Background:The deep fascia is increasingly recognized as a potential source of pain, with densification manifesting as discomfort at myofascial points. Central sensitization (CS) significantly influences pain sensitivity, resulting in temporal, spatial, and threshold alterations in both acute and chronic pain conditions. Purpose:This case series investigates the immediate effects of fascial manipulation (FM) on pain at myofascial densified points (MDPs) and on clinical measures of CS. Methods:A total of 10 patients, aged 18-45 years, experiencing pain at MDPs were screened and selected based on specific criteria. Baseline measurements for the Visual Analog Scale (VAS) and the Central Sensitization Inventory (CSI) were collected. Densification points were identified and treated in a single session following the Stecco FM guidelines. Post-intervention values were recorded immediately after FM. Results:The study demonstrated a significant reduction in pain following FM (p ≤ 0.05). Mean VAS scores decreased from 07.33 ± 00.82 pre-intervention to 01.16 ± 01.17 post-intervention, while mean CSI scores decreased from 50.33 ± 07.65 to 30.00 ± 05.17. Conclusion:The findings of this case series suggest that FM may produce immediate reductions in pain in patients presenting with myofascial densification and features of CS.
Background:Plantar fasciitis (PF) is a common foot condition characterized by heel pain. Deep friction massage and Graston technique (GT) are manual therapy techniques used to manage PF. This scoping review aimed to assess the effectiveness of these techniques on pain, disability, and function in individuals with PF, as measured by the Foot Function Index (FFI). Methods:A comprehensive literature search was conducted in electronic databases (PubMed, PEDro, EBSCOhost, Cochrane Library) using relevant keywords. Studies were included if they involved adult participants with PF, utilized deep friction massage and/or GT as the intervention, and employed the FFI as an outcome measure. Data were extracted on study characteristics, participants, interventions, and outcomes. Results:Six studies (five randomized controlled trials and one quasi-experimental study) involving 299 participants were included. All studies indicated statistically significant changes or improvements in within-group FFI after deep friction massage or GT. Four studies showed absolute changes in FFI measure beyond the minimal clinically important difference (defined as ≥7 points for the total FFI), which indicates some clinical significance regarding a functional change. However, between-group differences varied, and some studies reported no difference between the two treatments. Conclusion:The findings suggest that both deep friction massage and GT may be effective in managing PF. Further research with larger, well-designed studies is needed to assess long-term effects and optimize treatment for diverse patient characteristics. A multimodal approach, considering patient-specific factors, may be necessary to achieve optimal outcomes in PF management.
Background:Commonly, Bell's palsy has been treated with conventional therapy, which can cause secondary effects. On the other hand, manual lymph drainage Vodder (MLDV) is an intervention aimed at reducing edema in lymphatic cases. The use of MLDV as an intervention for Bell's palsy has not been extensively studied. Objectives:The objective of this study was to investigate the effect of MLDV on facial function in patients with Bell's palsy. Methods:This was a retrospective study conducted on 125 patients with Bell's palsy, comparing group 1 (MLDV) with group 2 (standard interventions). The study was conducted in Surabaya, Indonesia, from 2017 to 2024. The interventions were administered three times a week for 40-50 min until the patient was declared recovered. The measurements in this study were facial function (House-Brackmann (HB)) and facial muscle strength (manual muscle test). Results:Statistical analysis using the Wilcoxon test for each group consistently showed p < 0.05 in both facial functional assessment and facial muscle strength. The Mann-Whitney analysis between groups also consistently indicated p < 0.05 for both functional and muscle strength assessments of the face. However, the mean difference was greater in group 1 than in group 2. The mean HB difference in group 1 was -2.11, while in group 2 it was -0.61. The mean muscle strength differences in group 1 was 2.43 and that in group 2 was 0.56. Conclusions:MLDV can be used to improve facial function in Bell's palsy cases without the potential for side effects compared to conventional therapy.
