The Power of Touch: Exploring the Science Behind Massage Therapy for 10 Common Musculoskeletal Conditions

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Exploring the Science Behind Massage Therapy for 10 Common Musculoskeletal Conditions

Several clinical practice guidelines and systematic reviews support the use of massage therapy as part of a multidimensional approach for people suffering from common musculoskeletal Conditions.

Massage therapy can improve the health and well-being for individuals with a number of health-related conditions through interplay of immunological, neurological, and psychological factors (Keter et al., 2025; Packheiser et al., 2024). Several clinical practice guidelines and systematic reviews support the use of massage therapy as part of a multidimensional approach for people suffering from common musculoskeletal conditions including:

How Does Massage Therapy Work?

With a rich history spanning thousands of years people from around the globe have been utilizing massage to address a wide range of health issues. Early healing traditions were often rooted in an ecological understanding of health and well-being. Viewing our bodies as an ecosystem in delicate balance with its surroundings, constantly interacting with the environment and influenced by the natural world.

By combining the wisdom of ancient healing traditions with the evidence-based practices of modern science, we can develop a comprehensive whole-person approach to health and well-being. With these concepts in mind, the overall impact massage, known as the total treatment effect, can be analyzed through three lenses:

1. Specific effects: These are directly attributable to the massage techniques themselves. They include: 

  • Affective touch: Touch stimulates CT afferents (specialized receptors for gentle touch) and has been shown to influence neurobiological processes (dopaminergic and analgesic, opioidergic pathways) involved with relaxation and pain relief.

  • Mechanical factors: The effect that massage therapy can have on the musculoskeletal system (mediated by nerves, hormones, cytokines, neuropeptides and chemokines).

  • Neurological factors: Therapeutic massage may influence plasticity and adaptive changes in neuro-immune networks in such a way that pain subsides.

2. Contextual effects: These consider the environment and relationships surrounding the treatment. The patient-therapist rapport, expectations (set), and physical surroundings (setting) can all influence outcomes.

3. Non-specific effects: These encompass natural recovery processes, like the body's inherent healing ability and spontaneous improvement over time.

In terms of clinical response to massage therapy, outcomes may be attributed to a complex interplay of biological, psychological, and social factors. This evidence-based explanation of why massage therapy works can help develop a cohesive message of this conservative approach and the value that massage therapists deliver.

Whether you're an experienced massage therapist or a curious student, this infographic is a valuable reference when attempting to better understand the multidimensional benefits of massage therapy in alleviating pain and enhancing quality of life across a range of health issues.

Glossary of Massage Therapy Terms

Allostasis - The flexible regulation of physiology, underwriting maintenance of variables within specified ranges by pre-emptive responses based on current and predicted future physiological states, external environments and behavioural goals.

Complex system - One in which the properties of the system are highly dependent on interactions of its many parts, possibly involving feedback and cycles, as well as nonlinearities. In this context, “complex” should not be equated with “complicated,” which would refer to a system that has many components.

Biopsychosocial approach - The biopsychosocial approach systematically considers biological, psychological, and social factors and their complex interactions in understanding health, illness, and health care delivery.

Exteroception - Perceptual inference based on sensory signals originating from outside the body (e.g. vision, hearing, touch, taste, smell).

Force-based manipulations - The application of mechanical forces to the outside of the body with therapeutic intent. Force-based manipulations can include light touch, therapeutic massage, mobilization, cupping, and acupuncture or other needling interventions.

Interoception - The processing of sensing and perceiving sensory signals relating to internal bodily states.

Massage - Massage is a patterned and purposeful soft-tissue manipulation accomplished by use of digits, hands, forearms, elbows, knees and/or feet, with or without the use of emollients, liniments, heat and cold, hand-held tools or other external apparatus, for the intent of therapeutic change.

Massage therapy - Massage therapy consists of the application of massage and non-hands-on components, including health promotion and education messages, for self-care and health maintenance; therapy, as well as outcomes, can be influenced by: therapeutic relationships and communication; the therapist’s education, skill level, and experience; and the therapeutic setting.

Mechanisms - Mechanisms are the molecular, cellular, physiological processes or pathways contributing to a) disease development, b) treatment action, or c) pain signal sensation, transmission, perception, and modulation.

Neuroplasticity - Changes in neural pathways and synapses that result from bodily injury or changes in behavior, the environment, or neural processes. This is consistent with the concept that the brain is a dynamic organ that constantly changes in response to internal and outside events throughout life.

