Research about Massage & Stress Relief

Stress is thought to have both direct and indirect relationships to a host of physical and emotional conditions, including headaches, muscle spasms, anxiety and depression.
By investigating the impact of massage in general, we can learn potential ways it can alleviate stress. Stress is a commonly used word in massage research; a PubMed search using the words “massage research and stress” yielded more than 1,000 studies. Because massage has proven quite helpful in address-ing a host of stress-related conditions, it’s thought that it does so, at least in part, by decreasing the neurohormone cascade triggered by the SNS and by increasing PNS stimulation. Furthermore, since massage has been found to directly decrease muscle tension—and one result of stress is increased muscle tension via stimulation of the SNS—many assume that massage reduces stress by triggering the PNS. Numerous massage therapy studies have included objective outcome measures of stress, such as epinephrine and cortisol levels and subjective outcome measures, such as self- assessments of stress. In her review of massage research in 1998, Tiffany Field, PhD, suggested that massage had a positive impact on stress levels, as measured by norepinephrine and epinephrine levels in preterm infants and decreased anxiety and cortisol levels in burn patients and adolescent women with eating disorders.6 Field hypothesized that such stress reduction is accomplished by massage activating the PNS. A subsequent meta-analysis of massage therapy research by Moyer et al. didn’t support Field’s findings of decreased cortisol levels in the studies it reviewed and called into question the theory that massage therapy impacts the body by activating the PNS.7 Subsequent reviews of studies for low birth-weight infants and the pediatric population also showed no support for massage therapy reducing cortisol levels.8-9 Other studies have shown that massage can reduce both heart rate and blood pressure—indications of PNS activity. In a recent effort to explore the role of massage therapy treating migraine headaches, New Zealand researchers Sheleigh Lawler and Linda Cameron10 designed a small randomized control study of people with migraine headaches and divided them into two groups—one that received massage therapy, and another that received no treatment for 13 weeks. The researchers theorized that massage therapy would reduce the number of migraines by decreasing the SNS’s arousal and activating the PNS, thereby decreasing muscle tension, breaking down adhesions and increasing blood circulation. Stress levels were measured by both cortisol levels and a self-reported scale of perceived stress and coping efficacy. In addition, all participants were asked to maintain a daily log recording their perceived levels of stress and sleep. After each massage session, levels of stated anxiety, heart rate and cortisol levels were as-sessed. As a result, this study enabled a comparison between physiological (i.e., cortisol levels and heart rate) and perceived levels of stress. Compared with control participants, massage participants showed decrease in heart rate, anxious mood and salivary cortisol right after the massage. They also showed improvement in migraine frequency during the intervention weeks. Although the immediate results of massage showed decreases in both cortisol levels and perceived stress, the daily log reflected a steady level of perceived stress in the massage group and an increased level of stress in the control group. While massage therapy was not associated with an increased amount of sleep, it was associated with reports of better sleep quality. Though this study had a limited sample size and its study subjects had histories of limited migraine headaches, it was generally well-designed and provided a thorough explanation of the procedures and measures used. It included both physiological and affective measures of stress, both of which showed a positive effect of massage on decreasing the subjects’ stress levels, which supports the idea that massage may help reduce stress and activate the PNS.