The dark side of massage therapy

Massage is usually defined as manual (by hand) manipulation of the soft tissues of the body, using strokes that include gliding, kneading, pressing, tapping, and/or vibrating. The best known forms are sports massage, which focuses on muscle systems relevant to a particular sport; and Swedish massage which uses long strokes, kneading, and friction techniques on superficial layers of muscles, plus active and passive movements of the joints.

Massage can help people relax, relieve aching muscles, and temporarily lift a person's mood. There is no evidence-based reason to believe that massage can provide any overall health benefit or influence the course of any disease. However, many massage therapists and their organizations make therapeutic claims that go far beyond what massage can accomplish.

The American Massage Therapy Association (AMTA), for example, has stated that therapeutic massage can strengthen the immune system and help with allergies, asthma, bronchitis, spastic colon, constipation, diarrhea, and sinusitis. The AMTA Web site suggests that "massage is to the human body what a tune-up is to a car" and that "therapeutic massage can be part of your regular healthcare maintenance."

Many massage therapists offer irrational treatments in addition to ordinary massage. The methods include:

• Acupressure and shiatsu are often described as "acupuncture without needles." They are based on metaphysical concepts of traditional Chinese medicine, which holds that "life energy (chi or qi)" flows through hypothetical (imaginary) channels called meridians and that ill health is due to energy blockages and/or "imbalances." Practitioners claim to restore health by correcting these alleged imbalances. They may also use irrational diagnostic methods to reach diagnoses that do not correspond to scientific concepts of health and disease.
• Aromatherapy involves the use of aromatic oils from plants to affect mood or promote health. Some proponents claim that aromatherapy is a complete medical system that can "revitalize cells," strengthen defense mechanisms, and cure the cause of disease. Although pleasant odors may enhance a person's effort to relax, there is no scientific evidence that they can influence the course of any disease. In addition, some people are allergic to aromatherapy products.
• Colonic irrigation (also called colon hydrotherapy) is typically performed by pumping large into the rectum. The procedure is said to "detoxify" the body. However, no relevant "toxins" have ever been identified, and the procedure can cause fatal electrolyte imbalance.
• Craniosacral therapy (also called cranial therapy) is based on the notion that manipulating the bones of the skull can sure or prevent health problems by influencing the flow of "life energy" and/or "cerebrospinal fluid." Actually, the skull fuse early in life and cannot be moved independently.
• Polarity therapy is a system of manipulation, stretching exercises, clear thinking, and diet, which claims to restore health by removing blocks and balancing the flow of "life energy" between the positive (head) and negative poles (feet) of the body. There is no scientific evidence that this energy flow exists.
• Reiki practitioners claim to transmit "universal life energy" by placing their hands in on or near the patient's body or by visualize special symbols (even from far away). The existence of "universal life energy" has not been demonstrated.
• Reflexology (also called zone therapy) practitioners claim that each body part is represented on the hands and feet and that pressing these areas can have therapeutic effects throughout the body. However, the pathways postulated by reflexologists have no anatomic basis; and no well designed study has demonstrated that reflexology is effective against any disease. Done gently, reflexology is a form of foot massage that may help people relax temporarily. Whether that is worth $35 to $100 per session or is more effective than ordinary (noncommercial) foot massage is a matter of individual choice.
• Therapeutic Touch practitioners claim to correct "energy imbalances" by moving their hands above the patient's body. Healing supposedly results from transfer of "excess energy" from healer to patient. Neither the forces involved nor the alleged therapeutic benefits have been demonstrated by scientific testing.

Using the Internet, I have examined the course offerings of dozens of massage therapy schools and found that nearly every one of them advocates and teaches one or more of the above practices.

If you seek help from a massage therapist, try to select one who does not use the irrational practices mentioned in this article.

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Stephen Barrett, M.D. is Board Chairman, Quackwatch, Inc., and Vice President of the National Council Against Health Fraud. He edits a free weekly electronic newsletter and operates seven consumer-protection Web sites:

http://www.quackwatch.com
http://www.chirobase.org
http://www.homeowatch.org
http://www.ihealthpilot.org
http://www.mlmwatch.org
http://www.nutriwatch.org
http://www.ncahf.org

www.canoe.ca/HealthAlternative/home.html

Dr Stephen Barrett;