Background: manual massage (MM) is as a method of manipulating the soft tissue of whole body areas using pressure and traction. A combination of effleurage, petrissage, kneading, friction, tapotement, vibration and their derivatives can be seen in a wide diversity of massage styles, such as acupressure, aromatherapy massage, Ayurveda, Lomi-lomi, lymphatic drainage, reflexology, Russian, Shiatsu, Thai and Tui na. Hundreds of trials of MM for pain have been published, and several types of MM have been evaluated in systematic reviews (SRs). Some of these reviews arrived at contradictory conclusions.
Objectives: to summarize and assess the evidence of massage therapy for pain.
Methods: we searched six databases from inception to January 2019. All SRs of randomised controlled trials (RCTs) of any type of MM with any type of pain as the outcome measure were eligible. We did not impose any language restrictions. The methodological quality of the included SRs was assessed using the Oxman criteria. Data extraction and quality assessment were conducted independently by the review authors using a predefined data extraction form.
Results: we included 80 SRs. Even though most of them were of high methodological quality, they were based on poor quality RCTs. Unanimously positive conclusions were reached for cancer-related pain, dysmenorrhea, labor pain, low back pain, neck pain and shoulder pain. Reviews drew negative conclusions for tension-type headache, fibromyalgia and irritable bowel syndrome. A wide variety of MM techniques were examined, including acupressure, aromatherapy, classical massage, connective tissue, deep transversal friction massage, ischemic compression, lymphatic drainage, myofascial release, reflexology, Shiatsu, soft tissue massage, Thai massage and Tui na.
Conclusions: our overview of SRs shows that the research interest in massage is extensive. It suggests that MM is effective for cancer pain, dysmenorrhea, labor pain, lower back pain, neck pain and shoulder pain, and it is probably ineffective for fibromyalgia and headache. The current evidence has several limitations. In particular, there is a need for more high-quality primary studies to accurately define the therapeutic value of MM. This review may be of use for clinicians in making informed decisions about patients with chronic and acute pain.
Patient or healthcare consumer involvement: none.