Background:Plantar fasciitis is characterized by degenerative changes and irritation at the origin of the plantar fascia, primarily involving the medial calcaneal tuberosity and the surrounding perifascial soft tissues. Common causes include overuse from activities such as running, prolonged standing, or walking on hard surfaces, which can lead to small tears in the fascia. Other contributing factors include wearing unsupportive footwear, obesity, and foot conditions such as pes planus or cavus. Methods:Fifty-eight subjects with plantar fasciitis were selected and randomly assigned to two groups. Both groups underwent an intervention. The intervention group received myofascial release, while those in the traditional group received calf stretching. Both interventions were administered three sessions per week for 8 weeks. The Functional Foot Index (FFI) and Numeric Pain Rating Scale (NPRS) were used to assess outcomes before and after the intervention. The significance of the changes observed before and after the intervention was evaluated using the Wilcoxon signed-rank test and the Mann-Whitney U test. Result:The Wilcoxon signed-rank test demonstrated a significant reduction in NPRS following both the interventional therapy (Z = -4.898, p < 0.001) and traditional therapy (Z = -4.522, p < 0.001). The Mann-Whitney U test revealed no significant difference between groups at baseline (p = 0.77); however, a significant difference was observed post-intervention (p = 0.002), favoring interventional therapy. Effect sizes for the NPRS were r = 0.32 (small) at baseline and r = 0.58 (large) post-intervention. Similarly, FFI scores demonstrated a significant post-intervention difference between groups (p = 0.005), with effect sizes of r = 0.39 (small) at baseline and r = 0.52 (large) post-intervention. Conclusion:According to the study, myofascial release helps individuals with plantar fasciitis by improving function and reducing pain and disability, with no reported adverse effects. This technique appears to be a more effective treatment than traditional physiotherapy, thereby strengthening the evidence base for physical therapy protocols.
Background:After giving birth, women may experience postpartum neck pain, which is frequently brought on by hormonal changes, physical strain during labor, or bad posture while tending to the newborn. In order to encourage relaxation, lessen pain, and enhance general well-being, craniosacral therapy (CST) is a gentle, hands-on method that focuses on releasing tension in the craniosacral system, which includes the fluid and membranes surrounding the brain and spinal cord. Purpose:To assess immediate effects of CST on postpartum neck pain. It sought to evaluate changes in the intensity of neck pain and neck muscle contraction prior to treatment and 24 hours following CST. Pain severity was assessed using the Numerical Pain Rating Scale (NPRS) and neck muscle contraction was assessed using a pressure biofeedback unit (PBU). Setting:Maternity wards of a tertiary-care hospital in Karnataka, India. Participants:Postpartum women aged 21-40 years who were experiencing neck pain in the early puerperal period. Research design:A single-group pre- and post-intervention experimental study. Intervention:A single 30-min session of CST. Main outcome measures:NPRS and craniocervical flexion test against PBU. Assessments were conducted pre-intervention and 24 h post-intervention. The data analysis was carried out using SPSS 29.0 software and Microsoft Excel 2019. Results:CST resulted in a statistically significant reduction in postpartum neck pain, with the NPRS median score decreasing from 6 to 1 (76.14% reduction, p < 0.01). Additionally, there was a 4.40% increase in deep neck flexor muscle activation, as indicated by the PBU median value increasing from 27 mmHg to 28 mmHg (p < 0.01). Conclusion:A single 30-min CST session significantly reduced postpartum neck pain and improved deep neck flexor muscle activation. These findings highlight CST as an effective immediate intervention for pain relief and muscle function enhancement in postpartum women.
Credibility is fundamental to the continued development and integration of therapeutic massage and bodywork as a health profession. However, credibility does not arise automatically from advances in education, regulation, research, or professional standards. Drawing on literature from massage therapy, professional identity, sociology of professions, and health professional education, this editorial argues that credibility is a social judgment conferred through recognition by patients, colleagues, regulators, and the public. The discussion examines the relationships among professionalization, professional identity, trust, and everyday practice, emphasizing the importance of communication, informed consent, collaboration, accountability, and professional conduct. Credibility is presented not as an achievement but as an ongoing professional responsibility earned through the consistent demonstration of competence, integrity, and trustworthiness across professional contexts.
