Swedish Massage for GAD Symptoms

By Massage Therapy Foundation Contributor
2017-12-1

Swedish Massage for GAD Symptoms

By Massage Therapy Foundation Contributor
2017-12-1

Contributed by Jolie Haun, PhD, EdS, LMT; Derek R. Austin, PT, DPT, MS, BCTMB, CSCS; Drew A. Rowe, LMT, BGs, BCTMB

Generalized anxiety disorder (GAD) is the most common anxiety disorder reported in primary care settings. Symptoms include "feeling worried, apprehensive, or psychically tense most of the time about routine, everyday events and is often associated with irritability and restlessness." People with GAD often express physical symptoms, including insomnia, fatigue, muscle pain and tension, headaches, gastrointestinal complaints, and pain. GAD is known to cause impairment in quality of life and work, creating an economic burden.

Though traditional GAD treatments exist, there are barriers to treatment, including "the stigma of being diagnosed with a psychiatric disorder, the stigma of going to a mental health professional, the emotional challenge of participating in psychotherapy, the ambivalence people have about taking medication for anxiety, the cost of medication or therapy, and the burden of medication side effects."

Yet individuals with GAD endorse using some form of complementary and alternative medicine therapy to relieve anxiety and stress. Massage, particularly Swedish massage, is one of the most popular treatments for symptoms of anxiety in community practice. Recognizing that patients may prefer nontraditional treatment, Rapaport and colleagues conducted a proof-of-concept study to evaluate the acute effects of Swedish massage therapy for the treatment of subjects with GAD. This Massage Therapy Foundation Writing Group review highlights the findings from their study, published in the Journal of Clinical Psychiatry.

Applied Methods

Rapaport and colleagues conducted a randomized, single-masked, clinical trial with forty-seven currently untreated subjects with a GAD diagnosis. Participants were randomly assigned to Swedish massage twice-weekly for six weeks. Control participants were assigned to a light touch control condition for six weeks. The primary outcome measure was reduction in Hamilton Anxiety Rating Scale scores after six weeks. A mixed model repeated-measures analysis was completed for 40 subjects with complete data.

Intervention

Forty-five minute sessions were performed by licensed massage therapists, who adhered to a script that standardized protocols for treatment and control groups, where "each session began with the subject draped with a sheet and in a prone position on a massage table while the therapist worked slowly down the body from the shoulders to the feet. The subject then turned over to the supine position and the therapist continued the protocol from the feet back up to the shoulders."

Massage techniques used in the treatment sessions included effleurage, petrissage, and tapotement. The same therapists performed the light touch treatment with the control group. To maintain quality, the study employed audio taping, reliability sessions, weekly discussions, periodic protocol adherence spot checks, and feedback from participants.

Study Results

The study hypothesis was statistically and clinically significant, such that there was a reduction in Hamilton Anxiety Rating Scale scores after 12 treatment sessions at the end of week six for the Swedish massage treatment group compared to the light touch control group.

Within-group effects over six weeks of treatment were twice as high for the treatment group compared to the light touch group. Notably, treatment group differences became significantly different after six treatments at the end of week three.

Study Limitations

As with all research study limitations should be considered when interpreting study findings. Study limitations for this study include a small sample size that produced large confidence intervals around the effect size estimates, meaning the degree of clinical significance would have been more reliably determined if the study were larger. Another limitation, as with many studies on massage, is the inability to mask the participant to the treatment assignment. Further research to replicate and extend these study findings is warranted.

The Take-Home Message

Findings of this single therapy trial suggest that a manual therapy, like Swedish massage therapy, twice-weekly is an effective acute treatment for GAD as a monotherapy without other interventions. The implications of these findings on research, practice, and the field are significant:

  • Findings clearly warrant a follow-up large randomized controlled trial to replicate findings and inform advancing the science of using complementary and alternative manual therapy to treat GAD and potentially other psychological conditions.
  • Findings suggest that time-limited massage treatment may be a viable alternative for people with GAD. Both massage therapists and mental health providers can use these findings to form recommendations and suggest Swedish massage as a treatment option to support individuals who might otherwise be overwhelmed by barriers to GAD treatment.
  • As this body of knowledge grows, it is critical that provider groups from the field work together to integrate complementary and alternative manual therapies such as Swedish massage into traditional treatment plans to provide an integrative approach to health care therapies to optimize quality of life and function for individuals' with GAD.

Are you interested in learning more about research for mental health and wellness? To learn more about the effects of massage therapy, you can view the Massage Therapy Foundation review article archives, browse accepted MTF Research Grant abstracts, or search PubMed for massage therapy studies. To learn about grants and contests please visit massagetherapyfoundation.org.

Editor's Note: The preceding research synopsis is authored by volunteers from MTF's Writing Workgroup. To learn more please visit their columnist page.


Resource

  1. Rapaport MH, et al. "Acute Swedish Massage Monotherapy Successfully Remediates Symptoms of Generalized Anxiety Disorder: A Proof-of-Concept, Randomized Controlled Study." J Clin Psychiatry, July 2016;77(7):883-91.