Have you ever felt that your physical pain greatly diminishes after you treat yourself with a massage? Indeed, massage is an ancient practice that has been greatly advanced through modern research and new technology.
In this post, we discuss how massage is useful for pain relief.
If you exercise (especially just starting out), then you might pressure your muscles a bit too hard – on some occasions. In another state, you might be dealing with a chronic condition which might sometimes cause you to experience pain sensations.
Regardless of the area of pain in our bodies, scientific research suggests that massage is effective in dealing with muscle-related health issues.
Bottom line is – if you experience physical discomfort or pain, then massage is likely a reliable health strategy for you.
We start with an explanation of how muscles function as organs in our bodies. What causes pain sensations to occur in our muscles and how does our body process pain signals?
Next, we review different muscle areas of the human body – where massage has been proven to significantly reduce pain. What is the evidence that massage meaningfully lowers muscle pain in different muscle areas of the human body?
Last, we discuss common types of massage techniques that we can practice at home. Is there scientific support for using rolling-massage, cupping massage and related techniques for managing muscle pain?
Part 1: Muscle Tissue and Massage
Form a biological viewpoint, muscles are complex organs which greatly differ in structure and function. For example, the muscles found in arms and legs are somewhat different from the cardiac muscles which work to keep the heart pumping blood.
In this post, we mainly focus on movement-muscles. These are the muscles we use to move around, to work, and to carry out our daily activities. Movement-muscles are also the types of muscles which often get overwhelmed during physical exercise (especially true for beginners).
1.1 Defining Sensitive Spots in Muscles
Muscles mainly consist of stretches of muscle fibers which are surrounded by another type of tissue – known as the fascia layer [R1].
The fascia is a connective tissue that wraps around every muscle in our body. The fascia fuses skeletal muscles together with all internal body parts and basically keeps us anatomically in place.
Together, muscle fibers plus fascia tissue provide muscles with the elasticity which is necessary for different muscles to function properly.
When our muscles are worn out or injured, this puts the surrounding fascia tissue under pressure and causes it to contract in response [R2].
Importantly, the fascia layer includes nerve-endings that are specialized in sensing pain signals. Such pain receptors occur in great numbers around muscle-fascia junctions. For these reasons, the places where muscles attach with fascia are considered sensitive spots that are easily susceptible to cause pain sensations [R3].
1.2 How Massage Works?
The short definition scientist use for massage is physio-therapeutic sensory stimulation.
Most massage techniques work by using physical pressure (aka. stimulation) to cause a sensory response. This sensory response results in the improved physiology of painful muscle zones – and hopefully leads to pain relief (aka. the proposed therapeutic effects of massage) [R4].We break down complex scientific definitions and make it easy to understand healthClick To Tweet
On a physiological (body-processes) level, massage is effective because of three main reasons:
- changes in the body’s pain-sensing system
- increase in blood circulation to the pain-causing areas of muscles
- mechanical changes in the massaged area (re-arranging of muscle fibers and small blood vessels resulting in improved blood flow) | Resources: [R5] & [R6]
2 Massage is Efficient for Physical Pain Relief
Almost all authority public health organizations recognize massage as a complementary technique for pain relief. However, there is no actual scientific proof that massage completely stops muscle pain sensations – not even temporarily.
Nevertheless, massage is strongly associated with adequate levels of muscle pain relief – under various health circumstances. In addition to pain relief, massage is also associated with a range of benefits in muscle health and performance.
Next, we review the evidence that massage works towards pain relief in various muscle zones around the human body.
2.1 Massage & Neck Pain
Researchers estimate that worldwide one in two people deal with neck pain at some point during their lives [R7]. It is estimated that on average 14% of United States adults experience neck pain in the past 3 months (based on 1997-2012 data) [R8]. This means that a majority of people will likely experience neck pain in the following few years.
Several research publications have examined the effects of home-based massage techniques, specifically for neck pain relief.
