Massage, Science, and Your Health

A Conversation with Dr. Andrew Weil

By Loolwa Khazzoom

Originally published in Body Sense magazine, Autumn/Winter 2010.

Noted physician Andrew Weil, MD, author of Why Our Health Matters: A Vision of Medicine that Can Transform Our Future (Hudson Street Press, 2009) and a longtime proponent of integrative medicine, had a chance to sit down with Body Sense magazine to discuss the science behind massage and other effective complementary and alternative medicine (CAM) treatments.

Loolwa Khazzoom: What do you see as the benefits of massage?

Andrew Weil: Whether a massage therapist focuses on your feet, hands, scalp, or entire body, massage can be both wonderfully relaxing and clinically effective. It is also one of the CAM therapies most readily accepted by conventional medical doctors and hospital administrators.

Research demonstrates that massage therapy can offer a variety of healthful benefits, especially for people with significant stress or anxiety, strained muscles, or osteoarthritis. Massage therapy can enhance immune function, increase circulation while reducing heart rate and blood pressure, boost levels of endorphins and serotonin (the body’s natural painkillers and mood regulators), and reduce stress hormone levels, all while easing sore and achy muscles.

If you have problems with tension headaches, back or neck pain, sports injuries, arthritis, or fibromyalgia, experiment with massage as an enjoyable way to help reduce or even eliminate associated pain. Mothers-to-be can reduce stress levels and pain associated with labor, preemies may gain weight faster, and children with asthma may breathe easier when massaged. Studies also suggest that massage therapy can help prevent or manage some side effects and complications commonly experienced by people with cancer, both during and after treatment.

Anyone with open wounds should wait until they are healed to receive bodywork, and deep-tissue work should be considered cautiously by people on blood thinning medication (warfarin, for example) and anyone recovering from surgery. Other than that, work with a licensed massage therapist to ensure you get the most out of your session. Many forms of massage therapy are available. It pays to ask massage therapists what types of therapy they have studied and whether their skill sets are a good match for your needs.

LK: What are some common ailments you have seen treated effectively through other CAM methods?

AW: First of all, in treating autoimmune and inflammatory disorders, I have seen great success using an anti-inflammatory diet. I also recommend the use of herbal medication (especially things like ginger and turmeric), mind-body methods (everything from guided imagery to stress reduction), lifestyle counseling, different forms of exercise, and sometimes the use of Chinese medicine.

For depression, I think there are a huge range of approaches that are very effective, from aerobic exercise to high-dose fish oil, and various dietary supplements. I find the anxiety-reducing breathing exercise that I teach to be more effective than the standard pharmaceutical drugs.

LK: How is it that all these methods are effective? People generally expect to have to do something high-tech to respond to something that’s gone awry in their bodies.

AW: I think this is the key question of what’s wrong with American health care. It has us all dependent on high-tech solutions that are expensive. I think these low-tech methods work because the body has an innate healing capacity, and there are many ways of accessing it. I think that people, in this culture especially, have little confidence in their body’s ability to restore health.

Many of these methods have very sensible mechanisms behind them. High-dose fish oil affects brain chemistry; there’s a lot of research on that. With breathing exercises for anxiety, there is a logical mechanism—breath affects the involuntary nervous system.

There is very little research on the impact of breath work, because it is something that is just not taken seriously by the research community, probably because it is so simple. I have worked for years to try and get studies going on it. The lack of interest in this kind of stuff is remarkable.

LK: What is the backstory on scientific studies of massage?

AW: Unlike pharmaceuticals, which can be manufactured to small tolerances, dosed by weight, and compared to placebos, bodywork is less consistent and often better tailored to an individual’s needs. Massage therapy, nonetheless, has been studied and scientifically proven to be effective for reducing pain, fatigue, anxiety, and stress in patients with a wide range of medical problems, and to relieve a variety of symptoms in people with specific illnesses. In addition, the number of sound research trials into the potential benefits of massage therapy has grown significantly in recent years. Still, funding remains an issue. As is the case with any CAM therapy, funding will never be as accessible for research into massage therapy as it is for drug company studies.

