Massage Treatment for Fatigue

Massage is a good option for patients sufferng from fatigue who are not well enough to exercise because physical manipulations of the skin and muscles help promote good circulation. 

Deep tissue massage targets the muscle tissues, which are located several layers below the skin surface.  Deep tissue massage utilizes increased pressure and slower movements in order to stimulate the capillaries found in the soft tissues and is very effective in improving blood circulation.

Probably one of the most undervalued aspects of massage therapy when used to treat fatigue is its effect on the overall feeling of well-being of the patient.  When used with the right techniques, massage can be very helpful as means to treat the symptoms of fatigue and improve the physical and mental state of the patient. 

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Frequently Asked Question about Massage

What is a Massage Session Like?

Because of the many different types of massage therapy, this question can only be answered very broadly.  The experience can differ widely depending on the type of massage therapy you have decided to try.

During your first massage therapy session, you can expect that the massage therapist will gather some preliminary information.   They may ask you questions to identify your current condition/challenges, your over-all health and what benefits or results you want to gain from the massage therapy session. The massage therapist (particularly for types of therapeutic massage as opposed to massage purely for relaxation/enjoyment) is also likely to ask about your physical condition, medical history, stress levels, lifestyle, medications taken and any physical pain that they need to be aware of during the massage therapy session.

A typical massage therapy session will last between 40 and 90 minutes depending on the type of massage, the reason you are going for massage, your present condition and your desired result. Massage therapy generally requires you to undress (for some massage types you keep your underwear on, for others you undress completely - this option may also depend on your level of comfort with the massage and with undressing) but your privacy will generally be maintained with a light covering. You will be asked to lie face down under a sheet on a padded massage table. A light oil or lotion may be used and applied to your skin to start the massage. A full body massage usually starts on the back then eventually moves down to the legs then you will be asked to turn over face up to continue with the massage of your arms, legs and neck. During the massage session, you are under the sheet all the time and only part of the body being massaged or treated is uncovered.

Is Massage Therapy Painful?

Massage therapy should not hurt (with certain exceptions for types of massage therapy like deep tissue massage or Swedish massage). Occasionally there will be a mild ache when therapist applies pressure to body points, over "knots" and other areas of muscle tension but it should not be painful. Although the degree of pressure being applied varies widely with the type of massage, it is always a good idea to draw the attention of the massage therapist to any pain and they can then tell you whether that is to be expected with that type of massage or they can ease off on the pressure.

what Does Massage Therapy Cost?

The frequency of massage sessions will vary depending on the condition being treated. The cost per session also depends on the methods that will be used (i.e. Swedish, Deep tissue, etc) but other than luxury massages (i.e. at spas), the cost generally ranges from $30 to approximately $130 per session.

Is Massage Therapy Covered by Insurance?

Most extended health insurance plans in Canada and the United States cover some or all of the costs of therapeutic massage depending on the type of plan and massage.  Ask your employer or contact your provider for details on how the coverage works.  Massage for relaxation and enjoyment may or may not be covered.  Generally for the massage to be covered by your insurance, you need to be seeing a licensed Massage Therapist.

How to Select a Good Massage Therapist

There are a variety of considerations when selecting a massage therapist.  These include considerations about the massage therapist's training and certification, questions about their fit with you (i.e. chemistry - is this someone you will trust and be able to relax with), and possibly their answers to questions you may want to ask them.

Personal referrals from friends or health professionals are a great way to find massage therapists.  Equally, looking at reviews of massage therapists on can help you see what past clients have to say about the massage therapist.  Reading articles they have written can also give you a sense of their personality and degree of expertise and knowledge.  You can also ask the massage therapist questions that are important to you.  Some questions that you may want to consider include:

  • What certifications do you hold?  
  • How long have you been practicing?  
  • What types of oils or lotions do you use?  
  • What are your rates? Is there a payment option?
  • Do you have experience in providing massage to people with (my physical condition)?

If you are considered about whether or not you will have to undress fully, you can also ask about that.

Licensing and training differs for massage therapists depending on 

  • the location you are in, and
  • the type of massage the therapist offers

Different countries, states and provinces have varying but usually similar requirements that need to be met before a massage therapist can be certified.  This usually involves a combination of training, practical experience and some type of certification and/or licensing. In most states in the US, Massage therapists are required to have a license to practice. Most states also require massage therapists to have at least 500 to 1000 hours of training which has resulting in them obtaining a certificate, diploma or degree depending on the school they attended. The Commission on Massage Therapy Accreditation (COMTA) is one of the organizations that regulates and works with massage therapy schools in the U.S.

The website of the American Massage Therapy Association (AMTA) provides a state-by-state guide to requirements for therapist education and experience and National Certification Board for Therapeutic Massage and Bodywork (NCBTMB).

