Massage Therapy for Military Veterans

Military veterans can face a host of health concerns upon returning from service, from chronic pain related to physical injuries, to emotional and psychological issues such as post-traumatic stress disorder (PTSD). Massage therapists are in an excellent position to help veterans take control of their health and wellness. 

Health Conditions in the Veteran Population

Explore information on some of the most common health issues veterans face, and how massage therapy can help. Find out what you need to know when working with this population.

PTSD

Some research estimates that between 5 and 20 percent of veterans who were deployed to Iraq and Afghanistan have PTSD. This condition comes with both physical and psychological symptoms, and can include the following:

• Higher rates of musculoskeletal or cardiovascular issues
• Flashbacks and nightmares
• Increased feelings of detachment and isolation
• Irritability and difficulty falling asleep

There is research that suggests massage therapy can help veterans with PTSD. A 2021 case study, on a male veteran with a combat-related shoulder injury and PTSD, found that massage therapy provided meaningful benefits.¹ 

In another randomized controlled trial examining the effects of a web-based, self-directed program that included mindfulness and body-based wellness skills for veterans and their significant others, partner massage was found to produce significant reductions in self-reported levels of pain, tension, irritability, anxiety and depression. Massage was also found to be a positive addition to veteran health care in a June 2017 study.

Related: Massage Therapy Journal Article: Massage for PTSD

Chronic Pain

Chronic pain is another major issue within the veteran population. Musculoskeletal pain is common, with research showing it’s the leading cause of disability among veterans and that up to 70 percent of the veteran population is affected.

In a recent national survey of veterans' interest in and use of complementary and integrative health (CIH) approaches, 44% reported using massage therapy, while 37% indicated they used chiropractic care, followed by 34% who engaged in mindfulness. The two most frequent reasons veterans gave for using CIH approaches were pain relief and stress reduction/relaxation.²

In a 2022 pilot study, which focused on integrating massage therapy into the healthcare of female veterans, effleurage massage was performed on 96 patients attending gynecology appointments, 79% of which had a history of chronic pain. The results indicated that massage therapy may be an effective and safe treatement for pain and/or anxiety in female veterans.³ 

Additional research studies also back up the benefits massage therapy offers people dealing with chronic pain, including back pain, neck and shoulder pain and osteoarthritis. For example, one study comparing two different types of massage to usual care on 401 participants with nonspecific low back pain found massage to be an effective treatment, with benefits lasting at least six months.

Related: Massage an alternative to opioids for pain relief

Anxiety

For veterans especially, anxiety can present as generalized anxiety disorder (GAD)—what’s described as a persistent and uncontrollable anxiety and worry. In a 2013 study investigating the prevalence of GAD in the Department of Veterans Affairs primary care settings, researchers found that 12 percent of the 884 participants met the diagnostic criteria for GAD. Additionally, GAD was found in 40 percent of those participants who had been diagnosed with PTSD.

A 2016 study of the effect of Swedish massage therapy on symptoms of GAD found that participants’ anxiety was significantly reduced at the start of week three, suggesting massage may be an effective acute treatment for GAD.

Related: Learn more about massage for mental health

Depression

A 2016 study on U.S. veterans with PTSD and depression found those who also had low social support were at an increased risk for suicide.

And although the comorbidity rate between PTSD and depression is fairly high, a 2017 study found that approximately 40 percent of veterans not diagnosed with PTSD had other mental health issues, most frequently depression.

Here, too, massage therapy shows promise. A recent meta-analysis considering the treatment effects of massage therapy for depression found a significant association between massage and alleviated symptoms of depression.

Insomnia

While insomnia is a common issue among the general U.S. population, this condition presents an even greater problem to veterans. A study conducted in 2017 involving primary care providers’ perspectives on veterans showed that more than half of the veterans already enrolled in VA health care centers in the Midwest demonstrated having significantly higher levels of insomnia.

Research indicates that massage therapy can improve sleep in those with lower back pain, fibromyalgia, insomnia, pain and other health conditions.

Learn how to advance the use of massage therapy for military veterans especially those receiving services through the Department of Veterans Affairs (VA). Explore how complementary and integrative health (CIH) approaches, including massage therapy, are gaining ground in practice and research. 

What Massage Therapists Need to Know When Working with Veterans

Make a real connection before your first massage. 

First things first: Make a connection with the veteran before they even get on your massage table. Trust is going to be key for most veterans, and so you need to spend time talking before your first session. Some veterans may want to talk or visit your practice before they decide to schedule a session.

Pre-assessments will determine how to best structure a massage session, as well as the techniques that will prove most beneficial.

Be flexible and adjust to the client's individual needs. 

Because each veteran may have different health issues and come from a different background, no single technique will offer the same benefits to all.

It is also a good idea to use massage techniques and approaches during massage sessions that will put the veteran at ease, especially if they have a condition that might make the session more complicated, such as PTSD.

Set expectations early and communicate often.

Clients who have PTSD especially may have the tendency to arrive feeling nervous about the session, so it’s helpful to set expectations early and make sure that the client knows they are in full control of the massage session, including the music, how dark the room is, what areas of the body are OK to massage and how much pressure is used. Clients also need to know they can stop a massage session at any time.

You can get a great deal of information during intake, but don’t forget to check in during the session, too. Make sure the client is comfortable and feels safe enough to give you feedback, and be extra aware of anything that might trigger a flashback or response, such as specific smells, loud noises or even some kinds of touch.

References

1. Rosenow M, Munk N. Massage for Combat Injuries in a Veteran with Undisclosed PTSD: A Retrospective Case Report. Int J Ther Massage Bodywork. 2021 Mar; Published online 2021 Mar 1.PMCID: PMC789233 PMID: 33654501 Retrieved from: https://pubmed.ncbi.nlm.nih.gov/33654501/ 

2. Taylor SL, Hoggatt KJ, Kligler B. Complementary and Integrated Health Approaches: What Do Veterans Use and Want. J Gen Intern Med. 2019 Jul;34(7):1192-1199. doi: 10.1007/s11606-019-04862-6. Epub 2019 Apr 22. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/31011973/

3. Mitchinson A, Fletcher CE, Trumble E. Integrating Massage Therapy Into the Health Care of Female Veterans. Fed Pract. 2022 Feb;39(2):86-92. doi:10.12788/fp.0223. Epub 2022 Feb 9. PMID: 35444384; PMCID: PMC9014938. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/35444384/