It’s estimated that more than 51 million American adults discussed massage therapy with their doctors or health care providers in 2015. Stats like these tell us that more clients than ever view massage therapy as an integral part of their health care regime. In response, it’s essential that you understand when massage is indicated or contraindicated for specific pathologies.
How essential? Consider this: 20 years ago, massage for cancer patients was categorically judged unwise for fear that it accelerated the spread of the cancer.2 However, recent studies reverse this opinion, highlighting specific instances where massage is both indicated and highly beneficial for cancer patients. Similarly, researchers now feel that patients with any of the following five chronic medical conditions—or pathologies—can benefit from massage therapy.
Osteoarthritis
The most common form of arthritis, osteoarthritis (OA) is a chronic disease of the joints that affects more than 30 million Americans. Most people over age 60 have OA to some degree, which occurs as the protective cartilage on the ends of your bones wears down.4 Bones most often affected are in the hands, spine, and knee and hip joints, with symptoms including pain, stiffness, swelling and decreased range of motion.
The most common form of arthritis, osteoarthritis (OA) is a chronic disease of the joints that affects more than 30 million Americans. Most people over age 60 have OA to some degree, which occurs as the protective cartilage on the ends of your bones wears down.4 Bones most often affected are in the hands, spine, and knee and hip joints, with symptoms including pain, stiffness, swelling and decreased range of motion.
Research highlights
Specific to osteoarthritis in the knee, a research study funded by the National Center for Complementary and Integrative Health (NCCIH) found that a 60-minute “dose” of Swedish massage therapy performed once a week for pain was both optimal and practical. The study’s 125 participants, all with OA of the knee, were randomly assigned to one of four different eight-week regimens based on standardized Swedish massage performed 30 or 60 minutes/weekly or biweekly. The control group received “usual care” without massage. Researchers assessed the participants’ pain, function, joint flexibility and other measures at the start of the study and at eight, 16 and 24 weeks thereafter.
Specific to osteoarthritis in the knee, a research study funded by the National Center for Complementary and Integrative Health (NCCIH) found that a 60-minute “dose” of Swedish massage therapy performed once a week for pain was both optimal and practical. The study’s 125 participants, all with OA of the knee, were randomly assigned to one of four different eight-week regimens based on standardized Swedish massage performed 30 or 60 minutes/weekly or biweekly. The control group received “usual care” without massage. Researchers assessed the participants’ pain, function, joint flexibility and other measures at the start of the study and at eight, 16 and 24 weeks thereafter.
At eight weeks, participants in weekly and biweekly 60-minute massage groups reported significant improvements in knee pain, function and stiffness when compared to participants receiving usual care, although range of motion was not significantly affected by usual care or massage.
At 24 weeks, the clinical benefits had reduced for all groups, suggesting that consistency of massage therapy may be indicated.
Professional Tip
With an estimated 7,000 baby boomers turning 65 every day, many massage therapists are turning their attention to treating age-related conditions, which include osteoarthritis. “It’s a strong opportunity to expand my client base,” explains Rita Snow, a massage therapist located in Goshen, Kentucky. Serving this population is all about adjusting massage techniques, Snow advises. For example, she avoids trigger point and deep tissue massage for this demographic. “Deep pressure is too intense,” she says. “But I do see improvements in pain when I move to a firm but gentle, rhythmic touch.”
With an estimated 7,000 baby boomers turning 65 every day, many massage therapists are turning their attention to treating age-related conditions, which include osteoarthritis. “It’s a strong opportunity to expand my client base,” explains Rita Snow, a massage therapist located in Goshen, Kentucky. Serving this population is all about adjusting massage techniques, Snow advises. For example, she avoids trigger point and deep tissue massage for this demographic. “Deep pressure is too intense,” she says. “But I do see improvements in pain when I move to a firm but gentle, rhythmic touch.”
Gentle manipulation is essential, Snow emphasizes. This demographic, she adds, often has thin, delicate and fragile skin due to age as well as medications, such as blood thinners and/or arthritic medications.
Type 2 Diabetes
Affecting 29.1 million Americans, Type 2 diabetes (T2D) accounts for 90 to 95 percent of all diabetes cases diagnosed. This chronic disease affects how the body metabolizes sugar, or glucose, by either resisting the effects of insulin, a hormone that regulates the movement of sugar into your cells, or not producing enough insulin to maintain a normal glucose level. In either case, an important source of fuel is compromised.
Affecting 29.1 million Americans, Type 2 diabetes (T2D) accounts for 90 to 95 percent of all diabetes cases diagnosed. This chronic disease affects how the body metabolizes sugar, or glucose, by either resisting the effects of insulin, a hormone that regulates the movement of sugar into your cells, or not producing enough insulin to maintain a normal glucose level. In either case, an important source of fuel is compromised.
