Kessa Massage

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.