Massage as a Component of Integrative Healthcare

Position Statement

It is the position of the American Massage Therapy Association (AMTA) that massage therapy can provide significant benefit as a component of integrative healthcare.

Background Information

According to the World Health Organization, health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.¹ Currently healthcare in the United States is going through a paradigm shift from a biomedical model to a biopsychosocial model.

The biopsychosocial model places emphasis on viewing the patient as a whole and addressing all the patient’s needs by inter-professional health care teams which include both health and mental health, in a non-stigmatizing environment which considers the patient’s preferences and culture.²

Integrative care is at the core of this paradigm shift to the biopsychosocial model. “Integrative medicine is the practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic and lifestyle approaches, health care professionals and disciplines to achieve optimal health and healing.”³

A growing body of evidence supports the value massage therapy can offer to integrated health systems for a range of patient health conditions. Massage therapy has been shown to be effective in regards to chronic pain, behavioral health, rehabilitation, and acute medical treatment.^4–11 

Massage therapy is well accepted for managing pain. Dr. Albert Schweitzer is said to have proclaimed in 1931 that pain is a more terrible lord of mankind than even death itself. Chronic pain has become an epidemic affecting nearly 50 million American adults.¹² “Pain is a leading cause of disability and a major contributor to health care utilization. It is also costly to the United States, not just in terms of health care expenses and disability compensation, but also with respect to lost productivity and employment, reduced incomes, lost school days, and decreased quality of life.”¹³ “Effective pain management thus requires therapies that treat both pain and related sequela by addressing the whole patient through a holistic biopsychosocial model.”¹⁴ 

A recent meta-analysis gave massage therapy a strong recommendation, compared to no treatment, for reducing pain intensity/severity for those with musculoskeletal pain.¹⁴ Several treatment guidelines indicate massage therapy for treatment of low back pain^{6,9,10,15–17}, neck pain¹⁸, and migraines.¹⁹ Massage therapy has also been shown to be beneficial⁴ for low back pain^{9,10,17,20–28}, headaches^29–42, carpal tunnel syndrome^43–48, osteoarthritis^49–52, neck and shoulder pain^53–55, fibromyalgia^56–64, and in hospice care^65–74.

One key aspect of integrated, patient-centered care is assisting patients to participate in managing both their physical and mental health care needs. Incorporating massage therapy as part of a treatment plan enables treatment of not only the physical and behavioral aspects of a wide variety of health conditions, but also the myriad of symptoms that accompany these conditions.

“In 2014, there were an estimated 43.6 million adults aged 18 or older in the United States with AMI {any mental illness} in the past year.”(75) Massage therapy research has been shown to be beneficial⁴ for anxiety and stress^{25–27,29,35,38,64,76–94}, depression^{26,27,35,58,64,70,79,89,91,95–104}, PTSD^23,105–108, and Substance Abuse Disorder Recovery.^11,81,109 

As part of an integrative treatment plan, massage therapy can aid in the healing and rehabilitation following bodily injury. The Department of Labor recognized the potential benefit of massage therapy for injured employees under the Energy Employees Occupational Illness Compensation Program Act (EEOICPA), which provides compensation to those who work on certain high-risk projects for the Department of Energy.

The Department cited the potential benefits of massage therapy as “reducing pain and muscle tension, increasing flexibility and range of motion, and improving blood circulation.”¹¹⁰ Massage therapy has been shown to be beneficial⁴ in working with athletic training/injury treatment^111–119, ergonomics and job-related injuries^{43–46,48,120}, cardiac rehabilitation^84,121,122, joint replacement rehabilitation^123–125, and scar management.^126–135

Massage therapy can help make the healing process more successful by addressing not only the symptoms of medical conditions but also the treatments for those conditions which can have effects that significantly impair quality of life, sometimes generating pain, anxiety, and depression. Massage therapy for inpatient conditions in hospitals demonstrates how massage therapy can apply to a wide range of health issues.

Massage therapy has been shown to be beneficial^4,11 for cancer management^60,136–150, post-surgical pain management^{14,84,90,151–164}, lymphatic drainage^165–170, maternity and newborn care.^171–181

References

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Originally proposed by Sabrina Lopez

Approved September 2017