Running head: BENEFITS FOR CHRONIC ILLNESSES THROUGH MASSAGE
Benefits for Chronic Illnesses through Massage Therapy
Brandy Schnacker, Jessica Shirk
Washburn University School of Nursing
NU 504 Integrative Healing Modalities
Dr. Mary Ellen McBride
April 27, 2010
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BENEFITS FOR CHRONIC ILLNESSES THROUGH MASSAGE
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Benefits for Chronic Illnesses through Massage Therapy
Introduction
Patients with chronic illness need to be able to explore different treatment options that do
not attribute only to Western Medicine. Massage therapy is an option for patients to explore
when other avenues of treatment have been tried with no positive outcomes. Massage has
multiple techniques that can be offered to the patient based on their level of illness.
Massage therapy has many benefits in that enhances the overall health of the body by
improving circulation, joint function, soft tissue mobility/plasticity, and normalizing the body’s
ability to withstand stress (Healthy U: Your Pathway to Wellness). Therapeutic massage, a
general term for soft tissue manipulation by using touch and movement, reduces stress and
anxiety while promoting relaxation (Sturgeon, Wetta-Hall, Hart, Good, & Dakhil, 2009).
Massage therapy has been proven to assist cancer patients in relieving anxiety, nausea, pain, and
fatigue by promoting relaxation and calming muscle tissue.
Massage can be dated back to early Chinese history to before 2700BC. The earliest
documentation of massage appears in The Yellow Emperor’s Classic of Internal Medicine (Lee,
2005). Currently massage practices can be contributed to Per Henrik Ling of Sweden and to an
Amsterdam physician Johann Georg Mezger (Russel, Sumler, Beinhorn, & Frenkel, 2008).
Review of Literature
Introduction
The literature was selected because of the experiences that we had getting a message. We
both had experiences that were relaxing and relieved stress. Through investigating the research
we used the following terms; message therapy, chronic illness, and alternative pain relief. The
databases used were Cinal on the Washburn University library website. American Message
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Therapy website was also very helpful in understanding how massage therapy benefits patients
with chronic illness. Through the research we narrowed our search to patients with cancer and
how the massage therapy benefited their treatment and controlled their symptoms from the
different treatments.
Critique of Studies
Each of the studies showed how massage therapy contributes to helping patients with
cancer manage their symptoms through the different sessions. The first of the six articles is on
how massage therapy plays a role in cancer care. It gives information on the history of massage
and where it originated. The article explains the programs goals of the therapy sessions in that
they would improve circulation, decrease muscle tension, pain, anxiety, and stress (Russel,
Sumler, Beinhorn, & Frenkel, 2008). They way that they measured the results is by the StateTrait Anxiety Inventory scores and a Symptom Checklist. During the therapy sessions they used
licensed massage therapists and they provided Therapeutic Touch and aromatherapy with the
massage techniques. The results showed that the massage techniques provided decreased pain
and anxiety with going to the cancer treatment sessions.
The second article shows how massage therapy relieves nausea in women who have
breast cancer and are undergoing chemotherapy (Billhult, Bergbom, & Stener-Victorin, 2007).
During this study the patients received 20-minute massage of the foot /lower leg and hand/lower
arm in women with breast cancer during their treatment. The other group received friendly visits
from staff during their treatment. The groups contained 39 women who were undergoing
chemotherapy treatment for breast cancers. The women were divided into the two groups
randomly.
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The results were obtain be using the Visual Analogue scale for nausea and anxiety. The
other scale used with the Hospital Anxiety and Depression scale. According to the VAS the
massage treatment reduced the nausea in the patients as compared to the control group. It also
showed a reduction in anxiety of those patients with the massage therapy. According to the
HAD the massage therapy did not decrease the depression level in patients with the massage
therapy. The result was the same in the control groups as the experimental group. In their study
they should that massage therapy can be useful in lowering nausea in patient with breast cancer.
The third article shows the effects of massage therapy on the quality of life of patients
with breast cancer (Sturgeon, Wetta-Hall, Hart, Good, & Dakhil, 2009). In this study, there were
51 female patients selected to study the results of massage therapy on breast cancer. The study is
to measure the anxiety, pain, nausea, sleep quality, and distress of patient with breast cancer and
massage therapy. The patients received massage therapy three times a week for a five week
study. During the massage therapy sessions the type of massage used were Swedish techniques.
They also used massage oils and the different types of strokes that go with Swedish massage.
They started with effleurage which are gentle, rhythmic, gliding strokes. Then they proceeded to
petrissage which is gentle kneading and friction. The massage therapy sessions lasted 30
minutes and then they were asked to record medications and nausea episodes over that week.