Background:Chronic low back pain (CLBP) is characterized by its diverse etiological factors. Scientific literature implies that fasciae might be crucial in the presentation of CLBP. Myofascial release (MFR) techniques are frequently employed within the realm of manual therapy and are found to reduce pain. However, studies investigating the structural and biomechanical effects of MFR findings remain limited. Purpose:This study aimed to determine and compare the effect of MFR and simulated MFR on the flexibility of the erector spinae (ES) muscles and thoracolumbar fascia (TLF) utilizing sonoelastography in individuals with CLBP. Methods:An experimental study was conducted with 40 individuals diagnosed with CLBP, who were recruited from the outpatient department of a tertiary-care hospital based on specified eligibility criteria. Participants were then randomly assigned to one of the study groups. Stiffness of the ES muscle and TLF were assessed through sonoelastography, while fascial thickness was evaluated via B-mode ultrasound. Pain intensity was quantified using the Numerical Pain Rating Scale, and lumbar mobility was assessed through the modified-modified Schober's test. The statistical analysis was performed using an independent t-test with statistical significance established at p < 0.05. Results:The between-group analysis showed a significant reduction in bilateral ES muscle and TLF stiffness (p = 0.00). There was also a significant reduction in TLF thickness when compared to the simulated group (p = 0.00). Additionally, an immediate decrease in pain intensity (p = 0.00) and an increase in trunk mobility (p = 0.00) were found in the MFR group when compared to the simulated MFR group. Conclusion:The MFR group demonstrated immediate tissue changes, reduced pain intensity, and improved trunk mobility in comparison with the simulated MFR group.
Background:Cyclical mastalgia is common among perimenopausal women and often coexists with depressive symptoms, significantly impairing quality of life. Pharmacological treatments offer limited relief and may cause side effects. Oketani breast massage (OBM), a non-invasive technique targeting retro-mammary tissues, has shown benefits in lactating women but remains unexplored in perimenopausal women with cyclical mastalgia. This study aimed to assess its effectiveness in reducing breast pain and depressive symptoms. Materials and methods:A single-group pre-test and post-test quasi-experimental design was used. Thirty-eight perimenopausal women aged 45-55 years with cyclical mastalgia were recruited. Participants received OBM twice weekly for 4 weeks, delivered by a trained therapist. Breast pain and depressive symptoms were measured before and after the intervention using the Breast Pain Questionnaire (BPQ) and the Hamilton Depression Rating Scale (HDRS). Due to non-normal data distribution, the Wilcoxon signed-rank test was used for analysis. Results:Post-intervention analysis showed significant reductions in BPQ (mean difference = 5.00, p < 0.001) and HDRS scores (mean difference = 10.00, p < 0.001). Both outcomes had large effect sizes (1.00), indicating notable clinical improvements. No adverse effects were reported by any participants. Conclusion:OBM appears to be a safe and effective non-pharmacological intervention for managing cyclical mastalgia and associated depressive symptoms in perimenopausal women. Its simplicity, non-invasive nature, and dual benefits make it a valuable component of integrative women's health care. Further randomized controlled trials with larger samples are recommended to confirm these findings.
Background:Musculoskeletal shifts during pregnancy can cause structural stress, leading to pain symptoms. There is evidence that manual therapies such as massage therapy, physical therapy, and chiropractic may be of benefit. Neurosomatic therapy is a treatment that combines structural analysis with a variety of massage techniques to help restore proper postural alignment and alleviate the root cause of musculoskeletal pain. Objective:To examine the effects of neurosomatic therapy on pain reduction in a pregnant patient during her third trimester. Methods:A 36-year-old female in her third trimester of pregnancy received 10 massage therapy treatments performed by a student at the Center for Neurosomatic Studies. The sessions were conducted twice per week over a 5-week period, and began with an initial interview to gather information about the client's symptoms. Each session also incorporated the use of a posturology chart to assess structural asymmetries, followed by targeted massage therapy techniques. Outcome measures used to track progress included posturology charts, the McGill Pain Questionnaire (MPQ), Quebec Back Pain Disability Scale (QBPDS), Visual Analog Scale (VAS), as well as ongoing verbal feedback from the client. Results:While the MPQ and QBPDS questionnaires showed no significant improvement, verbal feedback indicated a decrease in or elimination of pain symptoms in some areas and an overall reduction in pain compared to the patient's first pregnancy. Conclusion:These findings suggest that there may be a need for the development of pregnancy-specific pain outcome measures that incorporate normative data that reflects the typical progression of symptoms. Without establishing such baselines, it is challenging to evaluate treatment-related changes in pain and functioning during pregnancy. Neurosomatic therapy may be a helpful intervention for decreasing pain throughout pregnancy; however, research with multiple participants is needed to provide stronger evidence supporting the benefits of this approach.