A strong body of research that defines the clinical effectiveness of, and indications for, massage therapy will help promote greater acceptance of the approach and perhaps lead to wider coverage by insurance companies. I would like to see more studies comparing the effects of massage therapy to pharmaceutical agents for the relief of pain and anxiety, as well as cost-benefit analyses of the preventive effects of regular massage. Further investigation into the underlying mechanisms behind the benefits of massage should be encouraged as well.

LK: What do you tell people who insist on having hard scientific data before trying something from the CAM toolbox?

AW: There is a lot of science out there. It is just often published in places that most doctors don’t look. I think the first thing is to see what evidence there is. Second, we should get into the habit of using a sliding scale of evidence, which works like this: the greater the potential of a treatment to cause harm, the stricter the standards of evidence it should be held to for efficacy. In the case of something like a breathing technique, the potential for harm is so low that I feel quite comfortable recommending it, in the absence of hard scientific evidence of its efficacy. I know it works, because I use it myself, and I use it widely on patients. It’s not going to hurt people.

LK: I keep encountering a disbelief that simple things can actually work.

AW: There is a prejudice. People wonder how it possibly could work, being that it doesn’t involve a drug, and it doesn’t involve a device. That, to me, is the big problem in this area. I think that the answer is education about the body’s remarkable capacity for self-maintenance and healing and about the value of knowing and using these low-tech solutions before going to complex, expensive ones.

If low-tech methods don’t work, then sure, you go to stronger methods. Or if you’re dealing with an emergency, then you use more drastic methods. But for the vast majority of conditions out there, there are inexpensive, low-tech, simple methods that people ought to know about.

LK: Do you see attitudes toward massage changing in the world of conventional medicine?

AW: The United States lags behind many other countries where massage is considered a trusted effective medical intervention. But surveys show it is one of the most popular forms of alternative medicine in North America and is increasingly incorporated into the services offered by hospitals and medical clinics. As more people, including doctors, experience its benefits and appreciate the healing power of appropriate human touch, I am confident that massage therapy will soon be offered within most cancer centers and readily available to at least expectant mothers and hospitalized children. Of course, additional sound research will help drive the inclusion of massage in the conventional medicine armamentarium.

LK: If there is an absence of hardcore scientific evidence proving that a given CAM treatment works, how can a person who is not that educated in CAM distinguish between what is medically sound and what is not?

AW: This is the whole point of the integrative medicine that I teach. We have now graduated over 500 physicians from intensive training in the program in integrative medicine at the University of Arizona College of Medicine. The training enables them to make those distinctions and teach their patients to do the same. Ideally, you find a trained health-care professional, preferably a physician or a nurse practitioner, who has this kind of training, who can advise you. Our website gives a directory of all our graduates.

On a related note, if pharmacists were trained in the use of vitamins, minerals, herbs, and other dietary supplements, they would be the best people to advise both patients and doctors about the uses of CAM and its interactions with pharmaceutical drugs. It’s really a matter of getting trained people out there.

LK: What are three safe and relatively easy ways people can try out CAM at home?

AW: Learn the basics of good nutrition and how diet affects health. The simplest rule is to try and get rid of refined products and manufactured foods. They may be what is causing all the trouble. It’s also a good idea to have a home medicine chest with simple remedies. There are about half a dozen herbal treatments that are very useful—like Valerian for sleep and peppermint for stomach upsets. Lastly, have some kind of relaxation technique to practice. My favorite is simple breathing methods, because they are so time-efficient.

LK: Is there anything you would like to add about getting professional massage treatments?

AW: Keep in mind that massage therapy typically provides short-term relief of symptoms and that the benefits of massage accrue over time. To experience the greatest benefit, try to schedule sessions at regular intervals and treat them as you would any important business appointment: non-cancellable.