Yes I am admitting that I still don’t get massage research even though there seems to be a movement towards more evidence based practices which would mean that it is based on research. It is also supposed to be based on clinical experience too so I don’t understand why that doesn’t seem to have any influence.
I have been trying. I started with the Massage Therapy Foundation Research Conference in 2010. (Ok it was one block away from my office so it was almost like I couldn’t not go.) I have taken a research Literacy Course in Seattle taught by Mike Hamm. I watch the constant battles on Facebook in various discussion groups bashing people who do things like Reiki, craniosacral therapy and reflexology. I watch them fight about toxins and whether or not they are released in a massage.
I have read Massage Therapy Research by Christopher Moyer and from that I gathered that yes there is a number of research studies out there but there really isn’t much so called ‘evidence’ that shows or PROVES that massage would work for the various conditions that he talked about : Pediatric Massage, Pregnancy Massage, Athletic (Sports Massage), Geriatric Massage, Headaches, Neck and shoulder pain, low back pain, Anxiety and depression, sexual trauma, scar tissue, fibromyalgia, and cancer. In most instances, he says in his book that massage ‘looked promising’ and that is about it.
What does that mean? “Looks Promising”. I guess I really do want to find out what that really means. If all of these things only look promising (except for anxiety/depression). Can we ever say that this proves massage works? Is there proof that anything works all of the time anyways?
Promising. That is it.
Meanwhile while I am waiting for all the research that proves beyond a doubt that massage works, I am off working with people with headaches, fibromyalgia, carpal tunnel etc. I see clients who have been going to their doctors with pain for years and have had extensive testing like MRI’s, Stress tests for heart conditions, had years of heavy drug therapy and oh after 3 massages they finally felt hopeful again and yes – even pain free.
Frankly Scarlet…Yes…. I don’t give a darn anymore. I am too busy helping massage therapists build their businesses and my own business.
Right now I am being asked to prove medical necessity with one specific health insurance company here in the Seattle area and with all of the research that we do have, they still will not pay for massage for depression/anxiety which is what I thought we had the strongest evidence for as far as research goes. They are now limiting all of our sessions based on their own criteria that is unknown to providers.
In WA we have been able to bill insurance since about 2000 when it became law that health insurance companies must cover massage. How/why did that come about? Was it because of research? Hmm…. I guess I don’t know if our insurance commissioner at the time (about 1996 when the law was created) was aware of research on massage. What she did have is a really good massage therapist who was also politically active with our local AMTA-WA chapter. They stood up for us. I also have asked Deborah Senn, the insurance commissioner at the time how other states could have this made available to them and the answer from her was “They just need someone to stand up for them.” I also just found out that the way we became health care providers in WA was almost by mistake. Some legislator or commissioner added massage therapists into the health care laws inadvertently and 2 massage therapists happened to see it and question it and went on to communicate with the person/group who made the mistake and proved to them that massage should stay in the HCP category. Yes it is true but probably needs more facts like who was the group that put it into the law? I just heard this from one of the people who was there to stand up for us. Again it was someone just standing up for massage therapists.
So on one hand billing insurance has been a blessing for me here personally as the fees started out being really great ($100 an hour approximately although not all companies paid that). I guess I am also making the leap to saying that billing insurance is the only reason why we need research or is it a leap?
There is the dark side to research that really bothers me. The stories I have heard of companies that have a very simple cure for cancer and can’t get money for funding their research because there won’t be big money in a drug or procedure or the cure is something so unbelievable that companies don’t believe it. Then there are the studies that take massage and break it into 15 minute increments saying that 15 minutes must be done on the back in a certain way and follow a certain pattern. Massage in real life just doesn’t happen like that. Then the stories that researchers will share like AIDS (HIV) was discovered in a case study. Well that is great, but not sure if we really have such big, life threatening things to discover but it sounds great.
Massage Therapists seem to be more in the crowd of I just want to do massage. I like to do what I see work day in and day out. Yes there are some that are jumping on the research bandwagon and are now like ex-smokers saying things like “I can’t believe I was so stupid to believe that Reiki worked or that such and such did that!” Ahhhh come on already! You will be also saying that after there is more research that does show it works. Research is only as good as – well how good is it?
I really, really want to know. Where is the evidence that shows that massage even works in the first place?
Why do we need research if it really can’t help us (me)?
I do see more and more insurance companies talking about evidence based this and that but the reason why they are talking about it is to limit what massage therapists do. They are using it to cut down the number of sessions with clients and to limit what they pay massage therapists. They are using it to tell massage therapists to stop doing what they are doing – Reflexology, craniosacral therapy and I don’t know what else is on the chopping blocks because of so called research.
What I would really like to see though is a resource like a website that will take a look at the studies one by one or take the most important ones and give a summary of them and tell which level of evidence are they and how was the massage portion done and what does it mean for someone in practice. What does it mean for someone in pain and looking for relief? What research do we need to show more that something does work? What things can massage therapists be doing to prove that massage does work?
Nope, we don’t have anything like that although I have suggested it many times to many people involved in the massage research sectors. (Sigh…I guess I have to do everything! Haha!) see massage research section on my other site.
So this may sound a little confusing to those of you who know I am always promoting billing insurance. Yes it is confusing to me too. On one hand it has been one of the staples that have supported me and allowed me to stay in business for over 25 years without having any research that massage works. I talked about this in 2005 in an guest editorial for Massage Magazine (PDF) and it doesn’t seem like much has changed. Billing insurance and being a health care provider is a very mixed blessing.
With more and more franchises opening up in the massage profession which means low pay for jobs in massage, where are we going? With more insurance companies paying for massage, could that provide more stability for the sole proprietor massage business or even a multi-practitioner massage business that hires massage therapist? Would that be more opportunity for a little bit higher paying jobs? Could we ever get our act together as a profession to negotiate contracts with insurance companies and work to get fair pay from insurance companies (which from what I understand needs to be done through a union because otherwise it would be considered to be price fixing).
Research -Smeasearch – who said – there ain’t no rhyme for research.
(Sorry this is more of a rambling on!)