Generally, it is advisable to seek a massage therapist who has trained at least 500 hours and to look for someone who is CMT (a Certified Massage Therapist).

Licensed therapists will have the initials LMT after their name (which stands for Licensed Massage Therapist) or LMP, which stands for Licensed Massage Practitioner.

In late 2007, the Federation of State Massage Therapy Boards (FSMTB) launched a new certification exam titled the MBLEx. To date, there are fewer than 10 states that are not regulated by the FSMTB.

Training for massage therapists consists of courses in body mechanics and motion, massage techniques, ethics and the study of organs and tissue.  

History of Massage

No one really knows definitively how Massage Therapy started and where it originated. There is evidence and writings about massage that have been found in many ancient civilizations including China, Greece, Rome, India, Japan and Egypt, to name a few. The first known record of massage in China was during the second century in a Chinese book “The Yellow Emperor's Classic of Internal Medicine” and in Egypt there are paintings of people being massaged found in tombs. Massage Therapy was one of the popular methods used for relieving pain by Greek and Roman physicians. Regardless of the mystery of the exact origin, it is clear that Massage Therapy is one of the oldest traditional holistic treatments.

Over the years, many different types of massage therapy have been developed, refined and or named. In the early 19th century, for example, Per Henrik Ling (known as the father of therapeutic massage) developed a method of massage that is now called Swedish massage.

Massage began to become popular in the United States in the mid 19th century when it was introduced by two New York physicians.

There are many methods of massage that have been practiced from antiquity up until the present in different parts of the world.  A few examples include:

  1. Acupressure, a traditional Chinese medicine.
  2. Anma, a traditional Japanese massage which involves deep tissue work
  3. Ayurvedic massage comes from a natural health care system which originated and is widely practiced in India (using aromatic oils and spices) 
  4. Balinese Massage, in which the massage movements include skin folding, kneading, stroking and other techniques
  5. Deep tissue massage which focuses on the muscles located below the surface of the skin. 

Theory behind Fatigue Treatment using Massage

Like all the other touch therapies, massage therapy helps relieve fatigue through skin and muscle manipulation, which relieves tension and spasm on the area, thereby promoting a healthier circulatory system.

A healthy blood flow is a very important key in the transfer of nutrients and oxygen to the various parts of the body to help maintain homeostasis and order, disruption of which leads to fatigue. Also, it aids in the transfer of essential immune cells to help fight infections at sites of injury, another possible etiology for the existence of fatigue. Massage also facilitates the activation of anti-inflammatory pathways via vagus nerve activation, which causes decreased pain associated with fatigue.

The benefit massage can provide is not only limited to physical relief, but also to the psychological burden of a person experiencing fatigue. As has been known, stress can either trigger or mitigate the presence of any diseases, which in this case is fatigue. The improved circulatory flow, resulting in decreased vitals, is a factor that contributes to the relief of stress and ultimate relaxation of the mind, body, and soul.

Research of Fatigue Treatment using Massage

A 2004 study by Cho and Tsay involved end-stage renal disease patients with associated fatigue and depression. The researchers aimed to determine the effectiveness of acupressure with massage therapy to these patients, randomly-assigned to control and experimental group. The conclusion extracted is that, acupressure with massage therapy improved the positive outlook and physical well-being of the participants in the experimental group. They therefore made a recommendation that it be performed as a complementary nursing protocol for these patients.

A more recent, randomized study by Myers in 2010 attempted to identify the clinical benefits as well as biochemical changes in breast cancer patients with symptoms of fatigue and insomnia who undergone massage therapy. The result is that, there is indeed a significant reduction in clinical symptoms as assessed from the indices used. The biochemical findings reveal a decrease in proinflammatory markers like interleukin-6 following the therapy, a good indicator of the relief of symptoms associated with fatigue.

This 2004 study conducted over a three-year period, where 1,290 Cancer patients were treated with massage found symptom scores were reduced by approximately 50%, even for patients reporting high baseline scores in areas such as pain and fatigue.

Stories of Fatigue Treatment using Massage

Massage therapy is useful in making people suffering from fatigue feel more energized and relaxed. Positive feedback has been given by those who have tried this complementary treatment.

One person shared, “...getting frequent massages helps keep my muscles loose and my body relaxed.” She even added that before, “I used to always think that a massage was a luxury, something that only the ‘privileged’ or the ‘pampered’ should get.” When she realized that nothing seems to relieve her fatigue symptoms, she decided to give massage therapy a try. “I have found it to be a necessity in my life. It is something that I have to get on a regular basis to keep functioning,” she further claims.

Questions and Comments about Massage for Fatigue

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