R E S E A R C H
Massage for Carpal Tunnel Syndrome
Massage therapy eases the symptoms of carpal tunnel syndrome and increases grip strength, according to a recent study.“Carpal tunnel syndrome symptoms are lessened following massage therapy” was conducted by staff at the Touch Research Institutes at the University of Miami School of Medicine in Miami, Florida.
Symptoms of carpal tunnel syndrome include pain, tingling, burning and numbness of the hand. Sixteen people diagnosed with this syndrome participated in the study. All of them held jobs involving heavy word processing or computer work.
Subjects were randomly assigned to either the standard-treatment control group or the massage-therapy group. Those in the massage group received one massage per week on the affected arm for four weeks. They were also instructed in self-massage, which they were to perform each night before bed.
The massage routine consisted of stroking of moderate pressure from the fingertips to the elbow. A massage and pain log was kept by subjects in the massage group. In the log, participants recorded the times at which they began and ended self-massage, as well as their levels of pain on a scale from zero to 10.
Subjects in the control group received no intervention, but were taught the massage routine after the study ended. Physicians evaluated participants’ carpal tunnel symptoms, such as tingling, numbness, pain and strength, at the beginning and end of the four-week study. The Tinel sign, which tests to see if light tapping of the affected area elicits pain or tingling, was also used at the start and finish of the study. Physicians used the Phalen Test at the beginning and end of the study as well. The Phalen Test involves flexing of the wrists to see if numbness or tingling occurs.
A nerve conduction test was also performed at the start and finish of the study. This involved stimulation of the median sensory nerves through electrodes placed on each subject’s index finger and wrist. Peak sensory latencies were recorded to test for nerve compression at the carpal tunnel. Median peak latency was the primary outcome measure.
Assessments were also made before and after the massage sessions on the first and last days of the study, including the Perceived Grip Strength Scale; VITAS, a pain assessment using a visual analogue scale; the state anxiety inventory; and the Profile of Mood States.
Results of the study showed that the subjects in the massage group had significantly less pain and reduced carpal tunnel symptoms, as well as shorter median peak latencies and increased grip strength.
“Functional activity also improved as noted in reduced pain and increased grip strength in the massage therapy group, both immediately after the first and last massage therapy sessions and by the end of the study,” state the study’s authors. “Finally, the massage therapy group reported lower anxiety and depressed mood levels both immediately after the first and last sessions and by the end of the study.”
- Source: Touch Research Institutes at the University of Miami School of Medicine in Miami, Florida. Authors: Tiffany Field, Ph.D.; Miguel Diego; Christy Cullen; Kristin Hartshorn; Alan Gruskin; Maria Hernandez-Reif, Ph.D.; and William Sunshine. Originally published in the Journal of Bodywork and Movement Therapies, 2004, Vol. 8, pp. 9-14.More Research
R E S E A R C H Massage Reduces Headache Frequency
Massage significantly reduced the number of headaches experienced by people with chronic tension headaches, and decreased the duration of the headaches, according to a recent study.
"Massage Therapy and Frequency of Chronic Tension Headaches" was conducted by Christopher Quinn, Clint Chandler and Albert Moraska, Ph.D., of the Boulder College of Massage Therapy in Boulder, Colorado.
Four people who had experienced two to three headaches per week for the past six years or more participated in the study, which lasted eight weeks. During the first four weeks, baseline headache measures were recorded. Throughout the last four weeks, participants received two 30-minute massages per week.
A standardized massage protocol was used, consisting of six phases that fit in the 30-minute time period: preparatory tissue warm-up (three minutes), myofascial release (five minutes), axial cervical traction (two minutes), trigger-point therapy (15 minutes), facilitated stretching (five minutes) and session closure (three to five minutes).
The trigger-point therapy, which made up the bulk of the routine, consisted of scanning palpation of the upper trapezius, sternocleidomastoid, suboccipital, splenius capitis, levator scapulae and temporalis muscles."When located, active trigger points were treated by pincer or flat palpation with just enough pressure to elicit referred pain or autonomic referral phenomena," state the study's authors.
