Susie Ellis on Susie’s Spa Blog last week called to my attention a new research study which is to be published this month in The Journal of Alternative and Complementary Medicine entitled “A Preliminary Study of the Effects of a Single Session of Swedish Massage on Hypothalamic-Pituitary-Adrenal and Immune Function in Normal Individuals.” The study compared two groups of healthy adults, one of which received a Swedish massage, while a second control group received a “light touch” treatment. They found some significant positive differences in the group experiencing the Swedish massage.
For those of us who work in the spa industry, this is exciting research, so I contacted Mark Rapaport, the study’s lead author and the chairman of the Department of Psychiatry and Behavioral Neurosciences at Cedars-Sinai Medical Center to get a copy of his report. The paper showed that the largest effect they found was on Arginine Vasopressin (AVP,) a hormone thought to play a role in stress and aggression. Smaller but significant effects were found in an increased quantity of lymphocytes in the blood (related to immunity,) cortisol hormones (related to stress,) and “lower levels of whole blood mitogen-stimulated cytokine production” (don’t ask me what this means but the researchers suggest this may help explain some of massage therapy’s benefits for children with asthma.)
The New York Times, in their article on Rapaport’s study noted that the researchers were surprised by their findings. (Susie Ellis’ response: “Well . . . it’s certainly not a surprise to any of us in the [spa] industry—nor to people who have had massages regularly.”) You tell ‘em Susie! In the spa industry, we may not be surprised at these findings, but there are several important things to rejoice in this piece of research. Here’s why I think this study is important:
1. They studied a healthy population. As I have protested in other articles (here and here,) the research that has been done previously on massage is limited and has focused on clinical populations (for example on patients with cancer, post partum depression, asthma, or insomnia.) In this study, the researchers point out that “although these studies suggest that massage therapy may benefit certain individuals . . . methodological problems in studies of massage severely limit their ability to generate scientifically valid and generalizable conclusions.” This is especially important for the spa industry which (for the most part) caters to healthy consumers and bills their services as preventative and beneficial to the general public, not as a treatment for specific ailments.
2. They showed benefits even against a light touch control group. I often argue that the benefits of a spa treatment may have very little to do with the massage itself. There are a lot of things going on in the treatment room of the spa: the client is separated from their cellphones and other technology, they have an intention and expectation of a healing experience, the environment (lighting, music, etc.) is soothing, they are given time in silence for reflection and/or mindfulness, and even before the therapy begins, they experience the presence and touch of a nurturing human being. So while avid spa-goers can speak anecdotally about the benefits of massage, there are so many confounding things happening in the experience that it is hard to say how much impact the massage itself had. But in this study, the control group experienced all of those confounding elements and so only the technique of how the massage was applied was different (Note to my spa savvy readers: the experimental group received typical Swedish massage techniques including “effleurage, petrissage, kneading, tapotement, and thumb friction.” The control group received “only a light touch with the back of the hand.”)
3. They found a benefit in a single session. It is easy to imagine that a lifestyle that includes regular massage and relaxation would lead to less stress and greater health. I’m sure what was surprising to the researchers was that they could see an effect even after a single treatment. And this is surprising, because even though we in the spa industry believe in what we have to offer, we also know that guests have to come in regularly and shouldn’t expect a miracle to happen in a single visit. But this study was able to conclude “that a single session of Swedish massage may have fairly profound acute effects on the immune system.”
Although there is much to celebrate here, even in the spa industry we have to take these findings with a grain of salt. Nothing is “proven” by a single research study. But a study like this that finds an effect on a healthy population after a single session opens the door for further research. Just by uncovering that there is something here that is measurable, it invites other scientists to dig deeper. And in digging deeper, we just may discover there is much more to spa than most people realize.
References and recommended reading:
Rapaport, M. H., Schettler, P., & Bresee, C. (October, 2010). A Preliminary Study of the Effects of a Single Session of Swedish Massage on Hypothalamic-Pituitary-Adrenal and Immune Function in Normal Individuals. The Journal of Alternative and Complementary Medicine, 16(10), 1079-1088.
Do we know if the people giving the light touch treatment were therapists (possibly the same as the ones giving the Swedish massages)?
I’m asking because I wonder if there is something about the intentionality from the “toucher” at play here. Let me explain: when I receive a massage, I get the impression I can feel when the therapist is in the zone, putting all her intentions in treating my areas of tightness, or whether she is thinking about what she’s going to have for dinner that day. My opinion is that the intentions behind the hands are as important as the techniques the hands are applying. So were the light touchers trained therapists intentionally trying to help the massage receiver or were they random individuals just trying to pass time and make a dollar at it? I’d be curious to know! Thanks for any info you have on this!
