Classical Massage

Rita Chiaramonte et al. (2026) · The Journal of manual & manipulative therapy

This systematic review of 18 randomized controlled trials explored whether hands-on treatment eases pain and improves jaw movement in adults with temporomandibular disorders (TMD). TMD is a group of conditions affecting the jaw joint, the chewing muscles and nearby tissues, and it is estimated to affect about 31% of adults. Its subtypes include muscle pain (myalgia), disc displacement (the cushioning disc slips out of position, sometimes locking the jaw) and joint pain. Manual therapy covers thrust manipulation, soft-tissue release, massage and intra-oral techniques, delivered by physiotherapists, chiropractors, osteopaths, dentists and physicians. The review asked which techniques help most and whether results differ by profession. Researchers searched four databases through March 2025 and screened 561 records, keeping 18 trials of adults with a clinical TMD diagnosis. Trials compared manual therapy with sham treatment, no treatment, splints, medication, exercise or education. Pain was rated on the visual analogue or numeric rating scale (0 to 10), and maximum mouth opening was measured in millimetres. Risk of bias was checked with the Cochrane tool and certainty with GRADE. Because the trials differed so widely in technique, dose, comparator and follow-up, results were summarized in words rather than pooled statistically. Most trials reported short-term pain reduction and wider mouth opening, but certainty was low to moderate for pain and low for mouth opening. High-velocity low-amplitude (HVLA) thrusts made up 56% of interventions and fascial manipulation with myofascial release made up 37.5%. Dry needling plus upper neck HVLA beat splint therapy, diclofenac and joint mobilization at three months (p < 0.001), and intra-oral therapy kept benefits for one year in chronic jaw-muscle pain. Upper thoracic HVLA showed no significant effect (p > 0.05), and jog manipulation gained only 6.86 mm of mouth opening at first visit with no later group difference. Massage and fascial manipulation by physiotherapists were linked to relief of jaw-muscle symptoms, while chiropractic, osteopathic and dental trials also reported gains. Physiotherapy trials were the most numerous, which the authors attribute to publication volume rather than superior effectiveness. The authors describe manual therapy as associated with short-term benefit and treat professional comparisons as descriptive, since profession was tangled with setting, technique and country. Limitations include small samples, short follow-up, mixed diagnoses, English-only searching and no meta-analysis. Safety findings were not reported in pooled form, and the evidence mostly covers weeks to months rather than years. The authors call for larger trials with longer follow-up and standardized protocols, and they state that manual therapy is best delivered by trained, licensed professionals.

Jeremy McGuire et al. (2026) · Journal of the National Comprehensive Cancer Network : JNCCN

This three-arm randomized pilot trial with 87 adults explored whether Reiki, a biofield therapy in which a practitioner rests or holds hands lightly near the body to work with the body's energy field, could ease cancer-related fatigue as well as therapeutic massage does. Cancer-related fatigue is a persistent, rest-resistant exhaustion driven by cancer treatment itself — it affects roughly 6 in 10 people on aromatase-inhibitor therapy for breast cancer and about 4 in 10 on long-term androgen-deprivation therapy (ADT) for prostate cancer, and unlike ordinary tiredness it does not improve with sleep. Because many patients cannot manage the exercise-based therapies oncology guidelines usually recommend, the study looked at two passive, low-effort alternatives instead. Participants — 57 with breast cancer on aromatase inhibitors and 30 with prostate cancer on ADT — were randomly assigned to two Swedish-massage sessions, two Reiki sessions, or four Reiki sessions, each delivered by licensed practitioners in up to 75-minute visits over one to two weeks. Fatigue was tracked with the well-validated 9-item Brief Fatigue Inventory at baseline, weekly through six weeks, and again at a one-month follow-up. All three groups reported real, clinically meaningful drops in fatigue by week six, with benefits still holding a month later. Statistically, the massage and Reiki groups did not differ from each other, but Reiki's improvements were consistently larger and grew with more sessions: on the total fatigue score, the effect size (Cohen's d, where 0.8 is considered large) was 0.57 for massage, 0.87 for two Reiki sessions, and 1.16 for four Reiki sessions — with a similar pattern for the "worst fatigue" and "fatigue interference" measures. Looked at by cancer type, both therapies helped breast-cancer patients across the board, but for prostate-cancer patients only Reiki improved every fatigue measure, while massage helped only the single worst-fatigue item. No one in either therapy arm reported a treatment-related adverse event. These results position Reiki as a safe, well-tolerated option that may match or exceed massage for cancer-related fatigue, particularly for men on ADT, and hint that four sessions work better than two. As a small pilot without a placebo or "sham Reiki" comparison arm, it cannot rule out expectancy or attention effects, and its per-group sizes (26-30 people) are too small to draw firm conclusions — the authors call for larger, sham-controlled trials next.