For example, the effects of self-massage have been assessed in a clinical trial focused on arthritis-associated neck pain. The results demonstrate that teaching people how to massage their necks at home adds to the anti-pain effects of massage. The relief effect was close to the effect of massage that was provided to participants by a therapist [R9].
In summary, self-reported neck pain additionally decreased in participants who practiced massage at home. Researchers also learned that this group of participants were also able to move their necks more freely – aka. they had improved neck range of motion [R9].
2.2 Massage & Back Pain
Similar to neck pain, many of us might also have experience with upper or lower back pain. In the United States, on average 27% of adults experience low back pain in the past 3 months (based on 1997-2012 data) [R8].
In one study, women participants with chronic back pain were randomly assigned to receive either massage treatment or physical therapy – as separate interventions for muscle pain relief. Researchers discovered that the group of participants who received massage experienced lower back pain levels, compared to the group who received the physical therapy intervention [R10].
In another study, researchers discovered that as little as 10 sessions of massage helped to adequately relieve pain – in approximately 1/2 of the study participants dealing with chronic low-back pain [R11].
2.3 Massage & Legs, Foot Pain
Massage of feet muscles (specifically heel muscles) has also been shown as helpful for people who exercise [R12]. In this study participants were treated with six sessions of foot massages – over a period of 4 to 6 weeks. This intervention resulted in lower levels of heel pain, along with improved functioning of feet and ankles [R12].
In another study, researchers examined how deep-massage of upper leg muscles relates to pain-sensing thresholds.
Here is a results summary image form this study:
Image 1: Massage Increases the Threshold for Sensing Pain | Resource: [R13]
Researchers use Pain Pressure Threshold (PPT) as a way to measure the level of pressure required to be put on sensitive spots in muscles, for an individual person to report experiencing mild pain sensations. This image shows that massage is effective in lowering pain pressure thresholds. Each time participants in the study were treated with more massage, this resulted in higher thresholds for sensing pain. Overal, more pressure was required for participants to sense pain – after participants received massage sessions. Adapted from: [R13]
2.4 Massage & Knee Pain
Massage has also been tested in people who exercise and who also experience arthritis-associated knee pain. One study compared “exercise” versus “exercise plus massage” – as interventions for knee pain relief. The combined effect (massage in addition to exercise) was discovered as more beneficial for participants [R14]. Therefore researchers concluded that massage has independent value in managing knee pain, in addition to the potential health effects of physical exercise.
Another study focused on whether massage helps against arthritis associated pain in the hamstring and quadriceps muscles. These are the power-muscles around the middle of our legs – the muscles which support the knees. The results demonstrated that pressure massage of these muscles increases motion range in knees [R15].
2.5 Massage & Pelvic Pain
For many of us, muscles found in the pelvis area often get worn out by the end of the day. The pelvis connects the upper and lower parts of the body and plays an essential role in supporting proper body position.
Researchers have also examined the link between massage and pain relief in the pelvis area. One study found that massage significantly lowers the intensity of pain sensations in the pelvis muscle area [R16].
Part 3: At-Home Ways for Muscle Pain Relief
There are different massage techniques which you can practice at home – as part of your efforts to manage tension and pain in muscles around your body.
Next, we review the efficacy of readily-available do-it-yourself massage techniques.
3.1 Heat Pads (Keeping Painful Muscle Areas Warm)
Heat pads are tools for applying heat to different muscle zones around the body. Practically, heat pads are used to increase the temperature of muscle tissues that cause pain sensations [R17].
Similar to the effects of pressure-massage, increasing the temperature of muscles works towards pain relief because of:
- increased blood flow to the injured muscle areas and
- increased elasticity of the fascia connective tissue [R18].
The higher blood flow likely promotes muscle regeneration and healing processes – essentially by increasing the supply of nutrients and oxygen to injured muscle zones [R19]. In addition, heat also causes changes in connective tissue that are likely responsible for the improved range of motion – reported in studies using heat interventions [R20].
