Massage has been used as a healing method for thousands of years. It was used as therapy in the ancient civilizations of both China and Egypt. Many of the forms now commonly found in the US are derived from Swedish massage, which dates back to the 1800s. Massage can be used as treatment alone, or as one component among many in broad-based healing methods such as traditional Chinese medicine and Ayurveda. Massage is also often used in conjunction with aromatherapy. (See sections on Acupuncture, Asian Herbal Medicine, Ayurveda, and Aromatherapy.)
Massage therapy usually takes place in a warm room with relaxing music and soft lighting. The person receiving the massage lies on a specially designed table and is either partially or completely undressed, wearing only a towel or sheet. Various techniques are used in massage therapy, such as stroking, pressing, slapping, rubbing, and tapping. These can be done with or without the aid of oil or lotion.
There are several possible mechanisms for the therapeutic effects of massage. It may relax muscles, helping with headache, muscle stiffness, low back pain, and neck pain. It is also possible that massage releases chemicals in the body called endorphins, which are known to alleviate pain. Finally, massage may be beneficial because touch itself may create positive feelings, such as caring, acceptance, and comfort. These positive feelings are hard to scientifically scrutinize. Often, this type of physical contact is lacking in the interactions between mainstream health professionals and patients.
Evaluation in MS and Other Conditions
Only limited work has been done investigating the use of massage therapy in treating MS. One small MS study, published in 1998, found massage to be associated with decreased anxiety, improved self-esteem, better social functioning, and reduced depression. The researchers concluded that massage improved people’s self-perception, both of disease progression and of their bodies as a whole. Another study found that slow massage over the spine produced measurable physiological changes in muscle stiffness while also improving anxiety. Preliminary research also suggests that massage therapy combined with aromatherapy may improve personal hygiene, dressing ability, and mobility.
Massage studies have also been conducted in patients with other medical conditions that have symptoms similar to those found in MS. This work is far from definitive, as the majority of this work has methodological limitations. The studies that have been published have suggested that massage may improve anxiety, stress, depression, low back pain, and cancer-related pain. Due to its relevance to cancer-related pain, the National Cancer Institute acknowledges massage therapy as a non-medication treatment for pain. Other research has found that abdominal massage may help with constipation. Massage is often assumed to be beneficial for muscle stiffness or spasticity, but the research into this belief is extremely limited.
In addition to any beneficial effects produced by the massage itself, the mere aspect of physical interaction between the practitioner and the person receiving the massage may produce some beneficial effects. These include increases in self-esteem and quality of life.
It is possible that massage may affect the immune system, although the details of this interaction and the mechanisms underlying it are poorly understood. One study suggested that massage stimulates the immune system, which theoretically could pose a risk to MS patients. This study found that infants with AIDS, a syndrome characterized by decreased immune system activity, had a better outcome if they received massage therapy.
Generally, massage is well tolerated. However, minor side effects are known to occur, including lethargy, muscle pain, and headache. There is also the possibility, although rare, of serious complications like bleeding in the liver caused by deep abdominal massage.
Certain people should approach massage with caution or avoid it completely due to increased risk of complications. Pregnant women should not get massages unless the massage therapies has experience in pregnancy massage. People with fever, clotted blood vessels (thrombosis), jaundice, infections, or recent injuries should avoid massages. Those with spleen enlargement or ulcers should avoid abdominal massage. People with heart disease, arthritis, or cancer should consult a physician if they are considering massage therapy.
Massage may produce many health benefits. It is generally considered safe and is of low to moderate cost. The studies directly examining massage in MS are limited, but work in other medical conditions show possible benefits for some symptoms commonly associated with MS, including depression, anxiety, spasticity, constipation, and pain.
References and Additional Reading
Bowling AC. Complementary and Alternative Medicine and Multiple Sclerosis. New York: Demos Medical Publishing, 2007, pp. 174-177.
Ernst E, ed. The Desktop Guide to Complementary and Alternative Medicine: An Evidence-Based Approach. Edinburgh: Mosby, 2001.
Oken BS, ed. Complementary Therapies in Neurology. London: Parthenon Publishing, 2004.
Vickers A. Massage and Aromatherapy: A Guide for Health Professionals. London: Chapman & Hall, 1996.
Weintraub MI, Micozzi MS, eds. Alternative and Complementary Treatments in Neurologic Illness. New York: Churchill Livingstone, 2001.
Brouwer B, de Andrade VS. The effects of slow stroking on spasticity in patients with multiple sclerosis: a pilot study. Physiother Theory Practice 1995; 11:13–21.
Hernandez-Reif M, Field T, Field T, et al. Multiple sclerosis patients benefit from massage therapy. J Bodywork Movement Ther 1998;2:168–174.
Vanderbilt S. Searching for comfort: alternative therapies and multiple sclerosis. Massage and Bodywork 2004;Aug/Sept:50–59.
Walsh E, Wilson C. Complementary therapies in long-stay neurology in-patient settings. Nursing Standard 1999;13:32–35.