Editing Massage (section)

== Medical and therapeutic use ==
The main professionals that provide therapeutic massage are massage therapists, [[athletic trainer]]s, [[Physical therapy|physical therapists]], and practitioners of many [[traditional Chinese medicine|traditional Chinese and other eastern medicines]]. Massage practitioners work in a variety of medical settings and may travel to private residences or businesses.<ref name=nccam/> [[Contraindication]]s to massage include [[deep vein thrombosis]], [[bleeding disorders]],  taking blood thinners such as [[warfarin]], damaged blood vessels, or weakened bones from [[cancer]], [[osteoporosis]], [[fractures]], and [[fever]].<ref name=nccam/>

=== Beneficial effects ===
[[File:Öldispersionsbad mit badendem Menschen und Bürstenmassage.jpg|thumb|Oil dispersion bath and brush massage]]

Peer-reviewed medical research has shown that the benefits of massage include [[Analgesia|pain relief]], reduced [[Anxiety (mood)#Trait|trait anxiety]] and [[Depression (mood)|depression]], temporarily reduced blood pressure, heart rate, and state of anxiety.<ref name= Meta/> Additional testing has shown an immediate increase in, and expedited recovery periods for, muscle performance.<ref>{{Cite journal |vauthors=Dupuy O, Douzi W, Theurot D, Bosquet L, Dugué B |year=2018 |title=An Evidence-Based Approach for Choosing Post-exercise Recovery Techniques to Reduce Markers of Muscle Damage, Soreness, Fatigue, and Inflammation: A Systematic Review with Meta-Analysis |journal=Frontiers in Physiology |volume=9 |pages=403 |doi=10.3389/fphys.2018.00403 |pmc=5932411 |pmid=29755363|doi-access=free }}</ref> Theories behind what massage might do include: enhanced skeletal muscle regrowth and remodeling,<ref>{{Cite journal |vauthors=Miller BF, Hamilton KL, Majeed ZR, Abshire SM, Confides AL, Hayek AM, Hunt ER, Shipman P, Peelor FF, Butterfield TA, Dupont-Versteegden EE |date=January 2018 |title=Enhanced skeletal muscle regrowth and remodelling in massaged and contralateral non-massaged hindlimb |journal=The Journal of Physiology |volume=596 |issue=1 |pages=83–103 |doi=10.1113/JP275089 |pmc=5746529 |pmid=29090454}}</ref> blocking [[nociception]] ([[gate control theory]]),<ref>{{Cite journal |vauthors=Chen L, Michalsen A |date=April 2017 |title=Management of chronic pain using complementary and integrative medicine |journal=BMJ |volume=357 |pages=j1284 |doi=10.1136/bmj.j1284 |pmid=28438745 |s2cid=23149656}}</ref> activating the [[parasympathetic nervous system]] (which may stimulate the release of [[endorphins]] and [[serotonin]], preventing [[fibrosis]]<ref>{{Cite journal |vauthors=Bove GM, Harris MY, Zhao H, Barbe MF |date=February 2016 |title=Manual therapy as an effective treatment for fibrosis in a rat model of upper extremity overuse injury |journal=Journal of the Neurological Sciences |volume=361 |pages=168–80 |doi=10.1016/j.jns.2015.12.029 |pmc=4729290 |pmid=26810536}}</ref> or [[scar|scar tissue]]), increasing the flow of [[lymph]], and improving [[sleep]].<ref name=nccam/><ref>{{Cite journal |vauthors=Owais S, Chow CH, Furtado M, Frey BN, Van Lieshout RJ |date=October 2018 |title=Non-pharmacological interventions for improving postpartum maternal sleep: A systematic review and meta-analysis |journal=Sleep Medicine Reviews |volume=41 |pages=87–100 |doi=10.1016/j.smrv.2018.01.005 |pmid=29449122|s2cid=23827078 }}</ref>

