Massage Therapy Reduces Hand Pain
By
Massage Therapy Foundation Contributor
June 6, 2012
Massage Therapy Reduces Hand Pain
By
Massage Therapy Foundation Contributor
June 6, 2012
Contributed by April Neufeld, BS, LMT; Sandra K. Anderson, BA, LMT, ABT; Karen T. Boulanger, PhD, CMT
Research on the effects of massage therapy for various conditions is increasing. The Massage Therapy Foundation is invested in reviewing research on how massage therapy affects these conditions, especially those that are musculoskeletal. As noted in the June article, "Recent Research Provides Evidence of How Massage Therapy Heals" by Jolie Haun, "musculoskeletal problems impact daily function and quality of life, so it is important to validate..." massage therapy treatments. Complementary Therapies in Clinical Practice has published a study conducted at the University of Miami School of Medicine in which Tiffany Field and colleagues examined how massage therapy affects hand pain.
The researchers recruited 46 participants from the medical school who complained of hand pain regardless of the cause, such as arthritis or carpal tunnel syndrome. Most noted that their hand pain was related to computer use. The participants averaged 50 years of age, were of middle socioeconomic status, and were Hispanic, Caucasian and African-American. They were randomly assigned to the massage therapy group or the control group.
The massage therapy group received 15 minutes of hand massage from a massage therapist once a week for four weeks. The hand massage procedure included four techniques: stroking, milking, friction and skin rolling. They were also taught home massage, although this procedure was not described. Both massage and control participants completed assessments before and after their first and last sessions. Assessments included pain (0-10 Visual Analog Scale), grip strength, the State Anxiety Inventory, depression (the Profile of Mood States) and the Sleep Disturbances Scale. The control group received no massage but was given the hand massage instructions after the final assessment.
After four weeks of treatment, Field and colleagues reported that the massage group had decreased pain, increased grip strength, decreased anxiety and decreased depression. The researchers concluded, "These findings are consistent with data on massage therapy with pain syndromes and especially with results from our carpal tunnel syndrome study in which pain was also decreased and grip strength increased by massage therapy. The psychological changes following hand massage in the present study, including the reduction in depressed mood and anxiety are indications of relaxation effects."
This is excellent news for massage therapy practitioners because it helps us understand that patients may feel significant benefits even after treatments as short as 15 minutes in length. Nonetheless, this paper had its limitations, mostly focused on the lack of detail provided. Field and colleagues reported, "Moderate pressure appears to be critical for these effects," and "Other studies on hand massage also suggest the importance of pressure." However, there are no indications in this study as to if and how pressure was measured. Methods for measuring pressure should have been included or reasons should have been given for not measuring the moderate pressure outlined in the procedures description.
The researchers listed the use of four different techniques: stroking, milking, friction and skin rolling. But in order for a practitioner to duplicate the results in clinical practice, the details of the massage procedure should have included: how many times each technique is repeated, amount of pressure used, duration of each technique and order of technique application. However, Field and colleagues did make a point to describe the hand position of the practitioner and the position of the subject's arm for each technique; this detail is missing from many research studies on massage therapy. Another example of poor procedural description involves the control group. What did the participants in control group do for the 15 minutes between the before and after assessments? We need to be able to evaluate exactly to what massage therapy is being compared.
A third example of needed detail involves the explanation of the procedure of home hand massage that was taught to the participants. The study only states, "They [the participants] were also taught the hand massage." Specificity regarding the method of instruction, including detailed descriptions of the self-massage and recommended duration, are needed to evaluate the internal validity of the study. Additionally, the authors stated, "The participants were asked to keep a record of their massaging themselves daily and were called on a weekly basis to check on their ability to schedule daily sessions." However, whether the self-massage was performed correctly and consistently was not reported. A future study comparing the effects of massage vs. massage plus home self-massage, would help us to understand any added benefit of having our clients perform self-care.
We agree with the research implication that, "Further research is needed to explore [the] potential mechanisms [of massage therapy]." Studies like these do help support the work that individual massage therapists perform daily with their clients. Practitioners who want more information on the mechanisms of massage therapy and successful treatment methods can go to the list of commonly used PubMed search terms on the Massage Therapy Foundation website.
Source
- Field T, Diego M, Delgado J, Garcia D, Funk CG. Hand pain is reduced by massage therapy. Complementary Therapies in Clinical Practice. 2011; 17: 226-229.