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Massage Today
January, 2012, Vol. 12, Issue 01

Massage Therapy Reduces Pain for Patients in a Postoperative Thoracic Surgery Care Setting

By Massage Therapy Foundation Contributor

What's new in research? We at the Massage Therapy Foundation always want to know! This month's review sponsored by the Foundation is an informative study examining the efficacy and feasibility of using massage therapy within a postoperative thoracic surgery setting at Mayo Clinic in Rochester, Minnesota.

General thoracic surgery is provided to patients for a spectrum of diseases and conditions, "varying from malignancies of the lungs, esophagus, mediastinum, and chest wall to benign conditions of these same anatomical areas. The surgical procedures encompass either resection-type procedures, such as pulmonary lobectomy or esophagectomy, or reconstructive operations, such as bronchoplasty or antireflux procedures." Patients face considerable challenges with pain and discomfort after undergoing thoracic surgery. This pain is often long-term if it is not managed effectively in the postoperative stage.

Massage therapy has gained support as an effective intervention to improve patient experiences during hospitalization, particularly for pain reduction. While previous studies have identified benefits of massage, none have evaluated its use in reducing pain for thoracic surgery patients. According to Bauer and his colleagues, certain medical strategies have been developed to reduce pain and discomfort for patients undergoing thoracic surgery, however, many patients still suffer from pain and discomfort in the postoperative setting. These authors hypothesized that the patients who received massage therapy would benefit by having their post-surgical pain and discomfort managed. To test this hypothesis, they evaluated patients' reports of pain before and after massage treatments received in a thoracic surgery practice.

MTF logo - Copyright – Stock Photo / Register Mark Bauer and colleagues used a descriptive pre-post measure evaluation design with a standard numeric pain rating scale. Patients who received massage reported pain scores on a scale of zero to 10; zero being no pain, and 10 being the worst possible pain. These scores were recorded before and after massage and throughout recovery. Descriptive comments provided by patients and staff also were recorded and analyzed.

Two massage therapists provided treatments. Each massage included 20 minutes of hands-on massage on the areas requested by the patient, typically the back, neck and shoulders, and sometimes the hands and feet. Patients were positioned to comfort; positioning depended on patient's comfort level and mobility. Therapists did not massage near surgical wounds. The two therapists in the study used several techniques and modalities including Swedish massage, craniosacral therapy, myofascial release, reflexology and diaphragmatic breathing. Depth and pressure of massage was light to moderate.

This study included a sample of 194 patients, with 160 completing the study. Patient characteristics were similar among the patients who provided responses, with an average age of 61 years and an equal number of males and females. Most patients received one individualized massage during their hospital stay (mean 1.2 massages), but 19 patients had two massages, and eight patients received three massages.

Study findings suggest "patients receiving massage therapy had significantly decreased pain scores after massage (p <= .001), and patients' comments were very favorable. Patients and staff were highly satisfied with having massage therapy available, and no major barriers to implementing massage therapy were identified." Only one patient out of the 160 receiving the massage reported a subjective negative experience. Patient responses after receiving a massage included: "I feel I can breathe again;" "That was wonderful, I can move my neck;" and "Before massage treatment pain was radiating, after treatment pain has completely stopped radiating." Staff comments related to massage therapy included: "The patients love it! They want another one;" "Once they try a massage they can't believe the difference. The pain is still there but they feel they can work with it;" and "Massage calms them."

The compelling findings of this pilot study indicate massage therapy is an effective intervention for helping patients deal with pain. Bauer and colleagues provide both subjective descriptions and objective measures of the benefits of massage therapy for thoracic surgical patients for pain management. Pain scores improved, and patient and staff comments were positive. Further, this study demonstrated the feasibility of integrating massage therapy into a high-volume thoracic surgical practice. Authors suggest, "Massage therapy in the hospital setting needs to be focused on individual patient symptoms, and then the therapy is individualized based on these symptoms, medical status, and positioning tolerance." Bauer and colleagues also suggest their findings warrant further research, particularly to determine optimal frequency, duration, and timing of treatment.

So, what do these findings mean for the massage profession and massage therapists? Postoperative massage therapy might have a significant role in pain management and the healing experience for patients recovering from thoracic surgery. Further, massage treatments can be integrated into hospital settings to facilitate pain symptom management. This research, and the growing knowledge base about the use of massage therapy in the clinical setting, is steadily growing. This work and others like it, published in the International Journal of Therapeutic Massage and Bodywork provide excellent references for the evidence-based practice of massage therapy in clinical and non-clinical settings.

Original research study source:

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