The scales used are State-Trait Anxiety Inventory, Visual Analogue Scale, Rhodes Index
of Nausea, Vomiting, and Retching scale, and Symptom Distress Scale. According to the scales
it showed that massage therapy decreased patients pain and distress level, reduced patient’s
episodes of nausea and vomiting. In conclusion the study recommends that future studies
include therapy protocols and more frequent sessions that could be longer.
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The fourth article demonstrates how massage can be used for patients that have tension
headaches related to psychological measures. A tension-type headache (TTH) is 15 days per
month and the chronic form dull aching headache that affects a 15 or more days per month
(Moraska & Chandler, 2009). In this study there were 18 subjects that were chosen to participate
in this study. This study was to explain how massage therapy can be used to focus on myofascial
trigger points, on psychological measures associated with tension-type headache (Moraska &
Chandler, 2009). Each subject was to receive twelve 45-minute massages over a 6-week period
however they had to be at least 48 hours apart. The massages they were to receive were to focus
on the cervical and cranial regions with the help of reducing myofascial trigger point (MTrP)
activity.
There were many different tests that the subjects had to answer during this six week
period. The tests were State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDIII), Perceived Stress Scale (PSS), and Daily Stress Inventory (DSI). The PSS, BDI-II and STAI
were administered at the beginning and at the end of the trial. The results of these tests were that
the headaches were decreased by the massages that they subjects received.
The fifth article that was chosen demonstrates how massage is increasingly being
considered as a means of relieving the pain many cancer patients experience (Liu, 2008).
Massage is reported to be one of the most commonly used complementary therapies for cancer
pain relief (Liu, 2008). This article was demonstrating the different studies that have been done
to prove that massage does help relieve stress and pain in cancer patients. One study highlighted
in this study was conducted on nine patients that had been diagnosed with cancer. These patients
received 30-minute massages over two consecutive evenings. The result of this study was that
the 30-minute did reduce the pain and anxiety of these patients. The conclusion of this article is
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to give all healthcare professionals evidence to assist them in talking with their patients about the
role of massage being able to improve their pain and anxiety.
The sixth article that was chosen is a case study that was able to highlight the therapeutic
benefits of combining the skills of the Registered Nurse and massage therapist (Lee, 2005). The
known benefits of massage therapy are: soothing, stimulating and healing (Lee, 2005). This
case study was performed on one patient. This patient had a chronic illness and had developed
peripheral neuropathy along with his illness. The patient was given the conventional treatments
to help reduce his pain but nothing was effective. The regimen that this patient experienced for
massage was weekly over a three month, then reduced to fortnightly and then after six months is
was reduced to monthly. Along with way of decreasing the frequency of the massage and
intensity of the massage was increased. The results of this article was to show the benefits of
therapy provided by a nurse/massage therapist includes a holistic approach to dealing with not
only the patient’s problem with muscle, ligaments and tendons, but also the overall health and
quality of life of that patient (Lee, 2005).
Conclusion
In conclusion through the articles we are able to understand how massage works and the
different types of massage techniques there is. In the articles it shows that massage therapy
reduces pain and nausea in patients with cancers. It could be a positive alternative for patients to
help reduce their symptoms. Massage can be demonstrated in these articles by how they can
reduce stress within the body which can make pain increase. Massage has been proven in these
studies to have a positive outcome for the patients and should be considered for patients with
cancer and chronic illness to improve their quality of life.
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Theoretical Framework
The theoretical framework that best supports the use of massage therapy would be
Rogers’ Science of Unitary Human Beings. Rogers’ model supports massage therapy in that
massage is used over the entire body and not just one specific area, like Rogers’ who is an open,
mutual process of energy fields that are within the human body. Massage therapy consists of
effleurage strokes that are gentle, rhythmic, and gliding strokes and then can progress up to
petrissage with are gentle kneading and friction strokes (Sturgeon, Wetta-Hall, Hart, Good, &
Dakhil, 2009). These different strokes can be shown in Rogers’ theory in that the rhythms of
strokes show the flow of energy to promote health potential.
Rogers’ Science of Unitary Human Beings is a theory that is holistically based to include
the human being as a whole entity. The human being energy field has a unique pattern in that
each person’s illness or health whether good or bad are not separate they coincide with each
other. Rogers’ theory is not linear it has many different dimensions that the human being energy
field has to flow through (Leddy, 2006).
Cultural, Legal, and Ethical Issues
As an Advanced Nurse Practitioner (APN) this could be included into their practice. The
APN would need to assess their patients appropriately to insure that the patient is really in
agreement with receiving massage. Culture is a very big hurdle to overcome with certain
patients. There are some cultures that do not like to be touched by other people. There are so
many different cultures in the world today that an APN does have to do his or her homework
before offering alternative medications to these patients. If an APN decides that massage is a
great therapy for a certain patient and that patient does not approve and is continued to be forced
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into massage then the patient has grounds for malpractice against that APN. Any APN needs to
be careful and cautious about the cultures within his or her practice.
