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Research With Massage Therapy Foundation

By Massage Therapy Foundation Contributor

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Massage Effective for Cancer Pain Relief

Contributed by MK Brennan MS, RN, LMBT; Jolie Haun PhD, EdS, LMT; Beth Barberree BA, MT

Complementary therapies are commonly used by cancer patients for physical, emotional, and spiritual benefits. Among these therapies, massage is often provided for relief of cancer-related symptoms and treatment, most notably the pain. Sook-Hyun, et al, conducted a meta-analysis to review studies in nine electronic databases in English, Chinese, and Korean languages. Twelve high quality studies were retrieved and used for the analysis. The twelve identified studies were conducted between 1990 and 2013 in four countries, and included 559 subjects in total. Nine of the twelve studies found cancer pain was reduced after massage.

Findings of the meta-analysis indicated 40% to 90% of cancer patients report pain due to changes in their bodies from the cancer itself or as a result of treatments such as surgery, chemotherapy, or radiation. Conventional treatment is not always effective in relieving the pain satisfactorily and many patients also use massage and/or other complementary therapies to treat it.

Massage Effective for Cancer Pain Relief - Copyright – Stock Photo / Register Mark Previous reviews of studies about massage for cancer pain have shown mixed results from not being significantly effective to suggesting that massage therapy can reduce cancer pain by 40.2%. For the purpose of this meta-analysis, randomized controlled trials (RCT) and nonrandomized controlled clinical trials (CCT) with a control group of those who received conventional care or no-massage and patients with all types of cancer were systematically reviewed. The review also included trials that used the Visual Analogue Scale (VAS), Brief Pain Inventor (BPI), Numeric Rating Scale (NRS) and present pain intensity (PPI) to reduce bias due to the use of different pain assessment scales. Evaluation of the methodological quality of the studies was based on the Physiotherapy Evidence Database (PEDro) scale and Cochrane risk of bias for quality of studies in meta-analysis. Studies awarded greater than or equal to six on the PEDro scale were considered a high-quality study.

Soon-Hyun, et al, reviewed the effects of massage therapy according to a number of items including pain relief, cause of cancer pain, type of cancer, massage type, methodological quality of the studies, blinding of studies, pain assessment scales, and time points of the studies. Results from these reviews show that massage therapy largely reduced pain in all types of cancer.

The authors recommended that future studies include the qualifications, affiliation, experience, and clinical expertise of the massage therapists, since these may influence treatment effects. They also recognized that there were some limitations in their study. They included RCT and CCT studies with possible selection bias however, results didn't change when the analysis was restricted to the assessment score in the PEDro scale. Another limitation is the possibility of both performance and response biases in some studies since the comparisons between massage and the control groups cannot be blinded. It was noted, however, that results did not change when either blinded or non-blinded studies were used in the analysis. Additionally, results did not change when the authors restricted the analysis to the time points measured at primary treatment or the following weeks. So, combining different measurement time points may be critiqued, but may not necessarily be a limitation.

Given that there are few long-term studies, the evidence is not sufficient to suggest that massage is an effective long-term treatment for cancer pain. Well designed, long-term studies are needed to draw firm conclusions about the effect of massage on cancer pain but this meta-analysis is a good resource for anyone wishing to pursue this research.

Meta-analysis studies make a significant contribution to advancing the science of a practice such as massage therapy. Analyzing multiple studies across diverse populations with a range of conditions in diverse geographic locations provide the power necessary to make strong inferences about the effects of an intervention such as massage therapy. As the adage goes, "there is power in numbers." Meta-analyses provide the numbers and power which often elude single study designs; this article provides more evidence to support the use of massage therapy with patients receiving treatment for cancer who experience related symptoms such as pain. Massage therapists in the field can share the results of this analysis with their patients who have cancer to provide support for the significant palliative effects of massage therapy.

As AMTA celebrates National Massage Therapy Week during the National Convention in Milwaukee, October 26-29, we invite you to visit our Poster session to learn more about recent studies in massage. Stay updated with more information at our website: www.massagetherapyfoundation.org.

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