Resilience - Refers in general to a system's capacity to recover, grow, adapt, or resist perturbation from a challenge or stressor.

Salutogenesis - The process by which individuals move from a less healthy state to a healthier state. The concept of salutogenesis emphasizes health factors that promote and maintain good health rather than focusing solely on pathogenesis.

Whole person health - Involves examining interconnections among all organs and systems of the body, as well as the effects of multicomponent interventions across physiological, behavioral, social, and environmental domains.

References and Sources

With over 15 years of clinical experience and extensive study of massage therapy research, I'm committed to creating resources that foster the professional development of massage therapists globally. Whether you're a seasoned massage therapist or a curious newcomer, this massage therapy glossary is here to be your one-stop shop for understanding terms as it relates to massage therapy. Additionally this post highlights a substantial body of evidence supporting the use of massage therapy in alleviating pain and enhancing quality of life across a range of health issues

This is a selection of sources I use to help formulate my ideas based on over-lapping concepts and research from fields of massage therapy, physiotherapy, chiropractic, osteopathy.

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Hu, D., Sun, H., Wang, S., Wang, H., Zheng, X., Tang, H., & Hou, H. (2025). Treatment and prevention of chronic ankle instability: An umbrella review of meta-analyses. Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons, 31(2), 111–125. https://doi.org/10.1016/j.fas.2024.07.010

Jung, A., Carvalho, G. F., Szikszay, T. M., Pawlowsky, V., Gabler, T., & Luedtke, K. (2024). Physical Therapist Interventions to Reduce Headache Intensity, Frequency, and Duration in Patients With Cervicogenic Headache: A Systematic Review and Network Meta-Analysis. Physical therapy, 104(2), pzad154. https://doi.org/10.1093/ptj/pzad154

Kennedy, A. B., Cambron, J. A., Sharpe, P. A., Travillian, R. S., & Saunders, R. P. (2016). Clarifying Definitions for the Massage Therapy Profession: the Results of the Best Practices Symposium. International journal of therapeutic massage & bodywork, 9(3), 15–26. https://doi.org/10.3822/ijtmb.v9i3.312

Keter, D. L., Bialosky, J. E., Brochetti, K., Courtney, C. A., Funabashi, M., Karas, S., Learman, K., & Cook, C. E. (2025). The mechanisms of manual therapy: A living review of systematic, narrative, and scoping reviews. PloS one, 20(3), e0319586. https://doi.org/10.1371/journal.pone.0319586

Koc, T. A., Jr, Bise, C. G., Neville, C., Carreira, D., Martin, R. L., & McDonough, C. M. (2023). Heel Pain - Plantar Fasciitis: Revision 2023. The Journal of orthopaedic and sports physical therapy, 53(12), CPG1–CPG39. https://doi.org/10.2519/jospt.2023.0303

Langevin H. M. (2024). Addressing gaps in pain research from an integrated whole person perspective. Pain, 165(11S), S23–S32. https://doi.org/10.1097/j.pain.0000000000003359

Lucado, A. M., Day, J. M., Vincent, J. I., MacDermid, J. C., Fedorczyk, J., Grewal, R., & Martin, R. L. (2022). Lateral Elbow Pain and Muscle Function Impairments. The Journal of orthopaedic and sports physical therapy, 52(12), CPG1–CPG111. https://doi.org/10.2519/jospt.2022.0302

Neal, B. S., Lack, S. D., Bartholomew, C., & Morrissey, D. (2024). Best practice guide for patellofemoral pain based on synthesis of a systematic review, the patient voice and expert clinical reasoning. British journal of sports medicine, 58(24), 1486–1495. https://doi.org/10.1136/bjsports-2024-108110

Packheiser, J., Hartmann, H., Fredriksen, K., Gazzola, V., Keysers, C., & Michon, F. (2024). A systematic review and multivariate meta-analysis of the physical and mental health benefits of touch interventions. Nature human behaviour, 8(6), 1088–1107. https://doi.org/10.1038/s41562-024-01841-8

Zhang, J., Chen, J., Li, X., Yan, Z., Zhang, Q., Gao, P., & Tang, F. (2025). Effect of three traditional conservative treatment techniques on patients with mild-to-moderate carpal tunnel syndrome: A systematic review and meta-analysis. Journal of hand therapy : official journal of the American Society of Hand Therapists, S0894-1130(25)00002-X. Advance online publication. https://doi.org/10.1016/j.jht.2025.01.001