Massage therapists who have received specialized training and are certified in prenatal massage know how to position and support the woman's body during the massage, modify techniques, and avoid certain areas and techniques during pregnancy. Most will have a special table that allows the woman to rest comfortably and safely during the massage. Ideally, you should seek out a practitioner who is experienced and licensed in prenatal massage.

I agree with almost every detail of the article and wrote a letter of support to Dr. Barrett, which is published as an addendum to it. That said, the article does neglect some nice things that can be said about massage therapy, and it contains a few minor errors. But I applaud the intent and embrace and welcome most of the criticism. I wish it weren’t mostly true, but I believe that it is.
There are a few “medical” massage therapists out there with some training in orthopedics and rehabilitation. My education in massage therapy here in British Columbia, Canada, was three years long — the longest massage therapy training program in the world. There are also a few other places with two-year programs. A massage therapist with this level of education is certainly the kind that patients should seek out if they want massage as a treatment.
A 2014 Chinese review of studies by Li et al48 is a good example of what a shabby state massage therapy research is in. Let me be clear up front: I don’t think this paper actually proves anything one way or the other. I think it’s straightforwardly inconclusive. It has a positive sounding conclusion that isn’t really justified and there are major caveats. But it doesn’t mean that I wouldn’t go get me some massage if I had fibromyalgia. I probably would! But that’s another story. This is about the science, so here goes:

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In the US, licensure is the highest level of regulation and this restricts anyone without a license from practicing massage therapy or by calling themselves that protected title. Certification allows only those who meet certain educational criteria to use the protected title and registration only requires a listing of therapists who apply and meet an educational requirement.[123] It is important to note that a massage therapist may be certified, but not licensed. Licensing requirements vary per state, and often require additional criteria be met in addition to attending an accredited massage therapy school and passing a required state specified exam (basically the certification requirements in many states). In the US, most certifications are locally based. However, as of March 2014, some states still do not require a license or a certification.[citation needed] However, this is thought to change eventually as more regulatory bodies governing the profession of massage are established in each state. Furthermore, some states allow license reciprocity where massage therapists who relocate can relatively easily obtain a license in their new state. Not all states provide this option.[124]

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The more often people check social media accounts, texts, and email, the higher their level of stress, revealed the American Psychological Association's 2017 Stress in America report. Findings from the Pew Research Center underline another negative Facebook effect: Women are particularly vulnerable to stress from social media due to being aware of lousy stuff happening to friends.


Trigger point masssage is still 100% experimental. It has rarely been directly tested and it has never been done well (and never for back pain specifically, which is probably of the greatest interest).78 If you squint optimistically, you could call the best of the evidence “promising.” You could say that where there’s smoke, there’s fire. But it’s like the smoke from last night’s campfire — more of a smokey smell than a smoke where any fire might be hiding. Dial up even a mild cynical impulse, and the evidence collectively looks more like a damning failure to produce any clearly good news.
Traction is a great example — pulling on the spine. Often used by massage therapists to treat low-back pain and neck pain, it might be an effective technique for a few patients, but I wouldn’t count on it, or advise anyone to spend much money on it. Like many popular therapies, the evidence is a mess.30 The absence of conclusive evidence is significant: if traction worked well, it probably would have shown up clearly by now. If traction works at all, it’s certainly not reliable. I discuss traction in considerable detail in both my neck pain and back pain tutorials.
A short but clear, compelling, and strong critique of cranial osteopathy. As an osteopath himself, Dr. Hartman’s opinion carries considerable weight, and he writes well. He concludes that techniques based on the assumptions of cranial osteopathy “should be dropped from all academic curricula; insurance companies should stop paying for them; and patients should invest their time, money, and health elsewhere.”
M&W Massage and Wellness Solutions provide a pathway to good mental and physical health through professional massage therapy services. My massage therapy services are tailored to the client’s needs at the time of the session. It is a very personalized treatment, where I also incorporate the concepts of visualization and stretching for maximum benefit.  I help my clients with pain management, stress reduction and relaxation utilizing the perfect bed, heating pad and top of the line lotions and oils.  ... View Profile 

