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In observation of the Thanksgiving holiday, AMTA National Office will be closed Wednesday, November 22, 2017 at 2:00 PM CST
through Friday, November 24, 2017. 
You can reach us during our normal business hours starting Monday, November 27, 2017.

Massage as a Component of Integrative Health Care

Approved September 2017

Position Statement

It is the position of the American Massage Therapy Association (AMTA) that massage therapy can provide significant benefit as a component of Integrative Health Care.

Background Information

According to the World Health Organization, health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.1 Currently health care in the United States is going through a paradigm shift from a biomedical model to a biopsychosocial model. The biopsychosocial model places emphasis on viewing the patient as a whole and addressing all the patient’s needs by inter-professional health care teams which include both health and mental health, in a non-stigmatizing environment which considers the patient’s preferences and culture.2

Integrative care is at the core of this paradigm shift to the biopsychosocial model. “Integrative medicine is the practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic and lifestyle approaches, health care professionals and disciplines to achieve optimal health and healing.”3

A growing body of evidence supports the value massage therapy can offer to integrated health systems for a range of patient health conditions. Massage therapy has been shown to be effective in regards to chronic pain, behavioral health, rehabilitation, and acute medical treatment.4–11 

Massage therapy is well accepted for managing pain. Dr. Albert Schweitzer is said to have proclaimed in 1931 that pain is a more terrible lord of mankind than even death itself. Chronic pain has become an epidemic affecting nearly 50 million American adults.12 “Pain is a leading cause of disability and a major contributor to health care utilization. It is also costly to the United States, not just in terms of health care expenses and disability compensation, but also with respect to lost productivity and employment, reduced incomes, lost school days, and decreased quality of life.”13 “Effective pain management thus requires therapies that treat both pain and related sequela by addressing the whole patient through a holistic biopsychosocial model.”14 A recent meta-analysis gave massage therapy a strong recommendation, compared to no treatment, for reducing pain intensity/severity for those with musculoskeletal pain.14 Several treatment guidelines indicate massage therapy for treatment of low back pain6,9,10,15–17, neck pain18, and migraines.19 Massage therapy has also been shown to be beneficial4 for low back pain9,10,17,20–28, headaches29–42, carpal tunnel syndrome43–48, osteoarthritis49–52, neck and shoulder pain53–55, fibromyalgia56–64, and in hospice care65–74.

One key aspect of integrated, patient-centered care is assisting patients to participate in managing both their physical and mental health care needs. Incorporating massage therapy as part of a treatment plan enables treatment of not only the physical and behavioral aspects of a wide variety of health conditions, but also the myriad of symptoms that accompany these conditions. “In 2014, there were an estimated 43.6 million adults aged 18 or older in the United States with AMI {any mental illness} in the past year.”(75) Massage therapy research has been shown to be beneficial4 for anxiety and stress25–27,29,35,38,64,76–94, depression26,27,35,58,64,70,79,89,91,95–104, PTSD23,105–108, and Substance Abuse Disorder Recovery.11,81,109 

As part of an integrative treatment plan, massage therapy can aid in the healing and rehabilitation following bodily injury. The Department of Labor recognized the potential benefit of massage therapy for injured employees under the Energy Employees Occupational Illness Compensation Program Act (EEOICPA), which provides compensation to those who work on certain high-risk projects for the Department of Energy. The Department cited the potential benefits of massage therapy as “reducing pain and muscle tension, increasing flexibility and range of motion, and improving blood circulation.”110 Massage therapy has been shown to be beneficial4 in working with athletic training/injury treatment111–119, ergonomics and job-related injuries43–46,48,120, cardiac rehabilitation84,121,122, joint replacement rehabilitation123–125, and scar management.126–135

Massage therapy can help make the healing process more successful by addressing not only the symptoms of medical conditions but also the treatments for those conditions which can have effects that significantly impair quality of life, sometimes generating pain, anxiety, and depression. Massage therapy for inpatient conditions in hospitals demonstrates how massage therapy can apply to a wide range of health issues. Massage therapy has been shown to be beneficial4,11 for cancer management60,136–150, post-surgical pain management14,84,90,151–164, lymphatic drainage165–170, maternity and newborn care.171–181

References

1. WHO definition of Health [Internet]. [cited 2017 Jan 27]. Available from: http://www.who.int/suggestions/faq/en/
2. Medicine’s Paradigm Shift: The Case for Integrated Care [Internet]. [cited 2017 Jan 27]. Available from: https://www.apa.org/about/governance/president/paradigm-shift-integrated-care.pdf 
3. Introduction - Academic Consortium for Integrative Medicine & Health [Internet]. [cited 2017 Jan 27]. Available from: https://www.imconsortium.org/about/about-us.cfm 
4. American Massage Therapy Association. The Value and Efficacy of Massage Therapy in Integrated Health Care [Internet]. American Massage Therapy Association; [cited 2017 Jan 27]. Available from: https://www.amtamassage.org/uploads/cms/documents/aca_book_final.pdf 
5. Weeks J. The Joint Commission Moves Integrative Approach Ahead of Pharmaceuticals for Pain Management … plus more. Integr Med Clin J. 2015 Apr;14(2):14–6.
6. Qaseem A, Wilt TJ, McLean RM, Forciea MA, Clinical Guidelines Committee of the American College of Physicians. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017 Feb 14;
7. NIH review finds nondrug approaches effective for treatment of common pain conditions [Internet]. National Institutes of Health (NIH). 2016 [cited 2017 Apr 29]. Available from: https://www.nih.gov/news-events/news-releases/nih-review-finds-nondrug-approaches-effective-treatment-common-pain-conditions 
8. Commision on Cancer. Cancer Program Standards: Ensuring Patient-Centered Care [Internet]. American College of Surgeons; 2016. Available from: https://www.facs.org/~/media/files/quality%20programs/cancer/coc/2016%20coc%20standards%20manual_interactive%20pdf.ashx
9. EVIDENCE-INFORMED PRIMARY CARE MANAGEMENT OF LOW BACK PAIN Clinical Practice Guideline [Internet]. [cited 2017 Feb 25]. Available from: http://www.topalbertadoctors.org/download/1885/LBPguideline.pdf?_20170225140153 
10. Guideline on the Evaluation and Management of Low Back Pain.pdf [Internet]. [cited 2017 Apr 29]. Available from: https://www.oregon.gov/oha/herc/EvidenceBasedGuidelines/Guideline%20on%20the%20Evaluation%20and%20Management%20of%20Low%20Back%20Pain.pdf 
11. Patrick Morrisey, Attorney General. Best Practices for Prescribing Opioids in West Virginia [Internet]. State of West Virginia Office of the Attorney General Consumer Protection and Antitrust Divisio; Available from: http://www.ago.wv.gov/Documents/2016.08.19%20BP%20Prescribing.PDF 
12. NIH Study Shows Prevalence of Chronic or Severe Pain in U.S. Adults | APS [Internet]. [cited 2017 Feb 25]. Available from: http://americanpainsociety.org/about-us/press-room/nih-study-shows-prevalence-of-chronic-or-severe-pain-in-u-s-adults 
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