Background: Cervical spondylosis is a degenerative condition caused by age-related wear and tear of the spinal discs and joints. It can lead to stiffness, pain, and reduced mobility. Three-dimensional myofascial release (3D-MFR) is a technique that involves stretching, compression, and movement to release fascial restrictions, reduce pain, and improve mobility. This case report illustrates the application of 3D-MFR in the treatment of cervical spondylosis. Purpose: To evaluate the effectiveness of 3D-MFR combined with strengthening exercises on pain, proprioception, range of motion (ROM), and function in a patient with cervical spondylosis. Participant description: A 55-year-old female reported with chronic neck discomfort, stiffness, and functional restrictions caused by cervical spondylosis. She was a pathologist by occupation, and her condition was exacerbated by prolonged use of a microscope at work, which required sustained neck flexion and sub-optimal posture. Intervention: The patient underwent 3D-MFR in combination with neck strengthening exercises over a period of 5 weeks. Results: The patient demonstrated significant improvements in pain, ROM, proprioceptive accuracy, and functional capability. The outcome measures used for assessment included the Visual Analog Scale, goniometer-based ROM, joint position error test, and the Neck Disability Index. Conclusion: This case report supports the potential efficacy of 3D-MFR and neck strengthening exercises in treating symptoms of cervical spondylosis and enhancing cervical spine function, particularly for individuals with work-related postural demands.
In massage therapy, it is generally advised to avoid dual relationships because they are believed to be difficult to manage and cross professional and personal boundaries. However, dual relationships are difficult to avoid in small, rural, and other communities. This paper is written from the perspective of a massage therapist who lives and works in a rural town and who works within dual relationships regularly. It discusses ideas around the ethics, management, and benefits of dual relationships as well as the need for supportive ethical guidance informed by the realities of living and working in small or rural communities. Research is lacking in massage therapy around ethical issues and dual relationships; therefore, this paper draws in research from other areas of health care such as rural health ethics and rural health care. The aim of this work is to encourage contemplation, discussion, and research around dual relationships in massage therapy. Dual relationships should be further studied in massage therapy to better inform ethics education, practice standards, and guidance, which may positively impact patients and massage therapists.
Fatigue is a multidimensional, subjective experience that can persist despite rest and significantly impair quality of life. While often addressed through physical modalities, fewer manual therapy approaches incorporate emotional processing. This case report describes the use of HeartSpeak Lite for BodyWork, a mindbody technique combining gentle fascial mobilization with guided emotional somatic release, in a client with long-standing fatigue symptoms and stress-related burden. A 52-year-old woman presented with over a decade of persistent fatigue, post-exertional exhaustion, generalized pain, insomnia, and brain fog. She had previously received a diagnosis of chronic fatigue syndrome from her general practitioner in 2019 but had declined pharmacological treatment. Prior use of massage and chiropractic care provided only temporary relief. She sought a natural, integrative option. Over 10 weekly sessions, she received HeartSpeak Lite for BodyWork, which involved structured emotional processing paired with gentle, sustained fascial contact, all delivered in a safety-informed and client-led setting. The client reported progressive improvements in fatigue severity, perceived stress, and daily functioning. Over the 10 weeks, Fatigue Severity Scale scores decreased from 6.8 to 4.2, and Perceived Stress Scale scores improved from 29 to 19. Subjective reports noted greater energy, emotional balance, and increased physical activity tolerance. She also reported feeling safe and supported throughout the intervention, with no adverse effects noted. This case illustrates the potential of a bodywork-based emotional somatic intervention to support individuals with complex fatigue symptoms. While causality cannot be inferred, the observed improvements suggest that gentle, structured, and emotionally attuned approaches may offer benefit by addressing both physical and emotional dimensions of persistent fatigue.
