The road to intellectual dishonesty is paved with good intentions. When I worked as a therapist, there were times when — confession! — I didn’t bother to explain to a patient that I was selling them a dubious approach to therapy . Sometimes it seemed okay because the atmosphere of experimental treatment was thick already, with a desperate patient who had low expectations and was pretty much there to try anything. But it was still dishonest, and I’m ashamed of those times. After all, if patients were my experimental research subjects, shouldn't I have been paying them?
This alternative medicine form is a component of Chinese medicine involving thin needles inserted into the body at certain points known as meridians. This is an ancient healing modality that can be used solely or in conjunction with other treatments. There’s ample research evidence to indicate that Acupuncture can be an effective treatment for anxiety.
Manual therapists routinely claim that their services are much safer and more effective than drug therapies. Yet this data pretty clearly shows that the difference is really not great. Depending on how you look at it, drugs are only a little worse in some ways, or maybe a little better in other ways. But no matter how you slice it, 20-40% is a pretty unpleasant rate of harm — especially at $60–120/hour!
"If you walk in the door decompressed, it gives you a jump-start for the rest of the evening," says productivity expert Julie Morgenstern, author of Time Management from the Inside Out ($15; amazon.com). Do you take public transportation home? Resist the siren call of email and try a meditation app, such as Insight Timer, Calm, or Stop, Breathe & Think (all free on iTunes and Google Play). "Call a friend or loved one, listen to music—any activity that breaks you out of your normal train of thought should help," says Morgenstern. "One client found it effective to set his relaxation intentions on his way home from work. He'd tell himself, 'I want to enjoy cooking with my partner and make sure so-and-so does homework, but I'll ask in a gentle way,' and so on."
So the imperfect evidence shows that massage can maybe help low back pain, and yet the world has certainly not been saved from back pain. What’s wrong? Why isn’t massage immediately, completely, and permanently fixing lots of back pain clients? Because there are many kinds of both massage and back pain. Results of therapy vary widely with the skills of therapists, and with the specific kinds of back pain brought to them. And so, on average:
According to the Neuromuscular Therapy Center, NMT is one type of deep massage technique that focuses on applying manual therapy to soft tissue with “quasi-static pressure” in order to stimulate skeletal striated muscle. (17) In addition to massaging a painful or inflamed muscle, the area around the affected muscle that normally supports it is also massaged in order to release tension. NMT therapists often focus on several factors that can add to muscle or tissue dysfunctions, including joint pathologies, postural positioning, disruptive habits of use, nutritional components, emotional well-being, allergies and neurotoxins.
For now, and maybe forever, we can only judge these methods on the basis of the the strength of their defining idea. What’s different about it from other common massage methods? Anything? What can it do that supposedly other techniques cannot? You’d be surprised how many barely count as more than a slight variation on Swedish massage. Even if it is distinctive, is the big idea any better than a pet theory? Most are not. The history of medicine is littered with pet theory corpses. Most treatment ideas do not work out (null hypothesis), even really good ones. And almost everything that is worthwhile about massage is probably thanks to being artfully touched, which you’ll get from most methods.
There are a lot of relaxation techniques out there that we can all learn and practice. However, I have found that many of my clients (and myself) struggle with the way these are presented, and they also have problems motivating themselves to use them. In response to that, I researched the types of relaxation techniques that have the most research support, and I developed a five-step sequence that anyone can do to feel more relaxed in minutes, minus the new-age vibes.
More technically and most seriously, massage research is plagued by a “stark statistical error”: the error of reporting statistical significance of the wrong thing, or the wrong comparison.5 Dr. Christopher A. Moyer is a psychologist and a rare example of a real scientist — someone trained and expert in research methodology — who has chosen to focus on massage therapy:
Seriously, walk away from the screen(s). In fact, once you finish reading this article, you can walk away from this screen, too. Today, there’s so much time spent taking in information. You read the news, have your most personal conversations, and work, all from the same little screen. So, leave it behind. Taking regular breaks from your phone and computer can help reset your brain and bring relief. And doing so before bed (at least 45 minutes before) will help you drift to slumber without a heavy mind.
In fact, the history of Thai massage is more complex than this legend of a single founder would suggest. Thai massage, like Thai traditional medicine (TTM) more generally, is a combination of influences from Indian, Chinese, Southeast Asian cultural spheres, and traditions of medicine, and the art as it is practiced today is likely to be the product of a 19th-century synthesis of various healing traditions from all over the kingdom. Even today, there is considerable variation from region to region across Thailand, and no single routine or theoretical framework that is universally accepted among healers.
Unsurprisingly, the conclusions here are superficially positive: massage “significantly improved pain, anxiety, and depression in patients with FM.” But that’s statistical significance only, not a clinically significant degree of improvement: the size of the effect is trivial (much smaller than amplitude of the noise in the data). As usual, using the word “significantly” this way is technically correct and defensible, but otherwise misleading to all but the most alert readers.