Submitted by by Keturah Tracy RN, BSN, LMT
Many of us have argued over the concept of “alternative” versus “complementary” medicine when it comes to massage therapy. Massage can be used as an alternative to narcotics, steroid injections, and surgery, but it can also be used as a complement to allopathic medicine to speed healing and reduce pain should surgery be necessary. Massage facilitates a body-mind-spirit balance, allowing the body to tap into its own recuperative powers. For clients who are afraid of doctors, it provides a useful alternative, along with diet, exercise, and other lifestyle factors, to help keep them healthy. For those who are actively under a physician’s care, massage helps minimize complications and provide the best possible outcome. It is well established as useful for musculo-skeletal issues such as low back and neck pain (Furlan, Imamura, Dryden, and Irvin 2008; Sherman, Cherkin, et. al. 2009) but evidence suggests massage is also beneficial for cancer (Kutner, Smith, et al. 2008), and heart surgery (Cutshall et. al 2007). Rather than belabor the argument of alternative versus complementary medicine, it is useful to apply the concept of prevention to a massage therapy practice. The concept of prevention encompasses both the alternative and complementary schools of thought and allows for a broader application of massage therapy as part of a total wellness program.
Primary, secondary, and tertiary prevention efforts each play a role in maintaining and restoring health (Pender 1996). With primary prevention, the client is healthy but is at risk of ill health. Massage helps prevent this person from becoming sick or disabled due to injury or emotional stressors. Clients who received regular weekly full-body Swedish massages often fall in this category.
Secondary prevention techniques are used when a person already has something going wrong. These techniques detect this state of dis-ease with the goal of reversing it. In allopathic medicine, secondary prevention includes screening for cancer and heart disease. In the massage field, an intake questionnaire and postural assessment are sometimes used. For massage clients requesting secondary prevention, chronic overuse, job stress, and other factors have clearly impacted them and resulted in a “kinked neck”, tingling of fingertips, or a host of other warning signs that this client is headed down a bad path (Nelson, Lieberman, and Kiener 2008). Massage is applied to allow this client to regain balance and restore health. This type of massage is often more specific and with a particular goal in mind, such as neuromuscular therapy. It is sometimes referred to as “alternative” healthcare, because clients may choose massage for reversal of the condition instead of western allopathic medicine.
Tertiary prevention is used in massage therapy when a client has had an illness or disability, has received medical care to manage this disability, and is at this point receiving massage to minimize complications related to the initial problem, as well as prevent other problems for which s/he is now at risk due to the initial disability. Clients receiving tertiary prevention efforts are most likely using massage as a complementary therapy, as they are currently under a physician’s care. Successful application of massage as tertiary prevention includes use during and after chemotherapy, after a mastectomy, and in recovery from amputation and during adjustment to prosthetic (Aldridge & Clifft 2002; Bryant 2001). Manual lymph drainage is one example of massage in this category.
Whether viewed as alternative or complementary healthcare, massage therapy is a valuable form of preventive medicine. It can prevent disease and disability through primary prevention, arrest and reverse dis-ease when it presents itself as secondary prevention, and reduce complications related to disability when it does occur as tertiary prevention. The “alternative” vs. “complementary” schools of thought can combine under the larger umbrella of prevention and serve as a united front to promote massage therapy as a valid field of healthcare.
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Bryant G. (2001). Stump care: Treatment after lower limb amputation can determine the patient’s future. American Journal of Nursing, 101 (2), 67-71. Cutshall S.M., Fenske L. L., Kelly R. F., Phillips B. R., Sundt T. M., Bauer B. A. (2007).
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Furlan A.D., Imamura M., Dryden T., Irvin E., (2008). Massage for low-back pain. Cochrane Database of Systematic Reviews, Issue 4.
Kutner J., Smith M., Corbin S., et al. (2008). Massage therapy versus simple touch to improve pain and mood in patients with advanced cancer: a randomized trial. Annals of Internal Medicine, 149(6):369-379.
Nelson, D., Lieberman, D., and Kiener, L. (2008). Massage for musicians: Linking injuries to instruments. Massage and Bodywork Magazine 23 (1): 82-88, 90. Pender, N. J. (1996). Health Promotion in Nursing Practice, ed. 3, Appleton & Lange: Norwalk, Conn.
Sherman KJ, Cherkin DC, Hawkes RJ, et al. (2009).
Randomized trial of therapeutic massage for chronic neck pain. Clinical Journal of Pain. 25(3):233-238.
Author Bio: Keturah is a full time nurse-massage therapist and graduate nursing student. She lives in central Illinois with her two children, a dog, and two cats.