Massage and Myotherapy Use in Multidisciplinary Care

With the growing use of remedial massage therapy and myotherapy (massage) in multidisciplinary and patient-centred care, general practitioners have highlighted a need for more research information to improve communication with patients about its use. 

Like advising on any treatment, a knowledge of what the research says about massage therapy is essential for general practitioners. You’ll find here a summary of research with citations to the research papers.

Summary of Research Results

Health bodies recommend massage therapy.

Recommended by RACGP and other international peak health bodies.

The RACGP recommend the use of massage, suggesting it can improve pain, depression and sleep1 while the UK’s National Institute for Health and Care (NICE) guidelines recommend considering it in the management of osteoarthritis and low back pain2,3.

The Ottawa guidelines indicate that massage therapy is effective at providing pain relief and improving functional status in lower back pain as well as in providing short term improvement of sub-acute and chronic lower back pain symptoms and decreased disability immediately post treatment4.

Most GPs surveyed regard massage as effective.

Massage therapy is viewed positively by a majority of general practitioners.

Surveys of Australian general practitioners' attitudes toward massage therapy have shown that 84% considered it a moderately to highly effective treatment and 91% regarded it as safe5. More than three-quarters of GPs (76.6%) referred to massage therapy at least a few times per year, with 12.5% recommending it weekly6.

Importantly, reports of positive results from patients receiving massage therapy increased referrals among GPs7.

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Aiding Acute and Chronic Pain Management

Massage therapy has been shown to aid in the treatment of acute pain and prevention and management of chronic pain.

The integration of massage therapy into the team-centred approach of patient care may help in preventing the transition from acute to chronic pain.

Effective with chronic back pain.

There is an emerging body of evidence that supports the effectiveness of massage therapy for the treatment of non-specific low back pain8, one of the ten most common general practice patient presentations in Australia.

Studies have found massage to be effective for persistent back pain and preliminary evidence suggests that massage may reduce the cost of care after an initial course of treatment9. An RCT of 262 patients aged 20 to 70 with persistent back pain showed massage to provide long-lasting benefits, reduce medication use and lower the cost of subsequent care10.

Improvement in osteoarthritis and WOMAC scores.

Massage therapy has shown to be efficacious in the treatment of osteoarthritis of the knee, another of the ten most common general practice presentations, with participants showing significant improvements in the mean global WOMAC scores (Osteoarthritis Index), pain, stiffness and physical function domains, and in the visual analogue scale of pain assessment, range of motion in degrees, and time to walk 50 ft in seconds11 (refer to Fact Sheet 1 – Women and musculoskeletal disease).

Improvement in shoulder pain and range of motion.

There is also evidence that suggests soft tissue massage is effective for improving pain, function and range of motion in patients with shoulder pain12 and neck pain13,14 (refer to Fact Sheet 5 – Pain management).

Improved post-surgical pain and anxiety.

Pain management is critical for patients after surgery and massage therapy has been shown to improve post-operative pain and anxiety15,16. The integration of massage therapy into the acute care setting has been shown to provide benefits to patients’ ability to deal with the challenging physical and psychological aspects of their health conditions and enhance the recovery process17.

Reduced acute pain and healing improvements.

Effective management of acute pain is vital in preventing the transition to a costly chronic state, which has negative outcomes for patients and healthcare systems. Massage can provide significant reductions in acute pain levels, but also improvements in related relaxation, sleep, emotions, recovery, and finally, the healing process. These factors all contribute to effective resolution of acute pain states, preventing chronic transition. Additionally, preliminary evidence suggests that massage may also reduce the costs of care after an initial course of therapy in the acute pain setting9 (refer to Fact Sheet 3 – Injury, rehabilitation and recovery).

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Improved Mental Health and Sleep

Massage can play a role in effective management of stress, depression, and anxiety.

Psychiatric illness accounts for a large proportion of general practice presentations. Massage therapy has been shown to significantly reduce psychological stress levels, as well as alleviate the symptoms of depression and anxiety. It has also been shown to improve emotional well-being, relaxation, vitality and quality of sleep18,19,20.

Massage can also enhance positive well-being and reduce stress perception among older adults, a vitally important factor in the face of an ageing population21 (refer to Fact Sheet 8 – Positive mental health).

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Improvements in Pregnancy and Postnatal

Reduced pain and anxiety in pregnancy and postnatal.

A viable non-pharmacological treatment option.

Anxiety, depression and lower back pain are common during pregnancy and the postpartum period. Non-pharmacologic treatments for these mental health symptoms are critically important during these periods.

Massage therapy has been shown to effectively reduce lower back pain22 while also reducing anxiety, depression and cortisol levels throughout the pregnant and post-partum periods (refer to Fact Sheet 7 – Perinatal and postnatal care).

Improvements in premature births.

As a secondary effect to these improvements, massage has also been shown to reduce premature birth and low birthweight23,24.

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Oncologists Include Massage in Multidisciplinary Care Plans

Oncology massage is not new and has long been available in many cancer centres. The use of massage is supported by a large body of evidence demonstrating its efficacy. Notable centres include the Chris O’Brien Lifehouse, Kinghorn Cancer Centre, Olivia Newton-John Cancer and Wellness Centre, Peter MacCallum Cancer Centre, and many others. The most recent 2021 systematic review of the effectiveness of complementary therapies for the management of symptom clusters in palliative care in paediatric oncology found that therapeutic massage and Reiki may be effective, especially the pain-anxiety-worry-dyspnea cluster in children and adolescents undergoing palliative care25 (refer to Fact Sheet 4 – Oncology massage).

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