Massage Therapy and the Evidence
Exploring the research behind neurological care.
A summary of published research on massage, with each study's limitations. Last reviewed October 2026.
Why we created this page
Massage therapy is often overlooked in neurological care. Having worked as a massage therapist for over 24 years, I've seen first hand how massage supports people living with neurological conditions. But I also know how important it is to look beyond personal experience and understand what the research tells us.
This page brings together published studies on massage for neurological conditions, pain, muscle tension, wellbeing and quality of life. Some findings are encouraging. Others show how much more research is needed. I'll keep adding studies and updating the page as new evidence is published.
Massage therapy deserves more attention in conversations about neurological care, and understanding the evidence is part of moving the profession forward.
Gemma Eves
Founder, Neuro Massage · Read Gemma's profile
Research on touch
Some of the most useful research is about touch itself: how the body senses gentle touch, and what larger reviews say about touch and wellbeing.
Coding of pleasant touch by unmyelinated afferents in humans
Löken, Wessberg, Morrison, McGlone and Olausson, 2009, Nature Neuroscience. Laboratory study recording nerve signals in the skin of healthy adults.
What it found: A type of slow nerve fibre in hairy skin (C-tactile afferents) responded most to gentle stroking at 1 to 10 cm per second, the same speeds people rated as most pleasant.
Limitations: A small laboratory study using soft brush strokes on the forearm. It describes how touch is sensed, not any health benefit.
Discriminative and affective touch: sensing and feeling
McGlone, Wessberg and Olausson, 2014, Neuron. Narrative review.
What it found: Touch has two roles: telling us about the world around us, and carrying emotional and social meaning. The authors propose C-tactile fibres as a biological basis for the rewarding side of touch.
Limitations: A review that puts forward a theory. It does not test treatments.
Packheiser et al., 2024, Nature Human Behaviour. Systematic review and meta-analysis of 137 studies, around 13,000 participants.
What it found: Touch interventions were linked to moderate benefits overall, with the largest effects for pain, anxiety and depression. Benefits were larger in people with health conditions, and more frequent sessions were linked to more benefit than longer ones.
Limitations: Signs that small studies may overstate effects, no blinding was possible, and only short-term outcomes were analysed.
Touch for socioemotional and physical well-being: a review
Field, 2010, Developmental Review. Narrative review.
What it found: Reviews research on touch in early development, the effects of touch deprivation, and massage studies across a range of conditions, concluding that touch matters for social, emotional and physical wellbeing.
Limitations: A narrative rather than systematic review, so it is less objective than a meta-analysis.
Does massage therapy reduce cortisol? A comprehensive quantitative review
Moyer, Seefeldt, Mann and Jackley, 2011, Journal of Bodywork and Movement Therapies. Quantitative review.
What it found: Effects of massage on the stress hormone cortisol were generally very small and often not significant. The authors suggest cortisol changes are unlikely to explain the benefits people report from massage.
Limitations: Few studies for some comparisons. We include it because it shows why we do not claim massage lowers stress hormones.
Pain, mood, sleep and family carers
Wider research that is relevant to many of the people we work with, whatever their condition.
Crawford et al., 2016, Pain Medicine. Systematic review and meta-analysis of 67 randomised trials.
What it found: Compared with no treatment, massage was linked to lower pain. Effects were smaller, though still in favour of massage, when compared with sham or other active treatments.
Limitations: The studies varied widely in technique, length of treatment and who gave the massage.
Treatment effects of massage therapy in depressed people: a meta-analysis
Hou et al., 2010, Journal of Clinical Psychiatry. Meta-analysis of 17 randomised trials, 786 participants.
What it found: Massage was linked to fewer depressive symptoms than control conditions.
Limitations: The trials varied in who took part and how depression was measured, and the searches only went up to 2008.
Wang et al., 2024, Frontiers in Neurology. Systematic review and meta-analysis of 23 randomised trials, 1,780 people with insomnia.
What it found: Tui Na was linked to better sleep quality scores and lower anxiety and depression scores than the comparison treatments.
Limitations: The authors rated the included studies as limited in quality, and the technique was Chinese Tui Na.
Touch, caring, and cancer: randomized controlled trial of a multimedia caregiver education program
Collinge et al., 2013, Supportive Care in Cancer. Randomised trial, 97 patient and carer pairs.
What it found: Carers who learned simple massage from a DVD and manual saw larger drops in their partner's ratings of pain, nausea and some other symptoms than carers who read aloud instead. Carers also felt more confident using touch.
Limitations: All outcomes were self-reported, reading aloud also helped, and all dropouts were in the massage group.
Stroke
Most research on massage after stroke comes from China and looks at Tuina, a Chinese massage technique, used alongside physiotherapy. How we work with stroke.