A common T2D complication is peripheral neuropathy, which is nerve damage caused by chronically high blood sugar. Symptoms include numbness; loss of sensation; pain in the feet, legs or hands; and, specific to diabetic peripheral neuropathy in the feet, impaired balance.
Research Highlights
Two recent clinical studies report that patients with diabetic peripheral neuropathy in their feet can significantly benefit from foot massage. Each study relied on a different massage technique, although both shared similarly positive conclusions.
A 2015 study, including 60 patients with T2D, suggests that Thai foot massage “is a viable alternative treatment for balance performance, range of motion of the foot and the foot sensation in diabetic patients with peripheral neuropathy.”
Two recent clinical studies report that patients with diabetic peripheral neuropathy in their feet can significantly benefit from foot massage. Each study relied on a different massage technique, although both shared similarly positive conclusions.
A 2015 study, including 60 patients with T2D, suggests that Thai foot massage “is a viable alternative treatment for balance performance, range of motion of the foot and the foot sensation in diabetic patients with peripheral neuropathy.”
Thai foot massage, somewhat similar in theory to acupressure massage, is a form of deep massage using thumb pressure applied along the meridian lines of the foot and leg. The application of pressure on particular areas of the soles of the feet is said to produce a reflex action in other parts of the body.
A smaller study, conducted in 2016, investigated the effect of manual foot plantar massage, a classic friction massage, on functional mobility level, balance and functional reach in patients with T2D. Results indicated that application of plantar massage in these patients improved balance, functional mobility and functional reach values. The conclusion states, “Foot massage to be added to rehabilitation exercise programs of [Type 2 diabetes] patients will be important in improving balance and mobility of patients.”
Professional Tip
If diabetic peripheral neuropathy interests you, Susan Salvo, author, educator, massage therapist and doctoral candidate, suggests that advanced classes in oncology massage therapy could provide “a natural bridge between knowledge and skill that will serve to increase your therapeutic value.” An integral part of continuing education concerning massage therapy and oncology care focuses on the study of chemotherapy-induced peripheral neuropathy (CIPN), a side effect of commonly used cancer treatments and a condition that overlaps with diabetic peripheral neuropathy.
If diabetic peripheral neuropathy interests you, Susan Salvo, author, educator, massage therapist and doctoral candidate, suggests that advanced classes in oncology massage therapy could provide “a natural bridge between knowledge and skill that will serve to increase your therapeutic value.” An integral part of continuing education concerning massage therapy and oncology care focuses on the study of chemotherapy-induced peripheral neuropathy (CIPN), a side effect of commonly used cancer treatments and a condition that overlaps with diabetic peripheral neuropathy.
In a study presented at the 2016 Palliative Care in Oncology Symposium, massage was shown to greatly decrease CIPN-associated symptoms, increase skin temperature in fingers and toes, and generally improve quality of life in persons affected by chemotherapy-induced peripheral neuropathy.
Alzheimer’s Disease and Dementia
Alzheimer’s disease and dementia are often mistakenly used interchangeably. Let’s set the record straight: Dementia is a group of signs and symptoms that affect mental cognitive tasks such as thinking, memory and communicating. It is not a disease but rather an umbrella term that covers multiple progressive neurodegenerative diseases with similar clinical profiles. Alzheimer’s is under that umbrella. Therefore, research that investigates how and when massage therapy can positively affect dementia may be applied to individuals diagnosed with Alzheimer’s disease—or as it’s also called, Alzheimer’s dementia. Here’s a brief list of dementia symptoms that apply to Alzheimer’s:
Alzheimer’s disease and dementia are often mistakenly used interchangeably. Let’s set the record straight: Dementia is a group of signs and symptoms that affect mental cognitive tasks such as thinking, memory and communicating. It is not a disease but rather an umbrella term that covers multiple progressive neurodegenerative diseases with similar clinical profiles. Alzheimer’s is under that umbrella. Therefore, research that investigates how and when massage therapy can positively affect dementia may be applied to individuals diagnosed with Alzheimer’s disease—or as it’s also called, Alzheimer’s dementia. Here’s a brief list of dementia symptoms that apply to Alzheimer’s:
- • Trouble focusing
- • Difficulty performing ordinary activities
- • Feeling confused or frustrated, especially at night
- • Dramatic mood swings—outbursts of anger, anxiety and depression
- • Feeling disoriented and getting lost easily
- • Physical problems, such as an odd walk or poor coordination
- • Trouble communicating
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