Beyonce, Blondie, or the Biebster, sometimes belting out the lyrics to a favorite tune makes everything seem all right. If you’re in a public place (that isn’t the opera), just listening to music can be a quick fix for a bad mood Relaxing music prevents stress-induced increases in subjective anxiety, systolic blood pressure, and heart rate in healthy males and females. Knight, W.E., Rickard, N.S. Monash University, Victoria, Australia. Journal of Music Therapy 2001;38(4):254-72.. Classical music can be especially relaxing right before bedtime.
Anxious? Just squeeze, release, and repeat. Progressive relaxation involves tensing the muscles in one body part at a time to achieve a state of calm Effects of progressive relaxation on anxiety and quality of life in female students: a non-randomized control trial. Dehghan-Nayeri, N., Adib-Hajbaghery, M. Tehran University of Medical Sciences, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran, Iran. Complementary Therapies in Medicine 2011;19(4):194-200.. The method (also used by actors) is a great way to help fall asleep.
Yet kicking back is hardly an unproductive activity; experts say that it keeps us healthy and happy. And research shows that regular de-stressing can help ward off heart disease and obesity, act as a buffer against depression, and even boost immunity against colds. Plus, when you're calm, you perform tasks smarter and more efficiently, leaving you with time to—wait for it—relax. Check out these strategies and inspiration for R in R: relaxing in reality.
The more often people check social media accounts, texts, and email, the higher their level of stress, revealed the American Psychological Association's 2017 Stress in America report. Findings from the Pew Research Center underline another negative Facebook effect: Women are particularly vulnerable to stress from social media due to being aware of lousy stuff happening to friends.
Massage developed alongside athletics in both Ancient China and Ancient Greece. Taoist priests developed massage in concert with their Kung Fu gymnastic movements, while Ancient Greek Olympians used a specific type of trainer ("aleiptes")[27] who would rub their muscles with oil. Pehr Ling's introduction to massage also came about directly as a result of his study of gymnastic movements.
Well, so much for controversy! Massage probably has many interesting physiological effects … but getting rid of acid in your blood is certainly not one of them. Nor is drinking extra water going to help. On the contrary, as mentioned above in the myths section, massage is probably modestly “toxifying,” not detoxifying. Other articles delving into detox myths:

I've been a massage therapist for 8 years. I still love and believe in what I do. I work with your body and I listen to your bodies energy. I like to spoil my clients begining each session with warm towels and enhancing the experience with  aromatherapy added to there session.I use only all organic hypoallergenic products.  Always catering to each individual in a professional manner.. Hoping they leave feeling fixed, healed, and balanced.  ... View Profile
No question: actually boosting performance would be a big deal, a humungous deal! But the cited evidence doesn’t remotely substantiate such a mighty claim. Even if we take that evidence at face value, it’s a huge and oversimplified reach to conclude that “a little increased range of motion” constitutes a meaningful effect on athletic performance as a whole. I can increase my ROM with a few seconds of stretching, too … and stretching does not enhance performance (look it up). 