The pressure was maintained until the referral pain ceased, or for a maximum of two minutes, then slowly eased to produce a vascular flushing. In a typical session, six active trigger points were treated, and the procedure was repeated three to five times on each point.
Every night before bed participants completed a headache diary form, recording number of headaches, intensity of most severe headache, and duration of longest headache.
Each subject experienced a reduction in headaches within the first week of massage treatment, and the mean number of headaches per week was significantly reduced from 6.8 to 2 during the four weeks of massage. "Because our therapeutic massage protocol specifically addressed trigger-point activity, we believe that the reduction in activity of these regions by massage was a major contributor to the observed beneficial effects on tension headache," state the study's authors.
Although duration of headache decreased for all four subjects, the decrease was not statistically significant, and there was no significant change in headache intensity."The findings suggest that a larger, more complete study that includes a proper control group is warranted," state the study's authors.
- Source: Boulder College of Massage Therapy. Authors: Christopher Quinn, Clint Chandler and Albert Moraska, Ph.D. Originally published in American Journal of Public Health, October 2002, Vol. 92, No. 10, pp. 1,657-1,661.More Research Back to Top of Page
R E S E A R C H
Massage for Long-Term Pain
Massage significantly improved self-rated health, mental energy and muscle pain in people with chronic musculoskeletal pain, according to a recent study.“A Randomized Clinical Trial of the Treatment Effects of Massage Compared to Relaxation Tape Recordings on Diffuse Long-Term Pain” was conducted by staff at the Uppsala University Department of Public Health and Caring Sciences, in Uppsala, Sweden.One-hundred-seventeen subjects with long-term, diffuse (spread out) musculoskeletal pain participated in the study. Each subject had pain that had lasted for at least three months and was not caused by a specific disease or condition.
Participants were randomized to either a massage or relaxation group. Subjects in the massage group received anywhere from six to 10 massages, each lasting 30 minutes. Subjects received the massages one to three times per week. Participants received an average of seven massages. One person administered all massages, and each session was adjusted to meet subjects’ individual pain thresholds.Subjects in the relaxation group listened to a relaxation tape twice a week for five weeks. The tape instructed them to tense and relax the muscle groups and breathe slowly and regularly.
Questionnaires regarding the subjects’ age, gender, smoking habits, country of birth, marital status and profession were filled out before, immediately after and three months following the study. A self-rated health questionnaire and rating scales for mental energy and muscle pain were also administered at these times.
Results of the study showed that, during treatment, there was a significant improvement in self-rated health, mental energy and muscle pain for subjects in the massage group as compared to those in the relaxation group.
“For all three outcome measures, massage was significantly more effective during treatment, even after controlling for other possible factors,” state the study’s authors.However, at the three-month follow-up evaluation these improved scores had reverted back to their initial levels.
“This lack of long-term benefits could be due to the short treatment period or treatments such as these do not address the underlying causes of pain,” state the study’s authors. “Future studies of long-term pain should include longer treatment periods and post-treatment follow-up.”
- Source: Uppsala University Department of Public Health and Caring Sciences, in Uppsala, Sweden. Authors: Dan Hasson, Bengt Arentz, Lena Jelveus and Bo Edelstam. Originally published in Psychotherapy and Psychosomatics, 2004, Vol. 73, pp. 17-24. More Research
R E S E A R C H
Massage Reduces Cancer Symptoms
Massage therapy significantly improved cancer patients’ symptoms, such as pain, anxiety, nausea, fatigue and depression, according to a recent study.
“Massage Therapy for Symptom Control: Outcome Study at a Major Cancer Center” was conducted by staff of Memorial Sloan-Kettering Cancer Center (MSKCC) in New York City.
Three types of massage are available to patients at MSKCC: Swedish, light-touch and foot massage. Each massage lasts 20 minutes for inpatients and one hour for outpatients. Patients may request the massage themselves, or be referred by a health professional or family member.
As a “routine part of clinical management,” patients rate pain, fatigue, anxiety, nausea and depression before and 5-15 minutes after each massage. For this study, the symptom with the highest score was deemed the presenting symptom.The study’s authors analyzed before-and-after data from the initial massage session of 1,290 cancer patients at MSKCC during a three-year period.