The ethical aspect of this integrative modality is that the APN has to respect their patient
and their feelings. If the patient does not want massage, even if the APN knows it would work
for them, then the APN cannot force this alternative therapy on them. Nobody can make
somebody do something they do not want to.
Incorporation into Advanced Nursing Practice
Massage therapy is feasible to incorporate in an APN practice; it is a simple and harmless
technique. The one problem is that most insurance companies at the time do not cover it on their
plans, so people would not be able to afford it most massage therapy times cost anywhere from
$60 to $100 for a hour session. As an APN advice on ways to reduce stress on the body is
always appreciated, with massage therapy a patient can go to a therapist and have them show
simple massage techniques that patients could have family do at home. Stress is so hard are the
body and you as patients need to have any possible ways to relax, so they can completely focus
on their treatment.
Massage therapy is a valuable integrative modality in that it increases the bodies’
circulation, releases muscle tension, and promotes relaxation, which is common symptoms in
patients with chronic illness (Russel, Sumler, Beinhorn, & Frenkel, 2008). If a patients have
alternative ways to control their symptoms from cancer treatment, as what was researched for
this paper, people would be more likely to continue their treatments, because of the stress they
cause on the body (Sturgeon, Wetta-Hall, Hart, Good, & Dakhil, 2009).
Potential nursing research studies could be how massage therapy helps reduce patient’s
blood sugars. Stress in the body is a major contributor to increased blood sugars for patients.
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During my massage therapy sessions I noticed reduced blood sugars from when I started my
massage to the end of the session. If you patient is relaxed and has no pain then they will
possible have lower A1C and better glucose control of their diabetes. Each patient is individual
and not all the results would be the same and that is with every research project.
Limitations of the use by an APN is that a thorough background history has to be
understood before recommending any new treatment sessions, because of possible
complications. Some chronic illnesses should not have massages’, like DVT’s because of the
chance of breaking loose a clot. Most conditions that patient’s have a massage therapy session is
likely to help reduce their pain and stress levels.
Conclusion
Massage therapy can be beneficial to most patients with chronic conditions, especially
cancer patients as seen in the research done. According to the studies researched most patients
had reduced pain and nausea symptoms if they had massage therapy treatments during their
chemotherapy sessions. The relief of stress that comes with the diagnosis of cancer was also
reduced with the help of massage. Throughout the studies massage was given a positive review
and should be further researched to give the patients the best care that they can get. The issue of
cost and repayment by insurance companies are still a concern for most patients, so they don’t
continue with the massage treatments after the study is done, so that is something that needs to
be understood by the insurance companies.
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References
(n.d.). Retrieved February 24, 2010, from Healthy U: Your Pathway to Wellness:
http://www.nwhealth.edu/healthyU/liveNaturally/mtcond.html
(n.d.). Retrieved Feburary 21, 2010, from Massage Therapy:
http://www.massagetherapy.com/learnmore/benefits.php
Billhult, A., Bergbom, I., & Stener-Victorin, E. (2007). Massage Relieves Nausea in Women
with Breast Cancer Who Are Undergoing Chemotherapy. The Journal of Alternative and
Complementary Medicine , 12 (1), 53-57.
Leddy, S. K. (2006). Intergrative Health Promotion. Sudbury, Massachusetts: Jones and Barlett
Publishers.
Lee, L. M. (2005). Is massage only a feel good thearpy? ACCNS Journal for Community Nurses ,
10 (3), 23-24.
Liu, Y. (2008). The role of massage therapy in the relief of cancer pain. Nursing Standard , 22
(21), 35-40.
Massage and Serious Health Conditions. (n.d.). Retrieved Feburary 24, 2010, from American
Massage Therapy Association:
http://amtamassage.org/findamassage/health_conditions.html
Moraska, A., & Chandler, C. (2009). Changes in Psychological Parameters in Paitents with
Tension-type Headache Following Massage Therapy: A Pilot Study. Journal of Manual
and Manipulative Therapy , 17 (2), 86-94.
Russel, N. C., Sumler, S.-S., Beinhorn, C. M., & Frenkel, M. A. (2008). Role of Massage
Thearpy in Cancer Care. The Journal of Alternative and Complementary Medicine , 14
(2), 209-214.
BENEFITS FOR CHRONIC ILLNESSES THROUGH MASSAGE
Sturgeon, M., Wetta-Hall, R., Hart, T., Good, M., & Dakhil, S. (2009). Effects of Therapeutic
Massage on the Quality of Life Among Patients with Breast Cancer During Treatment.
The Journal of Alternative and Complementary Medicine , 15 (4), 373-380.
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