Massage Therapy and Massage

¶ … nursing, and then provide some analysis to those different articles.

The first article is " The Effects of Massage Therapy on Pain Management in the Acute Care Setting" by Adams, White and Beckett (2010). The intention of the this article was to study the effects of massage therapy on inpatient pain levels in the acute care setting. The study was conducted at a single facility -- the Flagstaff Medical Center in northern Arizona.

The study authors used a convenience sample, and they recorded pain levels according to some sort of visual code. As such, there is a high degree of subjectivity in this study, and it relies strictly on qualitative inputs, which are then converted to quantitative for the purpose of statistical analysis.

The sample size was n=53, each one receiving massage therapy as part of their treatment. There was variability in how much therapy each patient received, which mirrors real life, as these were real life cases.

The findings of the study are as follows. The mean pain level of the patients prior to massage therapy was 5.18, and after was 2.33. Thus, the observed pain reduced is deemed to be statistically significant. The qualitative analysis also suggests that there was improvement in all levels, including "overall pain level, emotional well-being, relaxation and ability to sleep" (p.4).

These findings lead the authors to conclude that massage therapy has a positive impact on patients in the acute care setting. That almost all of the patients reported lower pain, to a statistically significantly degree, after the intervention. That the other outcomes, not pain, were also positive, provides further support for the quantitative findings. The authors therefore conclude that massage therapy holds significant value in the acute care setting, in particular with respect to most patients.

The study relies on qualitative assessments of pain that are then converted to quantitative data in order to be subject to analysis, but there is also a fair bit of qualitative information here as well. The overall results are fairly strong, even if the quantitative methodology is not great -- relying on underlying qualitative data without a consistent means of converting that data to quantitative is not the robust methodology. For something like pain, the measure will always be subjective, such that each patient will report pain differently according to their senses and their tolerance. So in that sense, such a method is unavoidable. In order to study pain, this is a limitation that must be accepted, and thus still represents best practices in terms of quantitative analysis for this particular subject matter.

Article #2

The second article is " Perceptions of other integrative health therapies by veterans with pain who are receiving massage" by Fletcher, Mitchinson, Trumble, Hinshaw and Dusek. The objective of this study was to determine the effectiveness of integrative health therapies on a small sample of veterans. The study was put together by the VA in order to get a sense of whether such interventions should be explored on a larger scale with their patient base.

This study was conducted in an interview setting. There were 38 interviewees, and they were all selected because they were suffering from chronic pain issues. The patients were asked about their experiences at VA health facilities, and about their opinions on what interventions they would recommend to other veterans in the VA system.

The outcome of this study is that the patients in general expressed positive response towards massage, that massage therapy decreased pain, increased mobility, and decreased opioid use, all of which are related to better outcomes.

The patients were asked about the challenges in recommending more of such therapies. They noted that there is a poor ratio of providers of complementary and integrative health providers to patients at the VA, and that it was also difficult to find fee-based CIH providers outside of the system, or that when they did these providers were too costly for some of the patients. The patients also expressed concern that there was uneven deployment of CIH practitioners across the VA -- that maybe some areas or facilities were well-staffed but others were inadequately staffed.

This study is qualitative in nature, as the different interviewees provided their view, which were based on their experiences and their interpretations about the VA system, again based on their experiences. There was no quantitative analysis done on the responses, only qualitative. The responses provide first-person insight into both the effectiveness of massage therapy and also the limitations that exist in seeking to obtain massage therapy both within the VA system and outside of it. These concerns are critical for the administrators of VA facilities, but the findings on the effectiveness of massage therapy add to the rich body of knowledge that highlights the value of massage therapy.

Article #3

The third article is " Deep tissue massage and nonsteroidal anti-inflammatory drugs for low back pain: a prospective randomized trial" by Majchrzyck, Kocur & Kotwicki (2014). This article investigates the value of deep tissue massage in chronic lower back pain therapy, and how this compares with the combination of NSAIDs and the same massage. So basically, testing whether NSAIDs add any value to therapy that in all cases includes deep tissue massage.

There were a total of 59 patients, consisting of a treatment group and a control group. In both groups, pain reduction was observed, which makes for a good selling point for the deep tissue massage therapy. There was no statistically significant difference noted between the outcomes for either group. What this research shows is that deep tissue therapy is effective, and it is inconclusive as to the difference between the addition of other therapeutic elements. An interesting addition to the study that was unfortunately passed over was the opportunity to have a control group with just deep tissue massage, as that would have provided insight as to the value of those other therapies -- do they add anything to DTM or is it just the DTM that is delivering the results.

Conclusions

The three studies are basically straightforward in terms of the results -- massage therapy is effective in pain management. It is shown in all three studies to reduce pain. That is the main takeaway from these studies. They all provide clear evidence from the sufferers of pain that massage therapy has value in terms of pain reduction, and therefore it is a worthwhile endeavor to increase the usage of pain reduction through massage therapy. The studies looked at a few other variables, but the consistent thread throughout the studies was the use of massage therapy and the reports of its effectiveness. As such, all of these studies add to the body of knowledge that promotes the use of massage therapy for those who suffer chronic pain, no matter what the form that chronic pain might take.