Massage Therapy Achieves Legitimacy in Health Care




Massage therapy has suffered an image problem in the United States for decades. But a combination of medical research and enthusiastic support is helping to end that, to the benefit of millions.

The first problem is rooted in American Puritanism. Adult services (i.e., prostitution), illegal in most states but available everywhere, cannot be marketed quite so openly in consumer services directories such as the Yellow Pages. So over the past several decades, members of the oldest profession have claimed to be offering a “massage.” The legitimate practitioners had to overcome that code word by affixing “therapy” to the name, which cleans it up a bit even if it is redundant.

Aside from that titillating detail, massage in one form or another has been found in a broad range of cultures in far-flung locations for millennia, most famously as an Ayurvedic discipline in India but also in pre-Columbian Mayan cultures, in Asia, in ancient Middle East countries and in Europe. Hippocrates himself said, “The physician must be experienced in many things, but assured in rubbing,” while this same rubbing is referred to in the Bible’s Book of Esther (2: 9-12).

Massage had become a mainstream method of health care in America by the late 19th century; however, the advent of other forms of medicine in the 1930s and 1940s led to its decline. Professional athletes began using it again in the 1970s, which has helped it rise in popularity ever since. Still, it was largely viewed as the province of the rich, an idle and relaxing time for those who could afford luxurious pampering.

Today, legitimate massage therapists licensed by the American Massage Therapy Association (AMTA) number 58,000 in the United States, providing therapy for conditions and diseases that range from autism to burn injuries, HIV/AIDS, cancer treatment, pain management, carpal tunnel, scoliosis, muscle injury, anxiety, depression, insomnia, diabetes, tension headaches and orthopedic rehabilitation, such as back injuries.

With massage therapy, back pain a primary target

According to the National Institutes of Health, 80% of the population suffer from back pain. It is the second-most-common cause of missed workdays (the common cold comes in at number one). So clearly, employers have an incentive to find ways to fix that, to enable workers to become functional and perhaps free from the pain associated with back problems. Larger, well-capitalized companies (Google, Boeing and others) provide massage services to employees, indicating an intuitive sense that it makes for happy, more productive people. Some health insurance companies also provide for massage as a treatment when it is what the doctor orders.

The research supporting this has built up in the past 10 years. Several studies document specific benefits, as follows:

  • Decreased pain, reduced depression and anxiety, increased range of motion and improved sleep (Maria Hernandez-Reif, M.D. and Tiffany Field, Ph.D.; 2001).
  • Reduction of lower back pain, lower use of medication and lowest cost of follow-up health care (Daniel Cherkin, Ph.D. and David Eisenberg, M.D.; 2001).
  • Decreased pain intensity when massage, remedial exercise and posture education were combined (Michele Preyde, published in the Canadian Medical Association Journal, June 2000).
  • Relief from back pain that can continue at least a year after the massage is over (a synthesis of eight randomized trials by the Cochrane Database of Systematic Reviews, 2006).

Apparently, an awareness of these benefits is driving an increase in the number of patients seeking massage for more than just relaxation. The AMTA reports that in 2009, 25 percent of Americans aged 35-44 sought massage for medical and health reasons, and that 86 percent of Americans agree it can be an effective way to manage pain.

Massage therapy is no longer just for the luxury class

Massage has definitively shed its image as a simple indulgence. “Even with the ongoing economic crisis, people are not willing to compromise their health,” says Judy Stahl, AMTA president. “It’s a clear signal of massage’s value when those making less than $35,000 a year are the second-most-active income bracket getting massage therapy.”

For the person who more typically exercises to stay healthy — another Puritan instinct, that nothing comes easy — perhaps Thai yoga massage (also known as Nuad Boran) would do the trick. It involves a practitioner who guides the patient through yoga postures, using palms and thumbs along energy lines (“sen”) and pressure points. Reported benefits are relieving muscle tension, improved circulation, immunity enhancement and what proponents call energy balancing.

There are literally dozens of massage methods that come from the four corners of the globe. Now that you know it is legit and healthful, perhaps it’s time to go for a rubbing.