Taewoo Kang et al. (2022) · Medicine

This single-blind randomized controlled trial with 41 adults explored two ways of treating chronic neck pain (CNP) -- pain lasting more than three months, often traced to a forward head posture that overloads the cervical spine. The researchers focused on the scapulothoracic region, the muscles connecting the shoulder blade to the rib cage and spine, because weakness in the middle and lower trapezius combined with tightness in the upper trapezius creates a muscle imbalance that drives neck pain and reduced neck mobility. One group performed a resistance exercise program targeting the weakened muscles directly; the other received trapezius massage targeting the tight ones, and both were compared head-to-head over four weeks. Adults aged 29 to 66 (mean 47.9, 22 men, 19 women) with confirmed chronic neck pain were split into a resistance-exercise group (21 people) and a massage group (20 people) at a South Korean clinic, training five days a week for four weeks. The exercise group used elastic bands for eight movements -- chin tucks, rows, and scapular retraction among them -- building from 10-15 up to 15-20 repetitions per set. The massage group received a standardized 20-minute trapezius massage combining myofascial release, trigger-point work, and friction techniques. Pain, neck motion, muscle tone, disability, and quality of life were all measured. Both approaches worked: pain, disability, and quality-of-life scores improved significantly within each group (p<.05 throughout). But head-to-head, resistance exercise pulled ahead on several measures. Pain dropped further with exercise (VAS change 2.67 vs. 2.30 points, p=.02), and disability scores on the Neck Disability Index fell more as well (p=.04). Quality of life improved more on both the physical (p=.04) and mental (p<.001) subscales. Muscle tone and stiffness in the upper trapezius -- the very muscle massage directly targets -- actually decreased more in the exercise group (p=.01 to .03), suggesting that strengthening the weakened muscles around it relieved tension more effectively than massaging the tight muscle itself. Cervical rotation, often the most functionally limited movement in this condition, also improved more with exercise (p<.001 to .02). Flexion, extension, and side-bending improved to a similar degree in both groups, with no meaningful difference in muscle elasticity. For people managing chronic neck pain, a structured resistance program targeting the shoulder-blade stabilizers may offer more relief than massage alone, particularly for pain, disability, quality of life, and neck rotation -- and it requires only elastic bands, making home practice feasible. The trial did not track adverse events or follow participants beyond the 4-week program, so how long the gains last is unknown. It also did not directly measure whether the weakened muscles actually got stronger, so the exact mechanism behind the improvement is inferred rather than proven. Larger studies with longer follow-up periods are needed.

Ángel Rodríguez-Ruiz et al. (2024) · Medicina (Kaunas, Lithuania)

