How Old is Massage? And more? Part two!

The first appointment generally begins with information gathering, such as the reason for getting massage therapy, physical condition and medical history, and other areas. The client is asked to remove clothing to one’s level of comfort. Undressing takes place in private, and a sheet or towel is provided for draping. The massage therapist will undrape only the part of the body being massaged. The client’s modesty is respected at all times. The massage therapist may use an oil or cream, which will be absorbed into the skin in a short time.

To receive the most benefit from a massage, generally the person being massaged should give the therapist accurate health information, report discomfort of any kind (whether it’s from the massage itself or due to the room temperature or any other distractions), and be as receptive and open to the process as possible.

Insurance coverage for massage therapy varies widely. There tends to be greater coverage in states that license massage therapy. In most cases, a physician’s prescription for massage therapy is needed. Once massage therapy is prescribed, authorization from the insurer may be needed if coverage is not clearly spelled out in one’s policy or plan.


Going for a massage requires little in the way of preparation. Generally, one should be clean and should not eat just before a massage. One should not be under the influence of alcohol or non-medicinal drugs. Massage therapists generally work by appointment and usually will provide information about how to prepare for an appointment at the time of making the appointment.


Massage is comparatively safe; however it is generally contraindicated, i.e., it should not be used, if a person has one of the following conditions: advanced heart diseases, hypertension (high blood pressure), phlebitis , thrombosis, embolism, kidney failure, cancer if massage would accelerate metastasis (i.e., spread a tumor) or damage tissue that is fragile due to chemotherapy or other treatment, infectious diseases, contagious skin conditions, acute inflammation, infected injuries, unhealed fractures , dislocations, frostbite, large hernias, torn ligaments, conditions prone to hemorrhage, and psychosis.

Massage should not be used locally on affected areas (i.e., avoid using massage on the specific areas of the body that are affected by the condition) for the following conditions: rheumatoid arthritis flare up, eczema , goiter, and open skin lesions. Massage may be used on the areas of the body that are not affected by these conditions.

In some cases, precautions should be taken before using massage for the following conditions: pregnancy , high fevers, osteoporosis , diabetes, recent postoperative cases in which pain and muscular splinting (i.e., tightening as a protective reaction) would be increased, apprehension, and mental conditions that may impair communication or perception. In such cases, massage may or may not be appropriate. The decision on whether to use massage must be based on whether it may cause harm. For example, if someone has osteoporosis, the concern is whether bones are strong enough to withstand the pressure applied. If one has a health condition and has any hesitation about whether massage therapy would be appropriate, a physician should be consulted.

Side effects

Massage therapy does not have side effects. Sometimes people are concerned that massage may leave them too relaxed or too mentally unfocused. To the contrary, massage tends to leave people feeling more relaxed and alert.

Research & general acceptance

Before 1939, more than 600 research studies on massage appeared in the main journals of medicine in English. However, the pace of research was slowed by medicine’s disinterest in massage therapy.

Massage therapy research picked up again in the 1980s, as the growing popularity of massage paralleled the growing interest in complementary and alternative medicine. Well designed studies have documented the benefits of massage therapy for the treatment of acute and chronic pain, acute and chronic inflammation, chronic lymphedema, nausea , muscle spasm, various soft tissue dysfunctions, anxiety, depression, insomnia, and psycho-emotional stress, which may aggravate mental illness.

Premature infants treated with daily massage therapy gain more weight and have shorter hospital stays than infants who are not massaged. A study of 40 low-birth-weight babies found that the 20 massaged babies had a 47% greater weight gain per day and stayed in the hospital an average of six days less than 20 infants who did not receive massage, resulting a cost savings of approximately $3,000 per infant. Cocaine-exposed, preterm infants given massage three times daily for a 10 day period showed significant improvement. Results indicated that massaged infants had fewer postnatal complications and exhibited fewer stress behaviors during the 10 day period, had a 28% greater daily weight gain, and demonstrated more mature motor behaviors.

A study comparing 52 hospitalized depressed and adjustment disorder children and adolescents with a control group that viewed relaxation videotapes, found massage therapy subjects were less depressed and anxious, and had lower saliva cortisol levels (an indicator of less depression).

Another study showed massage therapy produced relaxation in 18 elderly subjects, demonstrated in measures such as decreased blood pressure and heart rate and increased skin temperature.

A combination of massage techniques for 52 subjects with traumatically induced spinal pain led to significant improvements in acute and chronic pain and increased muscle flexibility and tone. This study also found massage therapy to be extremely cost effective, with cost savings ranging from 15-50%. Massage has also been shown to stimulate the body’s ability to naturally control pain by stimulating the brain to produce endorphins. Fibromyalgia is an example of a condition that may be favorably affected by this effect.

A pilot study of five subjects with symptoms of tension and anxiety found a significant response to massage therapy in one or more psycho-physiological parameters of heart rate, frontalis and forearm extensor electromyograms (EMGs) and skin resistance, which demonstrate relaxation of muscle tension and reduced anxiety.

Lymph drainage massage has been shown to be more effective than mechanized methods or diuretic drugs to control lymphedema secondary to radical mastectomy, consequently using massage to control lymphedema would significantly lower treatment costs. A study found that massage therapy can have a powerful effect upon psycho-emotional distress in persons suffering from chronic inflammatory bowel disease. Massage therapy was effective in reducing the frequency of episodes of pain and disability in these patients.

Massage may enhance the immune system. A study suggests an increase in cytotoxic capacity associated with massage. A study of chronic fatigue syndrome subjects found that a group receiving massage therapy had lower depression, emotional distress, and somatic symptom scores, more hours of sleep, and lower epinephrine and cortisol levels than a control group.

Training & certification

The generally accepted standard for training is a minimum of 500 classroom hours. Training should include anatomy, physiology, pathology, massage theory and technique, and supervised practice. Most massage therapists also take additional courses and workshops during their careers.

In the United States, massage therapists are currently licensed by 29 states, the District of Columbia, and a number of localities. Most states require 500 or more classroom hours of training from a recognized training program and passing an examination.

A national certification program was inaugurated in June 1992 by the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB). The NCBTMB program is accredited by the National Commission for Certifying Agencies, the chief outside agency for evaluating certification programs. Those certified can use the title Nationally Certified in Therapeutic Massage and Bodywork (NCTMB). Most states use the NCBTMB exam for their licensing exams.

A national accreditation agency, the Commission on Massage Therapy Accreditation, designed according to the guidelines of the U.S. Department of Education, currently recognizes about 70 training programs. The Accrediting Commission of Career Schools and Colleges of Technology and the Accrediting Council for Continuing Education and Training also accredit massage training programs.

All info in this post is pulled from

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