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Massage therapy association misrepresents studies; false claims of benefit for preventing winter colds and flu

Massage Therapy May Boost Immune System to Combat Cold, Flu

Our Review Summary

Man has deep tissue massage on the back.

Man has deep tissue massage on the back.

This news release from the American Massage Therapy Association (AMTA) encourages people to seek out massage therapists in order to fend off seasonal colds and flu, since regular massages “make the immune system stronger,” the release says. To support this point, the news release cites three studies from 2001, 2004 and 2010 and talks vaguely about the results of each trial. Sweeping, empty language is used, such as “enhanced immune function” and “significant changes,” without further elaboration. Hardly any data is given, including how many people participated in each study, what exactly the trials measured, the extent of the benefits and for how long each trial ran. And how does the AMTA know that these effects were due to the massage therapies themselves and not other factors? It is also unclear what exactly is newsworthy about this topic, since all of the studies took place years ago.

More importantly, the release makes sweeping assumptions between what was actually studied (and in what population) and their recommendations for the general population about “seasonal diseases.” Even without looking at the original studies, this is sloppy and done haphazardly.

Note: For a deeper dive into this issue, take a look at Tim Caulfield’s recent post on Immune Boost Bunk.

 

Why This Matters

People often seek alternative therapies to stay healthy, especially during flu season. This may be especially important for those who have compromised immune systems and those who could be more affected by the flu, such as young children and the elderly. But it’s always concerning when professional organizations tout approaches that aren’t backed by solid evidence. This has the potential to steer people away from prevention methods that are actually shown to be effective.

Criteria

Does the news release adequately discuss the costs of the intervention?

Not Satisfactory

Since there was no mention of costs in this news release, we rate it Not Satisfactory. It would have been helpful to readers to discuss the approximate cost of a massage session, which can vary widely depending on the region, therapist and setting. The Center for Spirituality & Healing at the University of Minnesota estimates the national average for an hour-long massage to be about $60. Many people may wonder if their insurance policy would cover a massage therapy session. Insurance companies rarely pay for massage therapy, particularly for indications that aren’t backed by science or evidence.

Does the news release adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The news release cited three studies, but descriptions of the research were too vague to be helpful.  Readers aren’t given any benefit data or any quantitative estimate on how well massage therapy actually works. We don’t know how many participants were in each trial and who actually benefited from massage therapy. The release alludes to the fact several times that the immune system became stronger, but how was this measured? There are also non-specific references to the benefits of massage therapy, such as increasing the activity of white blood cells and reducing anxiety levels, but again, we don’t know who actually benefited and by how much.

When we looked at the studies cited we were surprised to find that none of them related to massage therapy for reducing rates of the “common cold, flu and other seasonal illnesses,” as claimed in the release.

The first study was from 2010 and is described by its authors as “preliminary” work that looks at a “single-session comparison of Swedish Massage Therapy with a light touch control condition” measuring  “Oxytocin (OT), arginine-vasopressin (AVP), adrenal corticotropin hormone (ACTH), cortisol (CORT), circulating phenotypic lymphocytes markers, and mitogen-stimulated cytokine production.”  This study is far removed from patient-oriented, or even disease-oriented outcomes, and has nothing to do with their sweeping comments that massage may fend off flu and the common cold.

The second study (from 2001) involved 12 HIV patients. It’s hard to see how the results from this study translate to healthy individuals seeking relief from seasonal colds and flu. The third study (from 2004) enrolled 34 women with breast cancer whose outcomes following massage were “reduced anxiety, depressed mood, and anger. The longer term massage effects included reduced depression and hostility and increased urinary dopamine, serotonin values, NK cell number, and lymphocytes.” Again, this study does not provide evidence for the news release’s claims.

Does the news release adequately explain/quantify the harms of the intervention?

Not Satisfactory

Although massage is generally considered a “safe” therapy, it is still an intervention and not free from risk, particularly among those with musculoskeletal issues. Massage can cause soreness and also directly cause new injuries, exacerbate existing problems, distract patients from more appropriate care and mildly stress the body.

Since harms were not mentioned at all in the news release, we give it a Not Satisfactory rating here.

Does the news release seem to grasp the quality of the evidence?

Not Satisfactory

The news release provides only the bare bones of the clinical studies. We have no idea who participated in each trial, how many people participated, what each trial was aiming to study and for how long patients were followed up. There is no mention of the studies’ limitations or their design.

The language used in the news release is also vague and unclear. For example, “Massage therapy increases the activity level of the body’s white blood cells,” and “Regular massages have been shown to make the immune system stronger, according to studies.” How did the activity level of white blood cells increase and to what extent? What exactly does it mean to “make the immune system stronger?”