And yet some medical benefits are plausible despite the lack of evidence. For instance, many apparently successful treatments may be due to the effects of pressure on “muscle knots,” which are a likely factor in many common pain problems, but poorly understood (and difficult to treat). And regardless, the effects on mood and mental health are so profound that patients can’t really lose — it’s a valuable service whether it “works” for pain or not.
Prenatal massage uses mild pressure similar to Swedish massage. The therapist will focus on areas such as your lower back, hips, and legs. You can be fully or partially undressed depending on your comfort level. During the massage, you’ll either lie on your side or on a specially designed table with a cutout for your belly. If you’ve had pain in your calves or other parts of your leg, see a doctor before you have a massage.
Dr. Stephen Barrett is a prominent anti-quackery activist. In an article on his popular website, QuackWatch, Barrett condemns common non-massage practices in massage therapy, but not massage itself: “ordinary massage and the legitimate practice of massage therapy should not be categorized as quackery.”47 That’s surprising tolerance from such a fierce critic of questionable health care.
If you've been jonesing for a change from your traditional Swedish massage, or you are particularly stiff or sore due to exercise or arthritis, Thai massage may be just what you're looking for. Unlike most massage modalities that utilize massage oils and require you to disrobe and climb under a sheet on a massage table, Thai massage is performed while you are fully clothed, usually on a padded mat on the floor.
Meditation is often seen as a great way to relax, and many studies back up that idea. In a meta-analysis looking at several studies of relaxation training in people with anxiety, the observed effects of meditation were greater than those observed for other intentional relaxation techniques, such as autogenic training (a process that involves making your body feel heavy and warm) and applied relaxation. Other studies have also outlined its effect as an anti-anxiety and antidepressant method.
Swedish and deep tissue massages are very similar. The primary difference is the level of pressure involved. If you’re looking for relaxation and relief from tense, tight muscles, Swedish massage is probably right for you. If you’re recovering from an injury, deep tissue massage can be a helpful part of your treatment plan. Feel free to ask questions before you book a massage and to communicate feedback to your therapist during a massage.
The results are underwhelming. Although they did a little better than just guessing, the results suggest that it’s difficult even for expert examiners to detect the location of neck and back pain by feel. As well, they were only attempting to detect the side of pain. Imagine how much worse their performance would have been if they had had to identify the location more precisely, or if the pain could have been anywhere or nowhere. So they barely passed the easiest possible test, and probably would have failed a harder one and done no better than guessing.
Massage treats delayed onset (post-exercise) muscle soreness. Supposedly, massage therapy can stop that awful soreness that develops after an intense workout, known as delayed-onset muscle soreness (DOMS) — which is ironic, because massage is also well-known to cause a little next-day soreness. Although some studies have shown that massage can take the edge off DOMS, that’s about as good as it gets59 — perhaps a 30% temporary pain reduction when the planets align. It certainly doesn’t restore your strength any sooner. As with increasing circulation, it’s important to maintain perspective: it wouldn’t matter much even if massage did cure DOMS. Although DOMS can be pretty unpleasant, it’s one of the most trivial of all pain problems, guaranteed to solve itself within three days. On a closely related note …
Deep Tissue Massage can release the chronic patterns of tension in the body through slow deep strokes on any contacted areas and deep finger pressure on the contracted areas, either following or going across the grain of muscles, tendons and fascia. It is called deep tissue, because it also focuses on the deeper layers of muscle tissue. It can help reduce pain, increase range of motion, relieve muscle spasms and improve circulation.

There have been very few studies of pre-event sports massage. In 2018, a rare example of it had a clear negative conclusion,71 echoing the findings of a couple earlier ones.7273 It’s a very small study, but it’s still a useful contribution74 (and it's not actually the first such evidence). Seventeen sprinters were tested with four combinations of massage, dynamic warmup, and an ultrasound placebo and found that “massage decreased 60-meter sprint performance in comparison to the traditional warm-up.”
There are a few “medical” massage therapists out there with some training in orthopedics and rehabilitation. My education in massage therapy here in British Columbia, Canada, was three years long — the longest massage therapy training program in the world. There are also a few other places with two-year programs. A massage therapist with this level of education is certainly the kind that patients should seek out if they want massage as a treatment.
I’ve often said that massage therapy research is in its early stages. And after thinking about that more today, I’ve realized it’s worse than that. Massage therapy research is stunted, and not showing signs that it is ready to progress. Some might disagree, and would point to the increasing number of massage therapy studies. (I’ve charted it myself in at least one paper I’ve published, and there is no doubt that the number of papers on the subject is increasing.) But I would counter by noting that there is no discussion in the field. The studies are conducted and published in isolation. They are not often being critiqued, and researchers with different theories and perspectives are not addressing each other in the literature or even at conferences.
Aspects of sports massage therapy are gaining popularity as useful components in a balanced training regimen. Sports massage therapy can be used as a means to enhance pre-event preparation and reduce recovery time for maximum performance during training or after an event. Athletes have discovered that specially designed sports massage promotes flexibility, reduces fatigue, improves endurance, helps prevent injuries and prepares their body and mind for optimal performance.

Good massage therapists are the ones with more training and a bigger toolkit. They do what they can with the tools they judge to be the most useful, and they candidly discuss risks, benefits, evidence, and controversies. They don’t just pay lip service to humility as a general principle of alternative medicine — they make it a centerpiece, recognizing that they really are not trained enough to know much.


Lactic acid is not a dead-end, “bad” metabolic waste product, and it does not cause post-exercise soreness. This is a pernicious and seemingly un-killable myth. It originated with “one of the classic mistakes in the history of science,” according to George Brooks, a Berkley physiologist. I will not give the myth any further air time here. See Gina Kolata’s clear overview in the New York Times, or a concise professional summary by Robergs in Experimental Phsyiology. For a deeper and geekier, but excellent read, see Dr. Goodwin’s entertaining rant about the prevalence of the lactate myth in the 2012 summer Olympics coverage. BACK TO TEXT

“Runners put so much effort into training, but very few athletes put effort into taking good care of body that helps them perform,” says Gammal, who recommends incorporating regular massage—even if it’s just a 30-minute session once a month—so as to prevent injuries and the overtraining of muscles.  Scheduling mid-training appointments can also reveal places that are tight and places that should be addressed in post-workout stretching. “Massage isn’t a luxury, Gammal says. “It’s an investment.”


