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Techniques aimed at the reduction of experienced stress are the means by which a person either helps him or herself or is helped by someone else to feel more comfortable psychologically, that is, to experience less anxiety and sense of emotional disquiet.

Factors related to the induction and experience of stress vary in any given environment, as does each individual’s capacity to cope with stress-inducing events. Stress management techniques assist a person to promote thoughts and behaviors that help to counter the negative effects of events that are perceived as taxing a person’s coping resources and are therefore perceived as stressful.

One aim of complementary therapies is to assist in the reduction of stress and enhancement of well-being. The touch therapies, i.e., massage, aromatherapy and reflexology, all promote the relaxation response (Benson, 1975) in the immediate term and are non-drug interventions which, when used on a regular basis, can help to counteract the effects of stress. The touch therapies operate through somewhat different mechanisms to promote improved well-being over time.

Therapeutic massage can help to counter the deleterious effects imposed by everyday stressors, minor muscle strains and muscle tension. Regular therapeutic massage is an excellent way to help maintain health, as it works with both the musculoskeletal structure of the body and body function, which are interrelated. Massage facilitates an increased circulation of blood, promoting and improving the supply of vital oxygen and nutrients to cells, as well as relieving tension due to chronic muscle spasm and/or poor posture by loosening contracted hardened muscles, which are causing discomfort and consuming energy. Improving the circulation of a painful region helps to remove toxic neurotransmitters, chemical messengers that help to mediate the transmission of pain from the peripheral to the central nervous system. The pumping effect of movement of muscle assists in the draining of lymph fluid carrying waste products away from cells. Massage aimed at countering chronic muscle tension and relieving the aches and pains associated with minor injuries can therefore provide benefit to all body systems by facilitating improved circulation and more efficient function. The psychological benefits from massage are based on the interactions between mind and body, just as the consequences of physical tension and stress may impact on mental and emotional well-being.

The Relevance of the Gate Control Theory of Pain to Physiological Mechanisms Occurring During Massage

Back pain and fatigue are two symptoms that may be very effectively relieved through therapeutic massage, helping to relieve physical and emotional distress and to promote release of energy and feeling of well-being. The therapeutic physical and psychological benefits of massage can be explained by the principles of the Gate Control Theory (GCT).  According to the GCT theory, painful stimuli are transmitted by small, slow conducting C and A-delta nerve fibers, from the periphery to the transmission cells (T-cells) in the dorsal horn of the spinal column, activity in which it opens the gate to pain perception by the brain. T-cell activity is fundamental to pain experience. The Substantia Gelatinosa in lamina II of the dorsal horn contains inhibitory and excitatory interneurones, which dampen or amplify output from the T-cells. T-cell activity in the dorsal horn can be blocked or modified by touch information, transmitted from large fast A-beta fibers, also transmitting information from the periphery to the CNS. Information from the large, fast touch fibers overrides the information from the slower pain transmitting fibers, reducing T-cell activity thus closing the “gate” in the spinal cord and preventing the transmission of pain to the brain. As well as being concerned with the balance between impulses from large, fast touch and small, slow pain transmitting fibers, the GCT asserts that the experience of pain can be modulated by cognitive and emotional factors that can inhibit or exacerbate a person’s perception of pain and was the first theory of pain to acknowledge and incorporate the importance of psychological factors in pain perception. The principles of the GCT explain those of the application of TENS machines and of massage.

Some of the key benefits of massage are reduced muscle tension, improved blood circulation and lymph drainage, increased mobility, relief from acute and chronic pain, reduced stress and overall relaxation. The latter effect is also brought about because, in addition to pain-reducing properties already outlined, massage is based on stimulating the tactile sense that helps a person to concentrate on the here and now, providing respite from the mental anguish of worries and problems.

Different Methods of Massage Therapy

There are a number of different methods of massage therapy, most of which can be classified into five basic categories: Traditional methods, European, Contemporary Western, Structural/Functional/Movement Integration, Oriental and Energetic. Many massage practitioners combine a number of methods. Endacott provides a comprehensive summary of the aims and techniques and benefits associated with each type of therapeutic massage.

Traditional European Massage is based on the conventional Western concepts of anatomy and physiology using basic categories of soft tissue manipulation. Swedish Massage, developed in the early 19th century by Ling, is possibly the most practiced method of Traditional European Massage and aims to enhance health and treat illness through improving blood flow to the soft tissues, as well as the promotion of relaxation and relief of muscle tension. Alongside these methods, Contemporary Western Massage methods, developed since the 1960s, uses a wide variety of techniques focused on holistic principles of personal growth and integration of mind, body and spirit. For example, Esalen Massage focuses on achieving optimal states of relaxation and overall well-being and is often combined with the use of Swedish Massage.

Some of the common conditions for which therapeutic massage is very helpful include soft tissue injuries such as sprains and strains, the pain and stiffness associated with arthritis, the spasm and poor blood circulation of back pain and the relief of anxiety fatigue and tension headaches. It is, however, essential to have a medical check-up for injuries that involve considerable pain and loss of function and to be aware that there are some conditions for which the use of therapeutic massage, especially deep tissue massage, is contraindicated including unhealed wounds and later-stage osteoporosis. Deep tissue massage in the region of some types of early- to middle-stage cancers is thought to be a potential risk factor for the spread of micrometastases through the lymphatic system. The associated difficulties can be overcome through the use of gentle hand massage, which helps to alleviate anxiety and to promote relaxation for people with cancer.

Choosing a massage practitioner

Take care to select a massage practitioner either from a trusted friend, health-care professional or the professional body of a particular country, for example the American Massage Therapy Association in the United States. To be certified in the U.S. an examination is required by the National Certification Board for Therapeutic Massage and Bodywork. It is wise to be aware of the relevant professional body and to ask a practitioner what qualifications and credentials he or she possesses for methods practiced.

The massage experience

Prior to having a massage it is important to feel relaxed to optimize the benefits of the experience. Massage involves direct contact with the skin, so it is necessary to remove as much clothing as leaves a sense of personal comfort. A warm shower is helpful beforehand as is not eating heavily. If the aim of the massage is to reduce chronic tension then muscle tissues may be sensitive and the massage may involve a degree of discomfort, so good communication between client and practitioner is required to reduce risk of undue discomfort and maximize the benefits of the experience both during and after the massage. As with all therapies that promote removal of toxic waste from cells it is important to drink plenty of water afterward to facilitate the process.