Among different muscle zones in the body, using heat has been shown to promote pain relief in muscles found in the lower back. Continuous use of low-level heatwrap intervention has been shown to effectively lower pain in research participants with non-specific low-back pain [R21]. The same authors have also demonstrated that overnight use of low-level heatwrap intervention is also effective for people with low back pain [R22].
However, heat pads do not help with underlying inflammatory processes that may cause muscular pain. Remember that it is always necessary to consult your physician regarding using specific self-practices to relieve your muscular pain.
3.2 Cupping Massage
Cupping is another ancient technique which is often used for the purposes of pain relief. Nowadays, people practice a variety of common cupping massage methods.
A unique concept in all cupping practices is using suction on the skin. This process is thought to influence blood flow to affected muscle areas. Thus, cupping massage is likely beneficial for managing pain conditions [R23].
For example, recent research studies indicate that cupping is beneficial for people with chronic neck pain [R24]. In one study, patients with chronic neck pain who received 5 cupping massages (at a rate of two massage sessions per week), reported feeling lower levels of neck pain and improved functionality [R25].
In another similar study, the same authors compared cupping massage (carried out twice weekly by a partner at home) vs. a mind-body technique for muscle relaxation (used as a control group in the study). Although both participant groups reported less neck pain after 12 weeks of either intervention, participants who received cupping massage also experienced decreased sensitivity to pain caused by mechanical muscle pressure [R26].
Here is an image that summarizes the main findings of this study:
Image 2: Percentage of Patients Reporting Adequate Pain Relief Following Cupping Massage (compared to Progressive Muscle Relaxation) | Resource: [R26]
Gray color represents Progressive Muscle Relaxation – a muscle control and breathing technique. Black color represents Cupping Massage as a pain relief intervention.
The image presents the percentages of participants who reported adequate pain relief after each subsequent cupping massage session (black) and PMR session (gray). Overall, cupping massage resulted in greater pain relief. Adapted from: [R26]
3.3 Foam Rolling Massage (Using Own Body Weight)
Rolling massage involves you using the weight of your own body, in order to cause necessary pressure for muscle pain relief. This process occurs while you are resting on a pair of rollers – also known as roller massage bars.
Massage rollers are usually sphere-like structures and most rollers are either fully composed of foam or coated with a foam layer. Foam rollers come in different sizes and differ in the density of the foam – some types of foam are more rigid compared to other softer types.
Researchers have examined the effects of foam roller massage in managing chronic pain conditions. Foam roller massage over the muscle area between knees and hips has been shown to lower pain perception in research participants – when pain perception was measured immediately after participants received foam rolling massage [R27].
In another study, researchers examined the effectiveness of foam roller massage against muscle soreness. Delayed-Onset Muscle Soreness (DOMS) is observed and measured within three days after individuals exercise. In this study, DOMS was significantly lower in participants who used foam roller massage – foam rolling massage reduced post-exercise muscle soreness [R28].
Image 3: Model for Automatic Roller Massager | Resource: [R29]
Adapted from: [R29]
3.4 Massage Chairs
There are many common names associated with chair massage – including sitting massage, work-site massage, office massage etc.
Chair massage has been demonstrated as an effective pain relief technique. In a small study of 50 office workers, participants who received eight chair massage sessions (at a rate of two per week) experienced less pain in upper and lower back areas [R30].
Similarly, another study concluded that chair massage performed in the workplace is effective for preventing muscle overstrain related to prolonged sitting body posture [R31].
Health Optimizer Note:
What is important to always keep in mind?
Most recommendations by professional health organizations agree that you should continue to use complementary massage methods, as long as you are convinced that you gain health benefits form your practices.
Whichever way you choose to deal with muscle tension and pain, it is always smart to focus on practicing methods that are scientifically proven to be at least partially effective.