Therapeutic massage

What the scientific evidence shows

Studies suggest that some people may have temporary pain relief. For many conditions, the certainty of the evidence is low and results vary by technique, comparison and length of follow-up. For neck pain, a 2024 Cochrane review found uncertain benefit and little or no difference from sham massage on some outcomes.

This supports selective use and assessment of response, without promising a cure. In chronic low back pain, massage may be considered as part of a broader program. It should not be presented as sufficient treatment for every diagnosis.

How to interpret relief after a session

Touch, movement of tissues and the context of treatment can affect the sensation of pain and tension. The mechanisms are not fully clarified, and an immediate change in sensation does not prove a structural change.

Massage does not mechanically put a disc back in place, does not resolve serious nerve compression and does not rebuild damaged cartilage. Claims about removing toxins or correcting every problem of the spine are not a sufficient basis for choosing a treatment. The aim should be clear and assessable.

Why assessment is needed before treatment

Before a session, say where and for how long you have had pain, injuries, operations and medicines. Say whether you take anticoagulants, or have osteoporosis, cancer, sensory disorders, fever or skin changes. These do not always translate into a complete ban but may require adaptation or medical assessment.

A red, hot area, an open wound, a suspected fracture or unexplained swelling is not treated simply as a muscle contracture. In oncology patients or after surgery, the permitted techniques and areas are decided in coordination with the treating team.

When massage should be postponed and help sought

Sudden pain and swelling of one leg require assessment for thrombosis; do not massage it. Pain with new weakness, loss of sensation or a change in urination requires assessment before manual treatment.

How a suitable session proceeds

The goal, area, pressure and position are discussed. Give your consent and say at once if something is painful or uncomfortable. You can ask for a change or stop of the technique at any moment. Stronger pressure does not necessarily mean a better effect.

Severe pain, electric shocks, dizziness or new numbness should not be tolerated as proof that the treatment is working. Forceful techniques may increase the risk of injury in certain people. Bruising or persistent worsening after a session requires discussion and reassessment.

Frequently asked questions

Does massage solve the cause of back pain? Massage may bring temporary relief, but it does not put the disc back, does not resolve nerve compression and does not rebuild cartilage. For back pain it is more useful when used as part of a program with exercise and activity.

Does massage have to hurt to be effective? No. Stronger pressure does not mean a better effect, and severe pain does not show that the treatment is working. Say at once if something is painful or uncomfortable and ask for the pressure to be reduced.

Who should be careful with massage? People taking anticoagulants, those with osteoporosis, cancer, sensory disorders, fever, wounds or skin changes, and those with sudden pain and swelling in one leg. Tell the therapist before the session so that the technique can be adapted or medical assessment sought.

How often can I have massage? There is no universal frequency. When massage helps, it is used for a limited period as an aid to exercise. If the relief remains very short and does not improve function, the plan is reviewed instead of continuing sessions without benefit.

The link with active rehabilitation

When massage relieves symptoms, this relief can be used to do exercises and activity better. The program should follow function, not only the sensation immediately after the session. If the benefit remains very short and does not help activity, the plan should be reviewed.

Care at Tirana Polyclinic: The physiotherapy service assesses whether manual techniques are suitable and how to link them with exercise. When symptoms require another diagnosis or treatment, care is coordinated with the relevant specialist.