Cabanas-Valdés et al., 2021, International Journal of Environmental Research and Public Health. Systematic review and meta-analysis of 18 trials, 1,989 participants.
What it found: Massage added to physiotherapy was linked to small improvements in arm function and reduced arm and leg spasticity. Results for daily activities, walking, balance and quality of life were unclear.
Limitations: Most studies were from China and used Tuina, so it is unclear how far the findings apply to other styles of massage.
The effects of slow-stroke back massage on anxiety and shoulder pain in elderly stroke patients
Mok and Woo, 2004, Complementary Therapies in Nursing and Midwifery. Randomised trial, 102 older stroke patients in hospital.
What it found: Ten minutes of back massage on seven evenings was linked to less shoulder pain and anxiety than in the control group, with changes in blood pressure and heart rate consistent with relaxation. Effects were still seen three days later.
Limitations: A single hospital study with only three days of follow-up, and outcomes were mostly self-reported.
Yang et al., 2017, Clinical Rehabilitation. Randomised trial across several centres, 90 stroke patients.
What it found: Alongside usual rehabilitation, four weeks of Tui Na eased spasticity more than gentle rubbing in some arm and leg muscle groups, lasting to three months. There was no difference in movement or daily living scores, and no side effects were recorded.
Limitations: The benefit was limited to some muscle groups, and the technique was Chinese Tui Na rather than Western massage.
Spinal cord injury
Small studies have looked at massage for pain and fatigue after spinal cord injury. How we work with spinal cord injury.
Lovas et al., 2017, Spinal Cord. Randomised feasibility trial, 40 adults with chronic spinal cord injury.
What it found: Weekly upper-body massage for five weeks was linked to lower pain and fatigue. A guided relaxation group improved by a similar amount.
Limitations: Small feasibility study with short-term follow-up only.
Multiple sclerosis
Several small studies have looked at massage for pain, fatigue and spasticity in MS. How we work with multiple sclerosis.
Heidari, Shahrbanian and Chiu, 2022, Disability and Rehabilitation. Systematic review of 12 studies.
What it found: Fatigue improved with several massage styles, including Swedish massage and reflexology, and spasticity was reduced with Swedish massage and reflexology. Improvements in pain, anxiety and depression came from reflexology studies.
Limitations: Only 12 studies, rated fair to good quality, covering mixed styles including reflexology. Results were not pooled in a meta-analysis.
Negahban, Rezaie and Goharpey, 2013, Clinical Rehabilitation. Pilot randomised trial, 48 participants in four groups.
What it found: Compared with exercise therapy, 15 massage sessions over five weeks were linked to greater improvements in pain, balance and walking speed, measured straight after treatment.
Limitations: Small pilot with 12 people per group and no long-term follow-up.
McClurg et al., 2011, Multiple Sclerosis Journal. Pilot randomised trial, 30 people with MS.
What it found: Everyone had bowel management advice. Those also taught daily tummy massage, done by themselves or a carer, saw a larger improvement in constipation scores over four weeks.
Limitations: A small feasibility study, so it cannot show the massage works on its own.
Parkinson’s
A handful of small trials have looked at massage and Parkinson’s symptoms. How we work with Parkinson’s.
Kang et al., 2022, Frontiers in Neurology. Systematic review and meta-analysis of 7 trials, 363 participants.
What it found: Massage was linked to short-term improvements in motor symptom scores, but not in everyday activities.
Limitations: Small, unblinded trials with mixed methods, and most had no follow-up.
McClurg et al., 2016, Age and Ageing. Pilot randomised trial, 32 participants.
What it found: Constipation symptoms improved in both groups, with no significant difference between them. Participants found the massage acceptable.
Limitations: A small pilot designed to test feasibility rather than effect.
Cerebral palsy
Two recent trials have looked at gentle massage given by parents at home. How we work with cerebral palsy.
Mahmood et al., 2019, Pakistan Journal of Medical Sciences. Randomised trial, 86 children aged 2 to 10 enrolled, 75 analysed.
What it found: Gentle massage before physiotherapy was linked to greater reductions in spasticity over 12 weeks than physiotherapy alone. There was no difference in gross motor function.
Limitations: Parents gave the massage at home, so it could not be closely monitored.
Mahmood et al., 2024, Journal of Pediatric Rehabilitation Medicine. Randomised trial, 68 children aged 4 to 12 randomised, 63 analysed.
What it found: Adding gentle massage to a home exercise programme was linked to greater reductions in spasticity over 12 weeks. There was no difference in gross motor function and no side effects were reported.
Limitations: Same research team as above, with no follow-up after 12 weeks.
Brain injury
Most research on massage after brain injury so far looks at concussion. How we work with brain injury.
Exploring the use of manual therapy in the management of traumatic brain injury: a scoping review
Delion et al., 2025, Chiropractic and Manual Therapies. Scoping review of 42 articles on manual therapy.
