Patient Handout: Massage Therapy as CAM

Massage therapy is a practice that dates back thousands of years. There are many types of massage therapy; all involve manipulating the muscles and other soft tissues of the body. In the United States, massage therapy is sometimes part of conventional medicine, as practiced by holders of MD (medical doctor) or DO (doctor of osteopathy) degrees and by their allied health professionals, such as physical therapists, psychologists, and registered nurses.1 In other instances, it is part of complementary and alternative medicine (CAM). Complementary medicine is used together with conventional medicine, and alternative medicine is used in place of conventional medicine.2 This Backgrounder provides a general overview of massage therapy used as CAM and suggests some resources you can use to learn more.

Key Points

  • People use massage therapy as CAM for a variety of health-related purposes, from treating specific diseases and conditions to general wellness.
  • Scientists do not fully know what changes occur in the body during massage, whether they influence health, and, if so, how. The National Center for Complementary and Alternative Medicine (NCCAM) is sponsoring studies to answer these questions and identify the purposes for which massage may be most helpful.
  • There appear to be few risks to massage therapy if it is used appropriately and provided by a trained massage professional.
  • Tell your health care providers about any CAM therapy you are considering or using, including massage therapy. This helps to ensure safe and coordinated care.

What Massage Therapy Is

The term massage therapy (also called massage, for short; massage also refers to an individual treatment session) covers a group of practices and techniques. There are over 80 types of massage therapy. In all of them, therapists press, rub, and otherwise manipulate the muscles and other soft tissues of the body, often varying pressure and movement. They most often use their hands and fingers, but may use their forearms, elbows, or feet. Typically, the intent is to relax the soft tissues, increase delivery of blood and oxygen to the massaged areas, warm them, and decrease pain. A few popular examples of this therapy are as follows:

  • In Swedish massage, the therapist uses long strokes, kneading, and friction on the muscles and moves the joints to aid flexibility.
  • A therapist giving a deep tissue massage uses patterns of strokes and deep finger pressure on parts of the body where muscles are tight or knotted, focusing on layers of muscle deep under the skin.
  • In trigger point massage (also called pressure point massage), the therapist uses a variety of strokes but applies deeper, more focused pressure on myofascial trigger points--"knots" that can form in the muscles, are painful when pressed, and cause symptoms elsewhere in the body as well.
  • In shiatsu massage, the therapist applies varying, rhythmic pressure from the fingers on parts of the body that are believed to be important for the flow of a vital energy called qi In traditional Chinese medicine, the vital energy or life force proposed to regulate a person's spiritual, emotional, mental, and physical health and to be influenced by the opposing forces of yin and yang..

Massage therapy (and, in general, the laying on of hands for health purposes) dates back thousands of years. References to massage have been found in ancient writings from many cultures, including those of Ancient Greece, Ancient Rome, Japan, China, Egypt, and the Indian subcontinent.

In the United States, massage therapy first became popular and was promoted for a variety of health purposes starting in the mid-1800s. In the 1930s and 1940s, however, massage fell out of favor, mostly because of scientific and technological advances in medical treatments. Interest in massage revived in the 1970s, especially among athletes.

More recently, a 2002 national survey on Americans' use of CAM (published in 2004) found that 5 percent of the 31,000 participants had used massage therapy in the preceding 12 months, and 9.3 percent had ever used it. According to recent reviews, people use massage for a wide variety of health-related intents: for example, to relieve pain (often from musculoskeletal conditions, but from other conditions as well); rehabilitate sports injuries; reduce stress; increase relaxation; address feelings of anxiety and depression; and aid general wellness.

Who Provides Massage Therapy

A person who professionally provides massage therapy is most often called a massage therapist, although there are some other health care providers (such as chiropractors) who also have massage training. This Backgrounder mainly uses the term massage therapist. Most massage therapists learn and practice more than one type of massage.

To learn massage, most therapists attend a school or training program, with a much smaller number training instead with an experienced practitioner. Many students are already licensed as another type of health care provider, such as a nurse.

There are about 1,300 massage therapy schools, college programs, and training programs in the United States. The course of study typically covers subjects such as anatomy and physiology (structure and function of the body); kinesiology (motion and body mechanics); therapeutic evaluation; massage techniques; first aid; business, ethical, and legal issues; and hands-on practice of techniques. These educational programs vary in many respects, such as length, quality, and whether they are accredited. Many require 500 hours of training, which is the same number of hours that many states require for certification. Some therapists also pursue specialty or advanced training.

At the end of 2004, 33 states and the District of Columbia had passed laws regulating massage therapy--for example, requiring that massage therapists graduate from an approved school or training program and pass the national certification exam in their field in order to practice. Cities and counties may have laws that apply as well. Professional organizations of massage therapists have not agreed upon the standards for recognizing that a massage therapist is properly and adequately trained.


1 Conventional medicine is medicine as practiced by holders of M.D. (medical doctor) and D.O. (doctor of osteopathy) degrees and by their allied health professionals, such as physical therapists, psychologists, and registered nurses. An example of massage therapy as conventional medicine is using it to reduce a type of swelling called lymphedema.

2 CAM is a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine. While some scientific evidence exists regarding some CAM therapies, for most there are key questions that are yet to be answered through well-designed scientific studies. An example of massage therapy as CAM is using it with the intent to enhance immune system functioning.

Source: Accessed on November 20, 2007.