeletal pain”
Massage techniques assessed included Swedish massage, Thai massage, self-massage, and combinations of the above techniques. Active treatments compared to these included progressive muscle relaxation therapy, exercise, postural training, and two treatments which appear more appropriately categorized as passive treatments: acupuncture and joint mobilization/manipulation. However, for the purpose of this review, they were grouped in the “active treatments” category. Some studies, not all, included no-treatment or placebo groups.
The efficacy of massage vs no treatment was assessed in two domains: pain and function. With regards to pain, there is moderate-level evidence that massage reduces pain compared to no treatment in patients with shoulder pain, but not in those with back pain. There is low-level evidence that massage reduces pain compared to no treatment in patients with knee osteoarthritis. With regards to function, there is moderate-level evidence that massage improves function compared to no treatment in patients with low back pain. There is low-level evidence that massage improves function compared to no treatment in patients with shoulder pain and knee osteoarthritis.
The efficacy of massage vs active treatment was also assessed in the domains of pain and function. With regards to pain, a single study showed that acupuncture may reduce pain more than massage in people with neck pain. A second, separate single study showed that massage reduces pain more than joint mobilization in people with low back pain, but that there is no benefit of massage over manipulation or relaxation therapy in those with fibromyalgia, low back pain, and musculoskeletal pain. With regards to function, there is low-level evidence that massage does not improve function more than acupuncture or progressive relaxation therapy in the short term, and that in the long term progressive relaxation therapy is superior to massage.
These studies assessed massage therapy as a standalone treatment, rather than as a portion of a larger rehabilitation program incorporating strengthening, stretching, education, and modalities. It is difficult to perform blinded studies with this intervention, as patients are entirely aware of whether or not someone is performing a massage on them.
Incorporation into Practice:
Massage, by itself, is more useful than doing nothing at all. It is less useful, by itself, than active interventions. It has benefits with regards to both pain and function, especially in populations with low back pain, shoulder pain, and knee osteoarthritis.
Substantial research is required for further assessment. Studies of the efficacy of massage should include well-defined terms, improved reporting on treatment parameters (including type, duration, intensity or grade/depth of pressure), and immediate vs remote reporting of pain and function.
Relevance to Gaming:
For support staff working in the gaming community (Physical Therapists, Massage Therapists, Chiropractors, Athletic Trainers, etc.) we can utilize massage therapy as a way to both reduce pain and improve function although understanding it is not doing anything with underlying physical impairments
- Strength (and Endurance)
- Motor Coordination
While it does help with our pain system (CNS->PNS) we have to realize we are only addressing the source of the issue vs. the cause. Pain is coming from the muscle/tendon/nerve and massage helps to reduce that pain. The cause is likely posture, strength/endurance, coordination and potentially lifestyle choices causing tissue irritation. As support staff we need to address both.