- Stress is associated with rising levels of cortisol as well as muscle tension and sleep problems.
- Massage is known to decrease subjective ratings of stress, as well as cortisol levels.
- Evidence suggests massage may have some positive mental health effects.
I remember a psychologist suggesting I get a massage. I felt myself a bit aback. Massage seemed to me like an expensive placebo. She shared about massage assisting with emotional release and healing of trauma. Years later, after receiving a massage in physical therapy for neck pain, I found myself surprised. Not only did the pain decrease, but it felt as if I were letting go of the emotional tension and tangles that likely contributed to the pain.
Stress on the Body
Stress is associated with a number of physical changes. When we are stressed, levels of the stress hormone cortisol rise, leading to immediate psychological and bodily changes meant to help us fight off threats (or run from them). Over time, too much stress can have deleterious effects on our physical and mental health. Similarly, stress is associated with muscle tension and insomnia.
Massage on Stress and Mental Health
Massage is generally accepted to be relaxing and feel good. It is known to have benefits for specific physical health concerns such as muscle tension, and many health insurance carriers cover it. Still, in terms of mental health, the research is a bit murkier. This is partially because there are so many types of massage. Massage protocol varies wildly, making it difficult to truly gather how effective massage as a whole or even individual types are for any given outcome. In addition, unlike medications, research on massage is less funded.
Research has shown that massage can effectively reduce stress in populations ranging from pregnant women (Li et al., 2019) to emergency medicine practitioners (Mahdizadeh et al., 2019). On a basic level, this makes sense, as massage is known to decrease muscle tension (Simão et al., 2021). Cortisol has been shown to present in significantly lower levels after massage in infants (Jabraeili et al., 2023) and nurses when assessed upon morning awakening (Souza et al., 2019). So, the impacts on stress certainly are unlikely to be placebo.
But what about more chronic stress? While there are endless lists of indicators of stress, one common one is trouble sleeping. When we don't feel fully safe, we are likely to have trouble getting to sleep. Evolutionarily, it would have been unwise for our ancestors to relax when a predator is on the prowl. Naturally, short-term stress is associated with insomnia issues, and a meta-analysis of studies indicates a prevalence of insomnia at about 63 percent in individuals diagnosed with post-traumatic stress disorder (PTSD) (Ahmadi et al., 2022).
One study showed a significantly greater improvement in self-reported sleep quality for individuals living with primary insomnia after tactile massage than those who received nurse-delivered counseling on sleep (Jong et al., 2016). Research on the effects of massage on sleep quality among individuals who experience chronic stress is lacking. However, a study involving teaching simple massage techniques to veterans living with PTSD, alongside other relaxation strategies, found significant improvement PTSD symptoms (Collinge et al., 2012).
There is evidence to suggest that massage could have a positive impact on stress as well as stress-related mental health challenges. This should not be taken to imply that massage is a replacement for other treatments of chronic stress, such as psychotherapy or medication, but it may play a role in improving mental health for some.
Ahmadi, R., Rahimi-Jafari, S., Olfati, M., Javaheripour, N., Emamian, F., Ghadami, M. R., & Sepehry, A. A. (2022). Insomnia and post-traumatic stress disorder: A meta-analysis on interrelated association (n= 57,618) and prevalence (n= 573,665). Neuroscience & Biobehavioral Reviews, 141, 104850.
Cheraghbeigi, N., Modarresi, M., Rezaei, M., & Khatony, A. (2019). Comparing the effects of massage and aromatherapy massage with lavender oil on sleep quality of cardiac patients: a randomized controlled trial. Complementary Therapies in Clinical Practice, 35, 253-258.
Collinge, W., Kahn, J., & Soltysik, R. (2012). Promoting reintegration of National Guard veterans and their partners using a self-directed program of integrative therapies: a pilot study. Military medicine, 177(12), 1477-1485.
Jong, M., Ljadas, K., Englund, E., Jong, M. C., & Appelberg, J. (2016). Feasibility and Effects of Touch Massage and Nurse Led Sleep Counselling in the Treatment of Primary Insomnia. Journal of Sleep Disorders: Treatment and care, 5(1).
Jabraeili, M., Mirghafourvand, M., Montazeri, M., & Farshi, M. R. (2023). The effect of massage on cortisol level in infants: A systematic review and meta-analysis. Journal of Neonatal Nursing.
Li, H., Zhao, M., Shi, Y., Xing, Z., Li, Y., Wang, S., & Sun, J. (2019). The effectiveness of aromatherapy and massage on stress management in nurses: a systematic review. Journal of clinical nursing, 28(3-4), 372-385.
Mahdizadeh, M., Jaberi, A. A., & Bonabi, T. N. (2019). Massage therapy in management of occupational stress in emergency medical services staffs: a randomized controlled trial. International journal of therapeutic massage & bodywork, 12(1), 16.
Simão, S., Höring, A. C., Lima, B. D. O., Silva, N. C. D. O. V., & Alfieri, F. M. (2021). Immediate effect of quick massage on muscle tension and pressure pain threshold. BrJP, 4, 221-224.
Souza, T. P. B., Souza-Talarico, J. N. D., Kuba, G., & Turrini, R. N. T. (2019). Awakening cortisol response and perceived stress decrease after quick massage intervention in nursing professionals. Psychoneuroendocrinology, 107, 38.