Hi Marie-Josee, That is an excellent question. All of the treatments were performed by trained massage therapists who were given a specific protocol (either a Swedish massage protocol or the “light touch” protocol.) So they were trained therapists in both groups, however, since these are trained massage therapists, it is easy to imagine that the therapists themselves would have a greater belief in the healing effects of the massage protocol which is presumably more similar to the protocol they normally provide. I’ll definitely have to add intention and beliefs of the therapist to my list of things that are happening in a spa treatment that could have an effect on the client! Great point!
Hi Marie-Josee, referring back to the study, the author makes reference that “a possible criticism is that we did not measure expectancy and credibility of the two interventions” but here he is referring to the client, who may be more likely to expect a healing effect from a massage than from light touch.
Yes, good point! Intentions of the therapist and expectations of the client are probably equally important (and maybe expectations of the client even more so, actually!)!
Thanks for looking it up for me, Jeremy!
Always good reading and exchanging on your blog!
Thanks so much for taking the time to get a full copy of the research report and giving us additional insight and information. It was very helpful to have the background and expanded explanation of just what the physiological changes in the body were. It also helped clear up for me (sort of) what I considered to be a confusing description of the two massage techniques they compared. “Deep-tissue Swedish massage” versus “light massage” as stated in the NY Times.
Your great explanations helped me see that they compared a massage with “effleurage, petrissage, kneading, tapotement, and thumb friction” to a “light touch with the back of the hand.”
It does make me wonder, however, whether the titles they gave for these descriptions were the most accurate. You and I (and likely many in the spa industry) would probably take issue with calling something a “deep-tissue Swedish” when we normally distinguish a Swedish massage from a deep tissue massage because of the lighter touch of a Swedish Massage, In addition I, am not sure that I have ever seen anything done only with the back of the hand called a massage at all.
I hear Professor Mary Tabacchi’s mantra ringing in my ears – we both know her well and that she is always encouraging (ok, perhaps strongly and emphatically insisting) people to “read the research carefully.” While the results of this study were positive no matter the description of the two methods compared, it does bring up an additional point that when medical professionals do research regarding spa modalities, it might be a good idea to consult with spa industry professionals as well to make certain that terminology is correct.
Thanks Susie, you are so right! I was confused by the New York Times article as well, which is why I was curious to see the study itself. You were right to question the titles they used: the New York Times inaccurately describes the two groups as a “deep tissue Swedish massage” group and a “light massage” group. In fact, the study compared a “Swedish massage” with a control group that received “light touch.” The intention of the “light touch” protocol was that it is not a massage at all but a control group. In order to best measure the impact of the massage, they wanted the control group to go through as similar a protocol as possible without receiving the actual massage.
Mary Tabacchi’s mantra of “read the research carefully” is very valid here, but it also shows that we have to be careful when relying on news sources (even reputable news sources such as the New York Times) for understanding scientific research. Your point about researchers consulting spa industry professionals is a good one and should also extend to the journalists who are writing about the research. Unfortunately the newspapers are usually trying to write the best, or most interesting story, even if it means the research is not accurately represented.
The research papers are peer reviewed (by other researchers–not by spa industry professionals) and generally have to show not only the conclusions that were drawn but also some of the flaws or problems with the research. News sources tend to report on single research studies as “proven” or “facts.” The reality is, each research study done should simply add to a growing body of knowledge about a particular subject and will need to be replicated many times under different situations and using different controls before we can really say the weight of evidence is conclusive.
What is great about this study is that researchers want to find effects that are measurable. This is why most massage research is done on clinical cases where they have medical issues that can be measured and improved through a course of massage. The fact that this study found measurable effects of massage on a healthy population opens the door to additional research that is much more relevant to the spa industry.
Thanks again, as I may have never seen this study if it were not for your blog keeping me up to date on the latest spa news and trends!
Thanks for all the great research updates! Like Susie, I am always interested in the factors not studied, assumed, or taken for granted. In addition to the role of therapist intention, what about the role of personal choice in the type of treatment to the level of response? The intention of the massagee? Is there a way to amplify this (such as the “script” or dialogue between the therapist and client?)
Thanks Jen! “Is there a way to amplify this?” I think that is absolutely the right question. If we can measure some of the beneficial effects of the spa experience maybe we can turn the knobs up and down to have a greater positive impact. Thanks for reading!
The benefit of human touch has been known for years in nursing. Recent studies through blood samples post Massage have clearly demonstrated a positive response to Massage.