Timing Is Key to Massage’s Benefits for Neck Pain

By Dr. Mercola

Neck pain is the third most common type of pain in the US, impacting up to 70 percent of people at some point during their lives.1 While the causes are varied – car accidents, poor posture, and even sleeping in the wrong position – the standard, go-to treatment offered by most physicians is medication, including anti-inflammatory drugs.

Unfortunately, many patients grow tired of treating their pain with drugs, not only because they may not relieve the pain in its entirety but also because they may cause side effects that are as bad as the pain itself – or worse.

Seeking more effective and safer alternatives, many turn to massage therapy for pain relief, with varying success.

New research has helped to explain why some people swear by massage for pain relief while others feel little difference. It turns out that, just as with medications, the dose matters when it comes to massage and may make the difference between pain relief… or not.bookOnline

Longer, More Frequent Massage Sessions Work Best for Neck Pain Relief

Researchers from the Group Health Research Institute in Seattle set out to determine the optimal dose of massage for people with chronic neck pain. Study participants received 30-minute massages two or three times a week, or 60-minute massages one, two or three times weekly (with a comparison group that received no massages).

Compared with the no-massage group, those who got massages three times a week were nearly five times more likely to report a significant improvement in function and more than twice as likely to report a significant decrease in pain. The best pain-relief results were obtained by those who received 60-minute massages two or three times a week. One of the study’s researchers told WebMD:2

“In the short term, 60 minutes of massage is better than 30, and you want to do multiple treatments a week for the first four weeks.”

Dose Matters When Using Massage for Neck Pain

The featured study suggests that people who are not finding relief via massage therapy may not be getting the treatment in the proper dose. There are other variables that impact massage effectiveness as well, such as the technique used and the skill level of the massage therapist.

This may help explain why research on massage for pain relief often yields conflicting results. A review published in Cochrane Summaries, for instance, found that while massage appeared to offer little advantage over other treatments for neck pain, the quality of studies available was poor, making it difficult to accurately gauge effectiveness.3 The Cochrane researchers noted:

Overall, the quality of the studies was poor and the number of participants in most trials was small. Most studies lacked a clear definition, description, or rationale for the massage technique used. Details on the credentials or experience of the person giving the massage were often missing.

There was such a range of massage techniques and comparison treatments in the studies that we could not combine the results to get an overall picture of the effectiveness of massage. Therefore, no firm conclusions could be drawn and the effectiveness of massage for improving neck pain and function remains unclear.”


Massage Therapy for Pain: A Summary of the Research

That said, there is plenty of research in support of massage therapy. The featured study isn’t the first to consider dose when it comes to massage therapy. In 2012, researchers compared 30-minute and 60-minute massage sessions conducted once or twice a week for pain due to osteoarthritis of the knee.4

Like the current study, those researchers found that 60 minutes appeared to be the “magic number,” offering greater reductions in pain intensity than 30-minute sessions. However, they also concluded that just one 60-minute massage delivered once a week was the “optimal” dose when factoring in pain relief, convenience, and cost.

In 2008, separate research also found massage therapy to be effective for treating chronic neck pain, especially in the short term (pain relief and improvements in function were most significant after four weeks of massage therapy).5 Other research suggests massage therapy may help relieve many types of pain, including:

  • Back pain
  • Migraines
  • Labor
  • Fibromyalgia
  • Cancer

Why Are Some Hospitals Adding Massage Therapy to Their Standard Treatments?

While massage therapy is still considered “alternative” or “complementary,” it’s becoming much more widely accepted and utilized. Massage offers real health benefits, so much so that some conventional hospitals are making it a standard therapy for surgery patients, pregnant women, and others. Along with relieving pain, promoting relaxation, and improving your sense of well-being, getting a massage has been shown to:

  • Reduce stress, anxiety, and depression, and ease insomnia
  • Decrease symptoms of PMS
  • Relax and soften injured and overused muscles, reducing spasms and cramping
  • Provide arthritis relief by increasing joint flexibility

Massage affects your nervous system through nerve endings in your skin, stimulating the release of endorphins, which are natural “feel good” chemicals. Endorphins help induce relaxation and a sense of well-being, relieve pain, and reduce levels of stress chemicals such as cortisol and noradrenaline — reversing the damaging effects of stress by slowing heart rate, respiration, and metabolism, and lowering raised blood pressure.

Stronger massage stimulates blood circulation to improve the supply of oxygen and nutrients to body tissues and helps your lymphatic system to flush away waste products. It eases tense and knotted muscles and stiff joints, improving mobility, and flexibility. Massage is said to increase activity of the vagus nerve, one of 10 cranial nerves, that affects the secretion of food-absorption hormones, heart rate, and respiration. It has proven to be an effective therapy for a variety of health conditions — particularly stress-related tension. As reported by iVillage:6

“[A] … study from Thailand suggests that traditional Thai massage can decrease pain intensity, muscle tension and anxiety among people with shoulder pain. Meanwhile, research from the Touch Research Institute at the University of Miami in Florida found that when adults with hand pain had four weeks of massage therapy, they reported a lot less pain, anxiety and depression. Another study at the Touch Research Institute found that when pregnant women who were depressed received massages from their partners twice a week, they had much less leg and back pain and fewer symptoms of depression during the second half of their pregnancies.”

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