This randomized controlled trial with 44 women explored whether a four-week "HAMMAM" program -- combining hydrotherapy (therapeutic water bathing at varying temperatures) and Swedish massage (a full-body technique using kneading, stroking, and tapping to relax muscle tissue and improve circulation) -- could ease pain in women with endometriosis-related chronic pelvic pain that had not improved with standard medical treatment. Endometriosis is a condition where tissue similar to the uterine lining grows outside the uterus, commonly causing pain during menstruation (dysmenorrhea, governing cyclical cramping) and intercourse (dyspareunia) that standard analgesics and hormonal therapy fail to relieve in roughly a third to half of patients. Women aged 20-50 with confirmed endometriosis and pelvic pain rated at least 4 out of 10 were randomly assigned to the HAMMAM group (21 women) or a control group continuing usual care (23 women) at a hospital in Granada, Spain. The HAMMAM group attended three 90-minute sessions over four weeks at a bathhouse: a 60-75 minute circuit of warm, hot, and cold water baths plus a steam room, then a 15-minute Swedish massage with essential oils; the last session added a traditional exfoliating scrub. Pain was measured on a 0-10 scale, and pressure sensitivity with a handheld algometer. The HAMMAM group reported significantly less menstrual pain (p = 0.035, a large effect) and pain during intercourse (p = 0.020, a moderate-to-large effect) after the program compared with the control group. Pain interfering with sleep also dropped notably (p = 0.018), and pressure pain thresholds in the pelvic region rose (p = 0.029, meaning the area became less sensitive to pressure -- a sign of reduced pain sensitization), with the strongest change at the left groin ligament (p = 0.006). Everyone attended all sessions (100% adherence) and rated satisfaction at 9.71 out of 10, with no adverse events. However, overall pelvic pain ratings, catastrophic thinking about pain, general subjective well-being, and endometriosis-specific quality of life did not change significantly, showing the benefits were concentrated in specific pain measures rather than global wellness. For women whose endometriosis pain persists despite conventional treatment, this suggests a short, low-intensity spa-style program combining water therapy and massage may meaningfully ease menstrual and intercourse pain and pain-disrupted sleep, with high satisfaction and no safety concerns. Because hydrotherapy and massage were only tested together, it is not yet known which component -- or their combination -- drives the benefit, and the small, single-site sample limits how broadly these results apply. Larger trials testing each therapy alone are needed before firm clinical recommendations can be made.

Göktuğ Er et al. (2023) · Medicine

This randomized comparative trial with 70 adults explored whether connective tissue massage (CTM) or classical massage (CM, the "Swedish" style widely used in clinics) works better for chronic mechanical low back pain -- pain and stiffness in the lower back lasting more than 12 weeks with no specific structural cause like fracture or infection. CTM manipulates the skin and underlying fascia with pulling strokes, thought to trigger reflex effects on the autonomic nervous system (the body's automatic regulator of heart rate, blood pressure, and circulation). CM instead strokes and kneads muscle tissue, releasing endorphins and stimulating vascular pressure receptors to ease pain and support autonomic balance. The study compared which method controls pain better and whether either shifts autonomic activity more. Fifty-five participants (28 in the CTM group, 27 in CM, average age around 37) completed the full protocol: a hot pack plus a lumbar stretching and strengthening routine, combined with 20 sessions of their assigned massage over four weeks, five days a week. Pain was tracked on a 10-cm visual analog scale (VAS) at baseline, weekly, post-treatment, and at a six-week follow-up. Heart rate, blood pressure, and skin temperature were measured with standard clinical devices, while disability, quality of life, and sleep quality were tracked with validated questionnaires (Oswestry Disability Index, SF-36, and the Pittsburgh Sleep Quality Index). Both massages sharply reduced pain by the end of treatment and kept it low at six weeks (P < .001 for both, meaning the improvement is very unlikely to be chance). CM pulled ahead of CTM only briefly, at the two-week mark (1.90 vs 2.60 cm on the VAS, P = .04, a real but small and temporary difference), with no gap between the techniques at any other checkpoint. Peripheral skin temperature rose significantly in both groups (indicating improved circulation), but heart rate, blood pressure, and deeper trunk temperatures held steady in both. Disability, overall quality of life, and sleep quality all improved substantially and similarly in both groups; the one lasting difference was that CTM patients reported better emotional well-being at six weeks than CM patients (P = .03). No adverse events occurred with either technique. For practitioners and patients, the takeaway is reassuring rather than decisive: both CTM and CM are safe, effective options for chronic low back pain paired with heat and exercise, so the choice can rest on training, preference, or CTM's modest edge in longer-term mood rather than on a clear winner for pain relief. Limitations: one physiotherapist delivered every treatment and assessment (no blinding), the trial ran at a single center, and roughly one in five participants dropped out under the demanding five-day schedule. Future trials against a no-treatment control would clarify how much benefit comes from technique itself.