What it found: Most studies were in mild, sport-related brain injury and looked at headache, neck pain and dizziness, often alongside other treatments.
Limitations: Evidence is mostly case reports, and moderate to severe brain injury is rarely studied.
Concussion Treatment Using Massage Techniques: a Case Study
Burns, 2015, International Journal of Therapeutic Massage and Bodywork. Single case study.
What it found: One person with post-concussion symptoms reported fewer symptoms after two massage sessions.
Limitations: One person, no comparison group, short-term only.
Functional neurological disorder (FND)
Expert guidance on hands-on care for FND, together with the research on touch above, shapes how we approach sessions. How we work with functional neurological disorder.
Physiotherapy for functional motor disorders: a consensus recommendation
Nielsen et al., 2015, Journal of Neurology, Neurosurgery and Psychiatry. Expert consensus recommendation.
What it found: Recommends an active, self-management approach with limited hands-on treatment, and notes that gentle, graded sensory work may be appropriate where touch feels oversensitive.
Limitations: Based on expert opinion, as there was not enough data for evidence-based guidelines. It does not mention massage.
Transverse myelitis
This case report shows how soft tissue work can sit within wider care, alongside the research on touch above. How we work with transverse myelitis.
Onyekere et al., 2022, Journal of Medical Case Reports. Single case report.
What it found: Soft tissue work was one part of a wider physiotherapy and medical treatment plan, during which pain, spasms and function improved.
Limitations: The effect of massage on its own cannot be separated from the other treatment.
PTSD and trauma
Small studies have looked at massage for people living with trauma. How we work with PTSD and trauma.
Massage therapy for survivors of rape and sexual abuse: A systematic review
Amilhau et al., 2024, European Journal of Trauma and Dissociation. Systematic review of 11 small studies, mostly qualitative or mixed-methods, with only one or two controlled trials.
What it found: Several small studies reported lower PTSD symptoms, anxiety or stress after massage, and the authors concluded massage may have a positive role in care.
Limitations: Very small samples, varied methods, no blinded assessment, and only one group followed up after treatment. Four studies came from the same researcher.
Dementia and Alzheimer’s
Most research looks at hand massage and agitation. How we work with dementia and Alzheimer’s.
Massage and touch for dementia (Cochrane review)
Hansen et al., 2006, Cochrane Database of Systematic Reviews. Systematic review, 2 small studies met the criteria.
What it found: Hand massage may bring a short-term reduction in agitation, but the evidence was too limited for firm conclusions.
Limitations: Very few usable studies, and the review is now dated.
Schaub et al., 2018, Applied Psychophysiology and Biofeedback. Pilot randomised trial, 40 hospital patients.
What it found: Saliva stress markers (cortisol and alpha-amylase) showed some short-term changes around massage sessions, mainly in week 2, but agitation scores did not differ significantly between groups.
Limitations: Small pilot in which 10 of 40 people dropped out, and agitation ratings were not blinded.
Manual massage for persons living with dementia: A systematic review and meta-analysis
Margenfeld, Klocke and Joos, 2019, International Journal of Nursing Studies. Systematic review and meta-analysis of 11 trials, 825 people with dementia.
What it found: Massage was linked to less agitation and fewer depressive symptoms than control. There was no clear effect on memory and thinking.
Limitations: Only a few studies for each outcome, and it is unclear how much the changes matter in daily life.
Palliative care
Massage is widely used in palliative care for comfort, including massage that family carers can learn to give. How we work with palliative care.
Candy et al., 2020, Palliative Medicine. Systematic review of 22 trials, 1,956 participants.
What it found: Evidence on massage for anxiety, pain and quality of life was inconclusive.
Limitations: Many small trials with unclear risk of bias.
Massage with or without aromatherapy for symptom relief in people with cancer (Cochrane review)
Shin et al., 2016, Cochrane Database of Systematic Reviews. Systematic review and meta-analysis of 19 trials, 1,274 participants.
What it found: One small trial found short-term pain relief, but there was no clear difference for anxiety, mood, fatigue or quality of life.
Limitations: All evidence was rated very low quality.
Limb loss
Research has looked at massage alongside exercise for phantom limb pain. How we work with limb loss.
Effect of Limb Massage and Exercises on Phantom Limb Pain among Amputee Patients
Saker, 2016, Alexandria Scientific Nursing Journal. Before-and-after study, 30 participants.
What it found: Phantom limb pain scores fell after residual limb massage combined with exercise.
Limitations: No comparison group, massage was combined with exercise, and all 30 participants were adult men at one hospital in Syria.
Disclaimer
Massage at Neuro Massage is a complementary therapy. It does not replace medical assessment, prescribed treatment or rehabilitation. Studies report average results in specific groups of people, and individual experiences vary. Please talk to your healthcare team before starting any complementary therapy.