Infant massage has been found to hold therapeutic benefits for premature infants and their parents.<ref name="weight">{{Citation |journal=Infant Behavior and Development |vauthors=Hwu L, Tzeng Y, Teng Y, Liu S |year=2023 |title=Effects of massage intervention on discharged premature infants’ weight, parental stress, and parent–child attachment: A randomized controlled trial |volume=72 |pages= |doi=10.1016/j.infbeh.2023.101867 }}</ref> Premature infants are susceptible to low birth weight and decreased immune function;<ref name="comp" /> massage has been found to counter these effects, causing weight increase, reduced pain, and increased immune function.<ref name="comp">{{Citation |journal=Complementary Therapies in Clinical Practice |vauthors=Field T |year=2014 |title=Massage therapy research review |volume=20 |pages=224–229 |doi=10.1016/j.ctcp.2014.07.002 |pmc=5467308 }}</ref> Administering infant massage also reduces stress and increased [[oxytocin]] in parental figures regardless of gender, and overall improves emotional attachment with their child.<ref name="weight" />

Massage research is hindered from reaching the [[Gold standard (test)|gold standard]] of [[Scientific method|scientific inquiry]], which includes [[placebo]]-controlled and [[Blind experiment|double blind]] [[clinical trial]]s.<ref name="minn">{{Cite web |year=2006 |title=What Does the Research Say? |url=http://takingcharge.csh.umn.edu/therapies/massage/research |url-status=dead |archive-url=https://archive.today/20121211104940/http://takingcharge.csh.umn.edu/therapies/massage/research |archive-date=11 December 2012 |access-date=6 December 2007 |publisher=Regents of the University of Minnesota |vauthors=Evans R}}</ref><ref name="anatomy">{{Cite web |year=2004 |title=Anatomy of a Research Article |url=http://www.massagetherapyfoundation.org/pdf/Anatomy%20of%20a%20research%20article.pdf |url-status=dead |archive-url=https://web.archive.org/web/20080216045454/http://www.massagetherapyfoundation.org/pdf/Anatomy%20of%20a%20research%20article.pdf |archive-date=16 February 2008 |access-date=6 December 2007 |publisher=Massage Therapy Foundation |vauthors=Muscolino J}}</ref> Developing a "sham" [[manual therapy]] for massage would be difficult since even light touch massage could have effects on a subject.<ref name=minn/> It would also be difficult to find a subject that would not notice that they were getting less of a massage, and it would be impossible to blind the therapist.<ref name=minn/> Massage research can employ [[randomized controlled trials]], which are published in [[Scholarly peer review|peer reviewed]] [[medical journal]]s.<ref name=minn/> This type of study could increase the [[credibility]] of the profession because it displays that purported therapeutic effects are [[Reproducibility|reproducible]].<ref name=anatomy/>

==== Single-dose effects ====
[[File:Ghe-massage-tokuyo.jpg|thumb|right|Mechanical [[massage chair]]s]]
* '''Pain relief:''' Relief from pain due to [[musculoskeletal]] injuries and other causes is cited as a major benefit of massage.<ref name=nccam/> A 2015 Cochrane Review concluded that there is very little evidence that massage is an effective treatment for [[lower back pain]].<ref name="Furlan2015">{{Cite journal |vauthors=Furlan AD, Giraldo M, Baskwill A, Irvin E, Imamura M |date=September 2015 |title=Massage for low-back pain |journal=The Cochrane Database of Systematic Reviews |volume=2015 |issue=9 |pages=CD001929 |doi=10.1002/14651858.CD001929.pub3 |pmid=26329399|pmc=8734598 }}</ref> A meta-analysis conducted by scientists at the [[University of Illinois Urbana-Champaign]] failed to find a statistically significant reduction in pain immediately following treatment.<ref name="Meta">{{Cite journal |vauthors=Moyer CA, Rounds J, Hannum JW |date=January 2004 |title=A meta-analysis of massage therapy research |journal=Psychological Bulletin |volume=130 |issue=1 |pages=3–18 |citeseerx=10.1.1.509.7123 |doi=10.1037/0033-2909.130.1.3 |pmid=14717648}}</ref> Weak evidence suggests that massage may improve pain in the short term for people with acute, sub-acute, and chronic lower back pain.<ref name=Furlan2015 />
* '''State anxiety:''' Massage has been shown to reduce state anxiety, a transient measure of anxiety in a given situation.<ref name= Meta/>
* '''Blood pressure and heart rate:''' Massage has been shown to temporarily reduce blood pressure and heart rate.<ref name= Meta/>