Pre-event massage is given shortly before an athlete competes. It consists mainly of brisk effleurage to stimulate and warm the muscles and petrissage to help muscles move fluidly and to reduce muscle tension. Effleurage is generally a relaxing stroke , but when done briskly it is stimulating. As the massage progresses, the pressure increases as the massage therapist uses percussive strokes and cupping to stimulate the muscles to contract and flex. The part of the body being massaged varies from sport to sport, although leg and back muscles are common targets for this type of massage.

In New Zealand, massage is unregulated. There are two levels of registration with Massage New Zealand, the professional body for massage therapists within New Zealand, although neither of these levels are government recognised. Registration at the Certified Massage Therapist level denotes competency in the practice of relaxation massage. Registration at the Remedial massage therapist denotes competency in the practice of remedial or orthopedic massage. Both levels of registration are defined by agreed minimum competencies and minimum hours.[105]
Manipulative approaches to naturally treating pain and other health problems have been utilized for over 3,000 years, dating back to Ancient Egyptian and Chinese civilizations. Pressure massages were used to improve “Qi” (life force or energy), detox the body and promote better liver function — which today can be explained through the process of activating the lymphatic system.
The psychoanalyst David Morgan, of the Institute of Psychoanalysis, believes that for many of us this deadening retreat to our screens is both a reason for and a consequence of the fact that we no longer know how to relax and enjoy ourselves. Our screens and what we use them for are all techniques of distraction, he says. “People have got so used to looking for distraction that they actually cannot stand an evening with themselves. It is a way of not seeing oneself, because to have insight into oneself requires mental space, and all these distraction techniques are used as a way of avoiding getting close to the self.”

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The study involved 263 volunteers with an average age of 48.5. Overall muscle spasm/muscle strain was described as either moderate or severe for each patient prior to treatments, which consisted of a massage between 45–60 minutes in duration. Results demonstrated an average systolic pressure reduction of 10.4 mm/Hg, a diastolic pressure reduction of 5.3 mm/Hg, a mean arterial pressure reduction of 7.0 mm/Hg and an average heart rate reduction of 10.8 beats per minute following massage treatment. (6)
The Elements Promise™ is not transferable and may not be redeemed for cash, bartered or sold. Void where prohibited or otherwise restricted by law. Substitute massage session equal in value and duration to original massage session; gratuity not included. Substitute massage session cannot be combined with any other offer. Other restrictions may apply; see individual studios for details.
Panic attacks have certain patterns. Time how long it takes to build up, the duration of the panic attack, how long it takes to calm down and at what point you are finally able to resume your normal activity. It may not be easy doing this, but timing your panic attacks will enable you to have better control over it the next time it happens. You will also be able to tell those around you before an attack occurs, how long it is liable to last, and how they can help you.

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A short but clear, compelling, and strong critique of cranial osteopathy. As an osteopath himself, Dr. Hartman’s opinion carries considerable weight, and he writes well. He concludes that techniques based on the assumptions of cranial osteopathy “should be dropped from all academic curricula; insurance companies should stop paying for them; and patients should invest their time, money, and health elsewhere.”

Example: Despite their rationality, these therapists are usually factoring out several snake oils, because they assume they are legit, and have never gotten around to examining that assumption. For instance, they may consider energy work to be nonsense, but assume that acupuncture is evidence-based — a common and understandable mistake, but a mistake nevertheless. See Does Acupuncture Work for Pain?. BACK TO TEXT

Therapeutic Thai Massage is the first authentic Thai Massage spa specializing in age-old Thai practices along with contemporary procedures. Thai massages alternate between assisted Yoga and acupressure. This combination will ensure a unique experience to every customer seeking relief from tight muscles, chronic tension and those looking to promote overall health throughout the entire body.
Massage is reputed to be helpful, and certainly many fibromyalgia patients seek it out (while others avoid it, finding it too intense and exacerbating). Like low back pain, it seems like massage “should” be able to help with fibromyalgia. Surely massage can help soothe the frazzled nerves of a uninjured patient whose primary symptom is pain? And if it can’t, what good is it?
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:
Trigger points or stress points may also cause muscle soreness and decreased flexibility. These points are specific spots in muscle and tendons which cause pain when pressed, and which may radiate pain to a larger area. They are not bruises, but are thought by some to be small areas of spasm. Trigger points may be caused by sudden trauma (like falling or being hit), or may develop over time from the stress and strain of heavy physical exertion or from repeated use of a particular muscle.

