Don’t Believe the Pseudoscience Around Massage

You can enjoy those kneading hands and even get pain relief, without signing on to nonsense.

Massage has die-hard fans, and mild evidence suggests that it’s beneficial. The pressing, rubbing, and manipulating of your skin, muscles, tendons, and ligaments has been shown to reduce stress, pain, and muscle tension. However, you’re likely to hear any number of pseudoscientific claims, says Paul Ingraham, the author of PainScience.com, an assistant editor at ScienceBasedMedicine.org, and a registered massage therapist who specialized in difficult chronic pain cases for a decade. “Massage is a rich sensory experience,” he says, “but that doesn't translate well into discrete, evidence-based medical benefits any better than a deeply satisfying artistic experience, or having a terrific relationship with a dog.”

Claim: A good massage therapist can zero in on the places where “you’re tight.” Response: How tight you are to the touch doesn’t say much about your own comfort. Rocklike muscles may not be sore, and doughy muscles may feel awful, Ingraham says. In one study, examiners were asked to pick the most tense side of the back or neck in patients who, unknown to the examiners, suffered pain on only one side. The examiners picked the correct side in 65 percent of the back cases, and 58.5 percent of the neck cases. That’s not quite a slam dunk. “’You’re really tight,’ is often more of a sales pitch than a diagnosis,” Ingraham says.

Claim: A good massage therapist digs in deep — “no pain, no gain.” Response: Too much pressure can make you more tense and even feel like you have a flu, Ingraham explains. In one study in which researchers called 91 massage therapy clients after their session, 10 percent reported “minor discomfort.” Most of them said it came on within a day and was gone within three. Show anyone giving you a massage how much pressure you like, and tell them to back off if they dig too hard.

Claim: Massage “detoxifies” the body. Response: There’s no evidence that massage releases any nasty molecules. If you ask therapists what toxins they mean, they might name lactic acid — wrongly blaming it for post-exercise soreness — but research indicates that massage actually interferes with lactic acid elimination.

Claim: Massage increases circulation. Response: “It doesn’t really matter if massage increases circulation, because even a modest boost would be clinically trivial, dwarfed by the effect of any amount of exercise,” Ingraham says. Brisk walking would do more.

Claim: Fascia — connective tissue throughout the body — needs to be “released” by pulling on it. Response: While the surge of science on fascia may lead to remedies, there’s scant evidence for any of the therapies touted, Ingraham argues.  

Now the good side. There’s some science behind the idea that massage can lower anxiety and improve sleep. The same study following 91 clients found that 23 percent “experienced unexpected, nonmusculoskeletal positive side-effects.”

There’s also evidence that it can relieve pain, although not necessarily more than anything else that’s “pleasant, relaxing, and/or reassuring,” Ingraham says.

One key lesson: The origin of a muscle pain may be in a different spot. Ingraham tells the story of a relative, an uncomplaining weathered and cheerful former farmer who had an ache on the front of one shoulder. His doctor had diagnosed it as arthritis. When Ingraham saw him, he was “pale with pain,” and the pain was getting worse quickly. Ingraham rubbed a spot in the back — not front — for 5 minutes, and the man experienced complete relief. “He spent the rest of that weekend swinging his arm around, chuckling and saying things like ‘Who knew?’ and ‘Well, damn, ain’t that something!’”