Chances are, you’re as likely to be referred to a massage therapist via word of mouth, than by a doctor.

There’s that friend, who regularly pays for a pair of talented hands to take away their stress or their pain. And always ready with their therapist’s number.

Or maybe you’ll hear that certain techniques or styles have particular benefits. Be it shiatsu or the Swedish method. And you’ll give it a go.

And perhaps you’ll enjoy the results that were promised. Or not.

But what does the research say?

There are a lot of studies that suggest massage is an effective treatment for pain. And many of these are randomised controlled studies.

But a new review from the US Veterans Health Administration found that, “despite hundreds of clinical trials and dozens of previous scientific reviews on the topic, there’s no high-certainty evidence that massage is an effective pain treatment”.

Specifically, when assessing the strength of the evidence across 129 previous reviews, “they found just 41 used a formal method to rate the strength of evidence”.

They focused on 17 of these, covering 13 different health conditions.

There were no conclusions rated as high certainty of evidence.

There were just seven conclusions rated as moderate-certainty evidence, where massage therapy was linked with improvements in pain.

The rest of the conclusions “were rated as low- or very low–certainty evidence”.

How to respond to these findings?

If you’re enjoying a good relationship with a massage therapist, and feeling better during or after the sessions, then stick with that person.

You might get similar results more cheaply at home, with a foam roller. But you won’t have the human touch that may be the most powerful and therapeutic aspect of massage. Touch being a fundamental human need.

Whatever the case, there are questions to ask yourself. Are the benefits temporary? Do you have a long-standing issue, such as an injury, or restriction of mobility?

Has massage improved that condition over time?

If not, the question then is, might you benefit from a more active form of treatment, such as physiotherapy?

This involves being taught exercises that won’t have the instant feel-good quality of a massage. There’s no essential oils, candles or ambient music.

There’s just a lot of work to do.

Why randomised trials are faulty?

In 2018, Time magazine made an interesting point in a piece about the “controversy” attached to massage research.

The point was this: It’s impossible to design a gold standard randomised double blind study.

Usually, such a study had a placebo, a benign pill or agent as a control, something that has no real effect, except perhaps a psychological one.

A sham or pretend massage is still a massage. It may lack form or structure. It may resemble little more than the stroking you give a puppy. All of which might deliver a benefit.

This was echoed in the new study: “Unlike a pharmaceutical placebo, sham massage therapy may not be truly inactive. It is conceivable that even the light touch or touch with no clear criterion used in sham massage therapy may be associated with some positive outcomes, meaning that patients who receive the massage therapy intervention and those who receive a sham massage therapy could both demonstrate some degree of symptom improvement.”

Provocation from a physio

This points to another difficulty in scientifically testing massage. There is no standard practice. Practitioners have no standardised training.

There’s an interesting and provocative piece written by Adam Meakins, a UK physiotherapist, from 2014. Meakins has more than 213,000 Instagram followers, and a punchy style.

In the piece, ‘There’s no skill in manual therapy!’ he talks about a long-standing neck injury that gives him hell. The most reliable treatment is the touch of his wife’s fingers, underpinned by their intimacy and trust.

He backtracks a little in his universal dismissal of massage, but notes how it’s often, but not always, shrouded in mystical language. Which perhaps compensates for the lack of regulation.

But the most interesting point is the amazing potential of touch. If you’ve had a few massages in your time, you’ll know one thing: Some have got it, some don’t.