The Impact of Massage Therapy on Function in Pain Populations-A Systematic Review and Meta-Analysis of Randomized Controlled Trials: Part II, Cancer Pain Populations

Courtney Boyd, Cindy Crawford, Charmagne F Paat, Ashley Price, Lea Xenakis, Weimin Zhang, Evidence for Massage Therapy (EMT) Working Group, Chester Buckenmaier 3rd, Pamela Buckenmaier, Jerrilyn Cambron, Christopher Deery, Jan Schwartz, Ruth Werner, Pete Whitridge, Courtney Boyd, Cindy Crawford, Charmagne F Paat, Ashley Price, Lea Xenakis, Weimin Zhang, Evidence for Massage Therapy (EMT) Working Group, Chester Buckenmaier 3rd, Pamela Buckenmaier, Jerrilyn Cambron, Christopher Deery, Jan Schwartz, Ruth Werner, Pete Whitridge

Abstract

Purpose: Pain is multi-dimensional and may be better addressed through a holistic, biopsychosocial approach. Massage therapy is commonly practiced among patients seeking pain management; however, its efficacy is unclear. This systematic review and meta-analysis is the first to rigorously assess the quality of massage therapy research and evidence for its efficacy in treating pain, function-related and health-related quality of life in cancer populations.

Methods: Key databases were searched from inception through February 2014. Eligible randomized controlled trials were assessed for methodological quality using the SIGN 50 Checklist. Meta-analysis was applied at the outcome level. A diverse steering committee interpreted the results to develop recommendations.

Results: Twelve high quality and four low quality studies were subsequently included in the review. Results demonstrate massage therapy is effective for treating pain compared to no treatment [standardized mean difference (SMD) = -.20] and active (SMD = -0.55) comparators. Compared to active comparators, massage therapy was also found to be beneficial for treating fatigue (SMD = -1.06) and anxiety (SMD = -1.24).

Conclusion: Based on the evidence, weak recommendations are suggested for massage therapy, compared to an active comparator, for the treatment of pain, fatigue, and anxiety. No recommendations were suggested for massage therapy compared to no treatment or sham control based on the available literature to date. This review addresses massage therapy safety, research challenges, how to address identified research gaps, and necessary next steps for implementing massage therapy as a viable pain management option for cancer pain populations.

Keywords: Function; Health-Related Quality of Life; Massage Therapy; Meta-Analysis; Pain; Systematic Review.

© 2016 American Academy of Pain Medicine.

Figures

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Figure 1
PubMed Search String.
Figure 2
Figure 2
Flow Chart.
Figure 3
Figure 3
(A) Results of massage vs. no treatment meta-analysis for cancer populations experiencing pain: pain intensity/severity at post-treatment (sample size analyzed, N = 176). (B) Results of massage vs. active comparator(s) meta-analysis for cancer populations experiencing pain: pain intensity/severity at post-treatment (sample size analyzed, N = 370). (C) Results of massage vs. active comparator(s) meta-analysis for cancer populations experiencing pain: sleep (fatigue) at post-treatment (sample size analyzed, N = 235). (D) Results of massage vs. active comparator(s) meta-analysis for cancer populations experiencing pain: mood (anxiety) at post-treatment (sample size analyzed, N = 234).

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