Background:Cervicogenic headache (CGH) is a secondary headache linked to cervical spine disorders and musculoskeletal dysfunction. Recent research suggests that the posterior myofascial chain, extending from the cervical region to the lower limbs, may contribute to CGH. Muscle tightness and trigger points (TrPs) in this chain can exacerbate headache symptoms. However, limited research on the prevalence of tightness and TrPs in the posterior kinetic chain highlights the need for further investigation to inform targeted treatments. Objective:The main aim of this study is to determine the prevalence of tightness and the presence of TrPs in the muscles of the posterior myofascial chain in subjects with CGH. Materials and method:A total of 1,283 participants were screened using the Cervicogenic Headache International Study Group criteria, identifying 188 with CGH. This cross-sectional study assessed muscle tightness and TrPs in the posterior kinetic chain at one point in time. Seventeen TrPs across the upper back, lower back, and lower limbs were examined by examiner 1. Muscle tightness in the trapezius, thoracolumbar fascia, piriformis, hamstrings, and gastrosoleus was evaluated by examiner 2 using a goniometer or measuring tape. Results:Data show that participants with left or right CGH have higher tightness percentages in the trapezius (left: 96.93%, right: 98.88%), thoracolumbar fascia (89.89%), and hamstrings (left: 97.95%, right: 95.55%). TrPs were more in the occipital ridge (left: 84.69%, right: 86.66%), splenius capitis and cervicis (left: 65.30%, right: 61.11%), lower cervical spine (left: 90.81%, right: 96.66%), and rhomboid (left: 55.10%, right: 53.33%). A one-sample t-test, which compared the scores to normal values, revealed a significant difference (p = 0.0001) in tightness and TrPs in the posterior kinetic chain. Conclusion:The findings indicate that individuals with CGH exhibit a high occurrence of muscle tightness and TrPs on the posterior myofascial chain on the affected side.
Background: Conventional pharmacological treatment does not always relieve cancer pain satisfactorily, increasing the need for further medication. Complementary and integrative therapies are offered to cancer inpatients to improve their well-being. Although manual therapies such as massage and reflexology are commonly offered to hospitalized cancer patients in the UK, Shiatsu in this setting is little known and has been studied much less. Aims: The purpose of this project is to examine the pain-relieving effects of Heisei Shiatsu in hospitalized cancer patients and to compare those results with other bodywork modalities which have been established for longer in this field. Methods: Fifty-five inpatients received 66 Heisei Shiatsu treatments. Interventions are adapted to health issues and specific pain complaints. Patients scored changes in pain intensity, the relief provided, and changes in mood as a result of the treatment using the validated Integrative Medicine Treatment Evaluation Form. The pre- and post-treatment scores for pain and mood were analyzed with both student’s t-test and the Wilcoxon signed-rank test. Results for relief are given in percentage points. All results were com-pared to results for other therapies stated in comparable research articles. Results: Decrease in pain intensity and pain relief was reported after the Shiatsu session by all patients. The average reduction in pain was 40%. Thirty-two percent of the patients said their pain had been completely relieved, and 45% stated the pain had been mostly relieved. Compared to results in similar studies, Shiatsu is more effective than aromatherapy or reflexology in reducing pain among cancer patients. Almost all patients commented on the relaxing and soothing effects of these treatments. Conclusion: Heisei Shiatsu can be delivered alongside conventional care for patients with cancer. Although the sample size is not big enough to draw definite conclusions, it warrants further research into the safety of Heisei Shiatsu in this set-ting and its relaxing effects as described by many of the patients.
Language shapes how therapeutic massage and bodywork are perceived by clients, colleagues, policymakers, and the public. Professional credibility depends not only on what practitioners do but also on how they describe their work. The diversity of terms used across research, education, and practice reflects the field's richness but can also blur its public image, limit research coherence, and hinder integration within health systems. This editorial examines the role of language in defining professional credibility and reviews key initiatives that have sought to establish shared terminology and taxonomies. By advancing collaboration across research, education, and practice, massage therapists can continue to refine their professional language. Clear, credible, and inclusive communication strengthens public trust and reinforces massage therapy's contribution to health and well-being across the continuum of care.