==== Multiple-dose effects ====
* '''Pain relief:''' Massage may reduce pain experienced in the days or weeks after treatment.<ref name= Meta/><ref>{{Cite journal |vauthors=Bishop MD, Torres-Cueco R, Gay CW, Lluch-Girbés E, Beneciuk JM, Bialosky JE |year=2015 |title=What effect can manual therapy have on a patient's pain experience? |journal=Pain Management |volume=5 |issue=6 |pages=455–64 |doi=10.2217/pmt.15.39 |pmc=4976880 |pmid=26401979}}</ref>
* '''Trait anxiety:''' Massage has been shown to reduce trait anxiety; a person's general susceptibility to anxiety.<ref name=Meta/>
* '''Depression:''' Massage has been shown to reduce sub-clinical [[Depression (mood)|depression]].<ref name=Meta/>

==== Neuromuscular effects ====
Massage has been shown to reduce neuromuscular excitability by measuring changes in the [[Hoffman's reflex]] (H-reflex) amplitude.<ref>{{Cite journal |vauthors=Young JD, Spence AJ, Behm DG |date=April 2018 |title=Roller massage decreases spinal excitability to the soleus |url=http://research.library.mun.ca/12893/1/thesis.pdf |archive-url=https://web.archive.org/web/20180721072448/http://research.library.mun.ca/12893/1/thesis.pdf |archive-date=2018-07-21 |url-status=live |journal=Journal of Applied Physiology |volume=124 |issue=4 |pages=950–959 |doi=10.1152/japplphysiol.00732.2017 |pmid=29357488|doi-access=free }}</ref> A decrease in peak-to-peak H-reflex amplitude suggests a decrease in motoneuron excitability.<ref name="goldberg">{{Cite journal |vauthors=Goldberg J, Sullivan SJ, Seaborne DE |date=June 1992 |title=The effect of two intensities of massage on H-reflex amplitude |journal=Physical Therapy |volume=72 |issue=6 |pages=449–57 |doi=10.1093/ptj/72.6.449 |pmid=1589464 |doi-access=free}}</ref> Others explain, "H-reflex is considered to be the electrical analogue of the stretch reflex... and the reduction" is due to a decrease in spinal reflex excitability.<ref name="weerapong">{{Cite journal|last1=Weerapong|first1=Pornratshanee|last2=Hume|first2=Patria A.|author-link2=Patria Hume|last3=Kolt|first3=Gregory S.|year=2005|title=The Mechanisms of Massage and Effects on Performance, Muscle Recovery and Injury Prevention|journal=Sports Medicine|volume=35|issue=3|pages=235–256|doi=10.2165/00007256-200535030-00004|pmid=15730338|s2cid=44736682}}</ref> Field (2007) confirms that the inhibitory effects are due to deep tissue receptors and not superficial cutaneous receptors, as there was no decrease in H-reflex when looking at light fingertip pressure massage.<ref name="field">{{Cite journal |last1=Field |first1=Tiffany |last2=Diego |first2=Miguel |last3=Hernandez-Reif |first3=Maria |year=2007 |title=Massage therapy research |journal=Developmental Review |volume=27 |pages=75–89 |doi=10.1016/j.dr.2005.12.002}}</ref> It has been noted that "the receptors activated during massage are specific to the muscle being massaged," as other muscles did not produce a decrease in H-reflex amplitude.<ref name="goldberg" />