Hepatic hematoma. Hepatic hematoma is a painful liver condition, which The New England Journal of Medicine says has been instigated by deep tissue massage. In this case, a 39-year-old woman received a deep tissue massage, which included the abdomen and right upper quadrant. Within 24 hours, she developed abdominal discomfort, nausea, and pain in her right shoulder. A large hematoma was found in her right hepactic lobe, causing the woman to feel nauseous and have a fever for the following six months.


People think of massage therapy as a “safe” therapy, and of course it mostly is. But things can go wrong. Serious side effects in massage therapy are rare, however, and common side effects are minor. A 2007 survey of 100 massage patients49 found that 10% of 100 patients receiving massage therapy reported “some minor discomfort” in the day following treatment. This would mainly be a familiar slight soreness that is common after a massage — I’m surprised only 10% reported it. The massage must have been quite gentle.

Panic attacks have certain patterns. Time how long it takes to build up, the duration of the panic attack, how long it takes to calm down and at what point you are finally able to resume your normal activity. It may not be easy doing this, but timing your panic attacks will enable you to have better control over it the next time it happens. You will also be able to tell those around you before an attack occurs, how long it is liable to last, and how they can help you.

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The study involved 263 volunteers with an average age of 48.5. Overall muscle spasm/muscle strain was described as either moderate or severe for each patient prior to treatments, which consisted of a massage between 45–60 minutes in duration. Results demonstrated an average systolic pressure reduction of 10.4 mm/Hg, a diastolic pressure reduction of 5.3 mm/Hg, a mean arterial pressure reduction of 7.0 mm/Hg and an average heart rate reduction of 10.8 beats per minute following massage treatment. (6)

This powerful relaxation technique requires that you lay down somewhere comfortable and firm, like a rug or mat on the floor or a firm bed.  Choose a warm - but not hot - dark room if possible. This technique involves progressively contracting and relaxing the main muscle groups around the body that store tension.  If at any point during this technique you feel pain or cramp then stop. 

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Just a square (about 1.4 ounces) of the sweet stuff can calm your nerves. Dark chocolate regulates levels of the stress hormone cortisol and stabilizes metabolism Metabolic effects of dark chocolate consumption on energy, gut microbiota, and stress-related metabolism in free-living subjects. Nestle Research Center, Vers-chez-les-Blanc, Lausanne, Switzerland. Journal of Proteome Research 2009;8(12):5568-79..
In this particular study, published in Studies in Health Technology and Informatics, therapeutic massage included techniques of tapping and friction, while DTM used “oblique pressure and a combination of lengthening and cross-fiber strokes.” All sessions were 30 minutes long and preformed daily, and all participants did not receive any other treatments during the course of the study. After 10 days, participants treated with DTM reported significant improvements in pain (lower back pain in this case) compared to those treated with therapeutic massage, based on scores using the Modified Oswestry Low Back Pain Disability Index, Quebec Back Pain Disability Scale and Visual Analog Scales. (4)
The Touch Research Institute has conducted about many dozens of small studies showing the positive effects of massage and touch therapies on many conditions. It’s all a little too good to be true (or all true). I think the Touch Research Institute designs studies in such a way that a positive spin on touch therapy is inevitable. For instance, many of their papers are particularly afflicted by two statistical errors: confusing statistical and clinical significance (or just ignoring the difference when convenient), and comparing the wrong things to arrive at so-called “significance” (see Statistical Significance Abuse: A lot of research makes scientific evidence seem more “significant” than it is.) Also, conclusions in the abstracts of these papers are often so broadly stated as to be uninteresting: one of their studies concludes, for instance, that the subjects “report satisfaction.” Satisfaction is not a meaningful outcome. People are often satisfied with snake oil — that doesn’t mean it works! Some of these scientific papers seem more like press releases, produced by a professional association to promote the profession of massage therapy. I no longer take TRI studies seriously. BACK TO TEXT

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