This article is written by Andrea Winzer, MSc, BCTMB & Arthur Veilleux, PT, DPT, for the Massage Therapy Foundation.

During the current COVID-19 pandemic, health care providers and emergency medical services (EMS) staff play vital roles in response to the crisis. Many of them face unprecedented levels of stress, anxiety, and exhaustion as they support their communities. Even before the pandemic, EMS workers often suffered from work-related stress that affected their quality of life.

A March 2019 study published in the Massage Therapy Foundation’s International Journal of Therapeutic Massage and Bodywork focuses on the effectiveness of massage therapy in the management of occupational stress in health care and EMS workers. 

Nature Vs. Nurture

Based on prior research, chronic exposure to unpredictable, stressful conditions experienced by first responders has been shown to create a high risk of post-traumatic stress disorder (PTSD), as well as a variety of psychological and physiological symptoms like anxiety, depression, sleep disorders, gastrointestinal problems, burnout, emotional disturbances, overall diminished occupational satisfaction and frustration. 

A variety of coping skills and stress management strategies are often suggested to these workers, among them integrative health care strategies that include massage therapy. But how effective is massage therapy in helping regulate occupational stress, and is there any research-based evidence for positive influence on the well-being of first responders?

Research Based Progress

In this study, a research team from the University of Medical Sciences in Rafsanjan, Iran, designed and conducted a randomized controlled trial with 58 members of staff of emergency medical services working in pre-hospital emergency medical services stations. The goal of this study was to determine the effects of Swedish massage on the occupational stress levels of EMS staff working in 20 different EMS centers in both urban and suburban areas in Rafsanjan in the Kerman Province of Iran. 

To qualify for participation, individuals had to have at least one year of experience working in the emergency ward, have not received any additional complementary relaxation treatments or any type of anti-anxiety drugs or tranquilizers, have not suffered from acute or chronic diseases that affected their psychological status, have no signs of edema, inflammation or neuropathy on any of the body parts the massage treatment was administered, and displayed a desire to voluntarily participate in the research study. All participants were male and worked as nurses or EMS technicians, and all were randomly assigned to either an intervention or control group.

Data collection and evaluation included two questionnaire-based tools: A demographic information questionnaire and the Expanded Nurse’s Stress Scale (ENSS). The demographic information questionnaire was used to collect data on age, years of work experience, marital were kept to a minimum. The massage modality used was Swedish massage consisting of three main strokes: effleurage, petrissage, and percussion. Massage was performed on the back and shoulders, arms and hands, and legs and feet of the participants, first in prone and then in supine position, with an average duration of 20 to 25 minutes per body area.

The massage therapist made sure that each participant was comfortable on the massage table with appropriate draping and positioning to minimize stress on the body. Participants were advised to rest before and after the treatment.  

See Also: Massage & Stress: Understanding Viscerosomatic Reflexes

What the Studies Show

Overall, the results of this study indicate that receiving massage therapy sessions significantly reduces occupational stress in health care providers and emergency medical staff. Based on the evaluation of the ENSS pre- and post-treatment data, both the total occupational stress and the individual subcategories in the intervention group show significantly lower scores, which indicates a significant reduction in stress levels after receiving regular Swedish massage therapy sessions. 

The authors of the study conclude that especially for this target population, status, work hours per month, part-time or full-time employment, as well as exercise regimen. The ENSS was used to evaluate the stress levels of the participants in nine subcategories, including, death and dying, conflict with physicians, inadequate emotional preparation, problems relating with peers, problems relating to supervisors, workload, uncertainty concerning treatment, patients and their families, as well as discrimination. On a five-point Likert scale, participants indicated their respective stress levels, from zero to four, with four being the most stressful experience. Both assessments were conducted with all participants (control and intervention group) at the start and end of the trial period.

While the control group did not participate in any treatment, the individuals in the intervention group received regular massage therapy sessions (twice a week) over a period of four weeks. Each massage session had a duration of 60 to 70 minutes and was administered in the morning after a 24-hour work shift.

The treatments were performed in the staff rest areas in a quiet, safe, and clean environment where noise levels massage therapy could be utilized as an effective modality that can be easily implemented in the work setting of emergency medical centers to reduce occupational stress and help manage psychological and physiological symptoms related to the stressful occupational environment. 

Read the full study: Massage Therapy in Management of Occupational Stress in Emergency Medical Services Staff.

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