The quote from the president of ATMA is very problematic as well, generalizing from those with “compromised immune systems” to the general population, saying “Those same benefits translate to people seeking to fight off the common cold, flu and other seasonal illnesses.” This statement has no scientific validity according to the studies that they are citing.

Does the news release commit disease-mongering?

Satisfactory

The news release does not commit disease mongering, although it would have been helpful to learn more about conditions that compromise patients’ immune systems.

Does the news release identify funding sources & disclose conflicts of interest?

Not Satisfactory

The news release doesn’t list who the funders were for each study and whether there were any conflicts of interest.

The release is clearly identified as coming from a professional association and it’s evident its purpose is to drive new customers toward association members.

Does the news release compare the new approach with existing alternatives?

Not Satisfactory

The release included no discussion of other alternatives to prevent the flu, common cold or other infectious diseases that are common in the fall and winter months. The Centers for Disease Control recommends an annual flu shot, washing hands and frequently cleaning touched surfaces and objects. England’s National Health Service also recommends a healthy lifestyle, such as a wholesome diet, regular exercise and drinking plenty of warm fluids in the winter months.

Does the news release establish the availability of the treatment/test/product/procedure?

Satisfactory

Most people are aware that massage therapy is widely available nationwide. However, the news release provides a link to the American Massage Therapy Association’s locator service, presumably  dues-paying AMTA members.

Does the news release establish the true novelty of the approach?

Not Satisfactory

Massage therapy is not a novel intervention in general but the authors of the news release make novel claims that it is an immune enhancer, and that it can prevent the flu and the common cold, which is not backed up by science.

Does the news release include unjustifiable, sensational language, including in the quotes of researchers?

Not Satisfactory

We feel the language was unjustifiable due to its ambiguity, and some wording bordered on sensational.

Phrases such as “significant changes,” “rapid responses” and “immediate massage benefits” don’t inform the reader if no scale is given. Some additional examples of inappropriate language:

  • “Regular massages have been shown to make the immune system stronger, according to studies.”  This is an imprecise, and incorrect statement.
  • “Those same benefits translate to people seeking to fight off the common cold, flu and other seasonal illnesses” This is gross misrepresentation of the available evidence.
  • The phrase “According to research from Cedars-Sinai” appropriates the name of a famous medical center to bolster their assertions. The first study cited was a “preliminary” single study from a researcher who worked there.

Total Score: 2 of 10 Satisfactory

Comments (6)

We Welcome Comments. But please note: We will delete comments left by anyone who doesn’t leave an actual first and last name and an actual email address.

We will delete comments that include personal attacks, unfounded allegations, unverified facts, product pitches, or profanity. We will also end any thread of repetitive comments. Comments should primarily discuss the quality (or lack thereof) in journalism or other media messages about health and medicine. This is not intended to be a forum for definitive discussions about medicine or science. Nor is it a forum to share your personal story about a disease or treatment -- your comment must relate to media messages about health care. If your comment doesn't adhere to these policies, we won't post it. Questions? Please see more on our comments policy.

Bodhi Haraldsson

November 10, 2015 at 10:18 am

As the research director for a provincial massage therapy association in Canada I applaud your review. These type of claims are a stain on the profession.

Reply

Kate Zulaski

November 10, 2015 at 7:43 pm

I am involved in a few different efforts to improve research literacy in the massage profession in the United States, and I appreciate your efforts to improve the quality of news available about health care. Thank you for posting your criteria with explanations – I hope this resource helps people in our associations better understand how their posts are viewed externally.

Reply

Nick Ng

November 10, 2015 at 8:10 pm

Thank you so much for your review, Dr. Ranit and Euna. If I may offer one suggestion, it would be better if a link to those studies you cited are available. Thanks.

Reply

Jordan Pyfer

January 16, 2016 at 7:41 pm

This review is a rather pathetic attempt to devalue information that was provided to professionals not the lay public. The quotes were taken out of context where the reader could find more specifications regarding the immune system’s response to massage. Additionally, the AMTA’s claims were cited appropriately, where I found scholarly references from leaders in the field.

Reply

    Kevin Lomangino

    January 16, 2016 at 9:06 pm

    Jordan,

    This release was distributed via PR Newswire, which is widely distributed to the general public. In fact the release was clearly intended for the general public since it includes statements such as, “To find a massage therapist near you, the American Massage Therapy Association (AMTA), the most trusted name in massage therapy, offers a free professional massage therapist locator service.” Do professional massage therapists need help locating a massage therapist?

    Our review was appropriately critical of a release that made many claims that weren’t backed up by evidence. Nothing was taken out of context.

    Kevin Lomangino
    Managing Editor

    Reply