by Jill Richardson

IN THE U.S., massage is a multi-billion-dollar industry. As of July 2013, 16 percent of American adults received at least one massage in the last year. But, could it be that more Americans ought to get massages, and do so more regularly, to improve the fundamentals of their health?

Recent medical research suggests this might be the case.

In other words, those who are willing to plunk down as much as $90 for a 60-minute session appear to be doing more than treating themselves to having sore muscles and joints worked on, or relaxing. For those who are healthy, evidence suggests massage can help you stay healthy. If you’re suffering from a chronic health condition, massage might help reduce pain, minimize anxiety, improve sleep, and more.

Doctors are catching on, too. In 2013, 50 million adults said they discussed massage with their doctors or other healthcare providers in the previous year, although chiropractors were more likely to give patients referrals to receive massage therapy than physicians. Some insurance companies, like Group Health Cooperative of Wisconsin, recognize the medical benefits of massage and provide coverage for regular massages.

These days, scientists are studying the impacts of massage on everything from pain to immune function to weight gain in preterm infants. , chairman of the Department of Psychiatry and Behavioral Sciences at the Emory School of Medicine, is one such scientist. He began by asking, “Why was it that so many people get massages? What was it doing?”

He obtained funding for an initial pilot study from the National Institutes of Health National Center for Complementary and Alternative Medicine to examine the effects of a single massage as well as regular massage over time on the body. Rapaport and his team wanted to know the impact massage might have on cortisol, oxytocin, immune function, and another stress hormone called arginine vasopressin (AVP).

Oxytocin is often thought of as a love hormone, although Rapaport notes the caveat that it’s “very complicated” and “involved in a lot of different things in the body… It’s a hormone that is thought to be central to affiliation. It’s thought to be important in how we interact with each other.”

AVP, on the other hand, can be thought of as the yang to oxytocin’s yin. “AVP can be involved in more aggressive behaviors,” notes Rapaport. “It can be involved in helping to trigger stress hormones like cortisol.” Thus, a decrease in AVP is “thought to facilitate people interacting with each other and being less stressed.”

As noted, cortisol is a stress hormone. But cortisol plays other roles, too, impacting brain function and food metabolism and suppressing immune function. It’s the sort of hormone that would help you stay alive if you were being chased by a bear. It’s not time to digest food or worry about fending off flu germs, it’s time to run fast! Digesting lunch can wait.

Since massage is thought of as a relaxing experience, it was not a stretch to hypothesize that perhaps massage would increase oxytocin and decrease AVP and cortisol, and do so more than what was observed in the control group.

Rapaport’s first study, published in 2010, simply looked at the impacts of a single, 45-minute Swedish massage on healthy individuals. As a control, they also had a second set of healthy adults undergo what they called “light touch” for 45-minute. The control group had a practitioner touching their body, but not performing any massage techniques. That way, they could find out if healthy adults who pay to receive massages from a professional receive benefits above and beyond what they might get from, say, the soothing touch of a loved one at home.

His second study, published in 2012, was similar, but measured the effects of weekly or twice-weekly massage over five weeks. The scientists wanted to see if regular massage provided any different effects compared to a single massage. They also looked to see if there was a cumulative effect and if the effects were sustained beyond the time immediately after receiving a massage.

As Rapaport and his team hypothesized, after just one massage, cortisol and AVP levels declined significantly. “We also saw that people that had massages tended to have an increase in the number of circulating white blood cells they had, and an increase in particular in white blood cells that were involved in protecting the body from an acute infections.” They also had “an increase in the cells that are used to control the function of the immune system. These are activated T-cells.”

Rapaport continued, “We looked to see also if there are changes in any of the proteins that white blood cells tend to secrete. Some of these are involved in inflammation and some of these are involved in allergic reactions. And what we found was that [after a] massage… these proteins were decreased in production. And also that the proteins that are associated with the allergic reaction… were decreased as well.”

All in all, they found there are major benefits associated with even one 45-minute massage session.

Weekly massages provided an “additive benefit of the same findings,” particularly for immune function. And those who had massages twice a week had an increase in oxytocin as well. Rapaport concludes that these changes, particularly with weekly or twice-weekly massage, “would be suggestive of a potential decrease in inflammation compared with not being massaged, and also a potential decrease in cytokine-secreted allergic response.”

That’s altogether not a bad deal, particularly considering how much more pleasant massages are than other medical interventions, like taking medications.

Rapaport’s studies were solely on healthy individuals. However, those with acute or chronic conditions might find benefits from massage too.

One challenge of studying the effects of massage is that there are so many different kinds. What works for one condition might not help another and vice versa. A 2006 study on the effects of massage on blood pressure included many different styles of massage and examined the different results achieved by each. Massage practitioners in the study integrated six styles of massage: Swedish, deep tissue, myofascial release, sports massage, trigger point therapy, and/or craniosacral therapy.

According to the study, “Swedish massage is considered the most ‘traditional’ form of massage,” but other forms provide other benefits. Deep tissue massage, as the name implies, aims to reach deep layers of muscle. Myofascial release, on the other hand, is concerned with the fascia connecting and surrounding muscle. Trigger point massage is also concerned with fascia, the collagenous connective tissue surrounding muscles, focusing on releasing specific trigger points, taut bands of muscle fibers that can produce pain. Sports massage, as its name implies, prepares athletes for peak performance, and craniosacral therapy uses gentle touch on the head and sacrum.

In the case of blood pressure, Swedish massage produced a decrease in systolic blood pressure, although the result was not statistically significant, whereas trigger point therapy and sports massage produced significant increases. This may be because sports massage is a vigorous form of massage and trigger point therapy can be painful as the practitioner applies pressure to release muscles. A combination of sports massage and trigger point therapy also produced an increase in diastolic blood pressure. A later study, conducted in 2008, found that deep tissue massage reduced both blood pressure and heart rate.

Several studies examined whether massage helps the chronic pain of fibromyalgia patients (University of Miami and Duke University, 1996), hand arthritis (University of Miami, 2006), carpal tunnel syndrome (University of Colorado, 2008), and lower back pain (University of Washington, 2003). In all cases, massage helped pain and often anxiety, too. For fibromyalgia patients, it also improves sleep, according to a 2002 study by the University of Miami.

Massage even helps migraines, found a 2006 study by the University of Auckland. A 2011 University of Kentucky study of older adults with persistent pain found that “massage is associated with self-report of less limitation due to physical or emotional issues, better emotional health, more energy/less fatigue, better social functioning, and better overall health.” Yet another study, published in 2011 by Cairo University in Egypt, found that massage even improved pulmonary function in children with asthma.

As for Rapaport, he’s not ready to speak in detail about his latest study results on using massage on patients with generalized anxiety disorder (GAD) just yet, but he says, “It looks like to me that we are going to have very exciting findings there to help people with a documented anxiety disorder.”