Background:Massage therapy is an increasingly utilized user-pays service in Aotearoa New Zealand. People seek massage therapy for physical support, relaxation, and well-being. It is likely financially inaccessible to many and is generally not subsidized by the government; however, some private insurance companies in New Zealand provide limited cover for massage therapy sessions. Purpose:The aim of this project was to find out massage therapist (MT) and client perceptions of, and benefits and barriers to, using alternative payment schemes (APSs) to pay for massage therapy. These schemes included 'pay it forward,' 'pay what you wish,' and paying by installments. Setting:This project involved participants from Invercargill, Dunedin and Auckland, Aotearoa New Zealand. Participants:The participants were 12 employed MTs, and 7 massage therapy clients for whom cost was a barrier. Research design:This was a qualitative study using a semi-structured interview approach. Participants were interviewed either in person or over the phone. Results:Four themes emerged: financial contexts, APSs as a positive concept; considerations of administration, transparency and possible impacts; and installments as a preferred scheme. Massage is expensive, but many view it as an important investment in health and well-being. Owing to cost, massage is not utilized as often as needed. Perceived benefits to using an APS were increased accessibility and usage of massage therapy, resulting in potentially better health and well-being. Considerations for MTs centered around a lack of time and knowledge for scheme setup, a potential negative effect on the client-therapist relationship, and concern about losing money. For clients, considerations included uncomfortable feelings around accepting financial assistance and potential loss of money: a risk if funds had been prepaid toward a massage, and the therapist goes out of business before the massage was claimed. Overall, the installment scheme was preferred by MTs and massage clients. Conclusion:Massage therapy is a valuable health and wellness tool for many people. APSs may have a place in the industry as there may be enough interest from therapists and clients to engage in a system that is user-friendly, trustworthy, and safe, thus increasing the affordability and accessibility of massage therapy.
Background: Stillbirth is the death, in utero, of a fetus from 20 weeks’ gestation until immediately before birth. This may be spontaneous or can occur after termination for medical reasons (TFMR). The experience of stillbirth profoundly impacts subsequent pregnancies, with mothers frequently experiencing conflicted emotions, heightened anxiety, stress, symptoms of depression, fear, isolation, and a diminished sense of trust in a positive outcome. Supportive care options for individuals pregnant after a stillbirth or TFMR are needed to help meet their psychological and emotional needs. Individuals pregnant after a loss do not feel emotionally safe in their pregnancies; thus, the side effects and perception of safety in support interventions need to be explored. Purpose: This article reports participants’ experiences of safety, the harms, and adverse events in a study exploring massage as a support for individuals pregnant after a stillbirth. Methods: The study used questionnaires to collect side effect data and qualitative interviews to examine participants’ experience of safety. Results: The study found that 75% of participants experienced one or more side effects. Post-massage soreness (45.8%) was the most frequently reported side effect, followed by tiredness (43.1%). The main theme of the qualitative analysis was “safety: so much more than physical safety,” reflecting the importance of safety to study participants and that safety was much more than avoiding physical harm. Conclusion: Participants needed the massage space to feel safe, both environmentally and psychologically, to facilitate their capacity to engage. Having trained massage therapists was important as this helped reassure participants that mas-sage was a safe treatment for themselves and their baby.
Introduction:Addressing immune challenges and stress in young adults is crucial due to the impact of academic and early career pressures. Self-massage, a cost-effective technique, may provide health benefits. Objective:This study aimed to investigate the effects of self-massage on immune function, stress, and quality of life in young adults. Secondary objectives included evaluating the feasibility, adherence, and safety of the intervention. Methods:A total of 38 healthy young adults (58% women, aged 18-26 years) were randomly assigned to a self-massage group (n = 18) or a control group (n = 20) for an 8-week intervention. Outcome measures included immune status, perceived immune function, perceived health, stress levels, and quality of life, which were analyzed using mixed-effects repeated measures analysis of covariance (ANCOVA) with the pretest as a covariate. Results:The self-massage group adhered to the protocol without adverse events. The self-massage group demonstrated significant improvements in immune status compared to the control group (p = 0.044) and a significant within-group change (p = 0.028). While significant time effects were observed for all outcomes, within-group improvements were noted only for perceived immune status (p = 0.032) and perceived general health (p = 0.022) in the self-massage group. Conclusion:Self-massage enhances immune function and perceived general health in young adults, offering an effective approach. Future research should incorporate objective measures of the immune system, examine its long-term effects, and investigate its integration with other relaxation techniques to validate and expand these findings.