Swedish and foot massage were the most common interventions, with some patients receiving a combination of both. Anxiety was the most common presenting symptom of the cancer patients, followed by pain and fatigue.
Data analysis revealed a 54-percent mean reduction of the presenting symptom following massage therapy. Specifically, anxiety was the symptom eased the most by massage therapy (60-percent reduction), and fatigue was the symptom eased the least (43 percent). Outpatients showed a 10-percent greater improvement in symptoms when compared to inpatients, perhaps due to the longer massage sessions the outpatients received.
“[I]t is clear that massage therapy achieves major reductions in cancer patients’ pain, fatigue, nausea, anxiety and depression,” state the study’s authors.
Additional follow-up, beyond immediate post-session scores, involved 74 outpatients and 237 inpatients. Both inpatients and outpatients were assessed two-to-five hours after the massage. Outpatients were again assessed 24 hours and 48 hours after the massage.
Results of this extended follow-up showed that inpatients’ symptoms scores were about a half-point higher within hours of the massage. “This suggests that inpatient severity scores returned to baseline within a day or so,” state the study’s authors.
For outpatients, there was no regression toward baseline symptom scores throughout the follow-up period. “Massage therapy appears to be an uncommonly non-invasive and inexpensive means of symptom control for patients with serious chronic illness,” state the study’s authors. “It is non-invasive, inexpensive, comforting, free of side effects and greatly appreciated by recipients.
- Source: Memorial Sloan-Kettering Cancer Center’s Integrative Medicine Service and Biostatistics Service, New York City. Authors: Barrie R. Cassileth, Ph.D.; and Andrew J. Vickers, Ph.D. Originally published in Journal of Pain and Symptom Management, September 2004, Vol. 28, No. 3, pp. 244-249.More
R E S E A R C H
Massage Benefits Stroke Patients
Seven days of bedtime back massage, for 10 minutes each evening, significantly reduced the anxiety, pain, blood pressure and heart rate of elderly stroke patients, according to a recent study.
“The effects of slow-stroke back massage on anxiety and shoulder pain in elderly stroke patients” was conducted by staff at the Hong Kong Polytechnic University Department of Nursing and Wong Chuk Hang Hospital, in Hung Hom, Kowloon, Hong Kong.
Participants were stroke patients 65 years or older, experiencing shoulder pain and not already receiving pain-relief measures. One-hundred-and-two subjects, with an average age of 73, completed the study. They were randomly assigned to either the massage group or the control group.
Those in the massage group received 10 minutes of slow-stroke back massage before bedtime for seven evenings in a row. The massage involved slow, rhythmic stroking while the subject was either seated, leaning on a pillow, or lying prone in bed.
Subjects in the control group received standard care. Outcome measures were self-reported anxiety and pain; systolic and diastolic blood pressure; and heart rate. These were evaluated before the massage on the first day of the study and after the massage on the last day of the study, as well as three days after the massage sessions had ended. For subjects in the control group, the outcomes were measured on day one and seven of the study, and three days later.
The State-Trait Anxiety Inventory was used to gauge participants’ anxiety levels, and the Vertical Visual Analogue Scale was used to measure pain. The research nurse measured subjects’ blood pressure and heart rates.Results of the study showed that subjects in the massage group had significantly lower pain, anxiety, blood pressure and heart rate, compared to subjects in the control group. Three days after the massage had ended, these improvements were maintained among the massage recipients.
“The results of this study support the view that [slow-stroke back massage], as an alternative adjunct to pharmacological treatment, is a clinically effective nursing intervention for reducing anxiety and shoulder pain in elderly stroke patients,” state the study’s authors.
- Source: Hong Kong Polytechnic University Department of Nursing and Wong Chuk Hang Hospital, in Hung Hom, Kowloon, Hong Kong. Authors: Esther Mok and Chin Pang Woo. Originally published in Complementary Therapies in Nursing & Midwifery, 2004, Vol. 10, pp. 209-216.