An illustration of a troubled woman holding her hands to her face. Words including trauma, kids, anxiety and on edge are superimposed.

At some point in our lives, most of us will experience some form of distressing or disturbing event, known as trauma.

News headlines remind us of the disasters that regularly occur in our communities worldwide. Often those events happen to people we don’t know — strangers — yet every one of those individuals is somebody’s family member and friend.

Although it doesn’t always make headlines or the news, trauma occurs along with these events.

Traumatic events don’t have to be dangerous. They can be something that happens suddenly or unexpectedly, such as the death of a loved one.

Sometimes those traumatic experiences slip away with time, and sometimes they don’t.

Traumatic events can lead to Post-Traumatic Stress Disorder (PTSD), a mental health condition that can have an impact on one’s ability to function in the world.

PTSD And How it is Treated

Although statistics vary across different resources, the National Center for PTSD suggests seven or eight out of 100 people will have PTSD at some point in their lives. Given this significant statistic, it is highly likely a client with this condition will present for massage therapy. It is important for massage therapists to understand the nature of PTSD and the potential needs of individuals with this mental health condition.

The National Institute for Mental Health identifies the following symptoms associated with PTSD:

• Re-experiencing symptoms, such as flashbacks: Repeatedly reliving the trauma, including physical symptoms like a racing heart or sweating, bad dreams, also known as night terrors, and frightening thoughts.

• Avoidance symptoms, such as staying away from reminders of the experience or avoiding thoughts or feelings associated with the traumatic event.

• Arousal and reactivity symptoms, such as easily being startled, feeling tense, or having difficulty sleeping, or experiencing angry outbursts.

• Cognition or mood symptoms, such as not remembering aspects of the traumatic event, negative thoughts, distorted feelings of guilt or blame, or lack of interest in enjoyable activities.

As these symptoms suggest, PTSD is also associated with high rates of depression, anxiety, stress and fatigue. This mental health condition often has significant long-term impact on individuals’ ability to work, function socially, maintain healthy relationships and generally enjoy life.

The primary forms of treatment for PTSD are psychotherapy, mental health counseling and medication. These forms of treatment have shown significant benefits, but often individuals struggle to cope with the adverse symptoms associated with this chronic mental health condition.

Furthermore, medication, more formally known as pharmacotherapy, has shown positive effects for treating symptoms — but results are limited and medication can result in other negative consequences, such as substance use disorders. Ultimately, innovative nonpharmacological approaches are needed to help individuals manage their symptoms without the side effects and adverse events associated with pharmacological management.

Massage’s Potential Impact on PTSD Symptom Management

Very little research has been published to establish the connection between massage and PTSD symptoms; however, data evaluating mindfulness-based stress-reduction modalities, such as massage, presents it as a viable treatment option for consideration.

Massage therapy research has shown significant impacts on physical, mental and emotional symptoms in many studies across several diverse populations. The alignment of massage as a therapeutic modality for mental health conditions is intuitive given evidence suggesting the therapeutic benefits of massage including stress reduction, decreased depressive symptoms, less anxiety, reduction in hypertension, and sleep improvement.

Massage therapy’s popularity for managing psychosomatic symptoms sets the stage for this nonpharmacological modality as an option for individuals with PTSD.

Based on the literature of outcomes associated with massage therapy, this modality holds promise to improve wellness and promote recovery. Massage therapy is not recommended as a primary mental health treatment; but this modality can complement primary health services to support individuals dealing with the long-term impact of trauma.

There is much to learn as practitioners and scientists in the field advance the science of understanding the connection between massage therapy and PTSD. Though the impact of massage therapy for mental and emotional symptoms, such as stress and anxiety, has been studied, there are other PTSD-related symptoms that may also benefit from this complementary modality.

Notably, individuals with this condition commonly report an emotional numbing or emotional detachment. Emotional numbing is the mental and emotional process of shutting out one’s feelings. Although progress has been made in treating many of the symptoms associated with PTSD, fewer advances have been made in treating emotional numbing.

Massage Creates Connection

As a massage therapist, I and many of my colleagues have noticed a connection that can result from massage therapy. Often massage clients report feeling more connected to themselves and others when receiving massage. As a massage therapist and scientist, I have hypothesized that massage therapy may alleviate the symptoms associated with PTSD, including emotional numbing.

As professionals in the field it is critical to increase our understanding of the impact of massage therapy on this debilitating condition through observations and measurement in practice and research.

With the potential benefit of using massage therapy as a complementary modality for treating PTSD, there may also be adverse consequences or contraindications that must be considered. Individuals with PTSD — particularly in acute stages — may experience hypersensitivity or become physically or emotionally aggravated when receiving massage therapy.

For example, if an individual has this condition resultant from sexual trauma, that individual may have flashbacks which they associate with touch. The reason this example is so poignant is because it demonstrates the importance of building rapport, trust, and a sense of safety and support when providing massage.

While building rapport, clear communication, and creating trust and a safe space are second nature to massage therapists, these interpersonal skills are central when working with an individual with PTSD. 

As practitioners and scientists continue to increase the understanding of the impact and associated outcomes of massage therapy, inquiry focused on mental health conditions, such as PTSD, will continue to be critical for advancing the field of practice.

Although traditional science considers randomized controlled trials as the benchmark of good science, practitioners and scientists alike will add to the body of knowledge by opening up the conversation about practice-based experiences with professional commentaries, case studies, and other qualitative forms of information exchange to provide insight into the potential benefits of massage therapy for individuals experiencing the long-term impact of trauma.

Recently, the International Journal of Therapeutic Massage and Bodywork (IJTMB) published an article entitled “A Series of Case Reports Regarding the Use of Massage Therapy to Improve Sleep Quality in Individuals with Post-Traumatic Stress Disorder (PTSD),” by Bryn Sumpton and Amanda Baskwill.

Results found inconsistency in improvement and worsening of symptoms of sleep quality. Further case studies and case reports can help inform practitioners and clients. Google “massage and PTSD” for helpful information.

PTSD is a prevalent and serious mental health issue. As health professionals in a field of complementary and integrative health, in a caring community, we must start the conversation — and get help for those who suffer from PTSD. When we do this — we can help individuals heal the emotional wounds of trauma.

PTSD Resources

Do you want to know more about PTSD, its symptoms, and ways to support individuals who have PTSD? You can learn more by visiting the National Institute of Mental Health.

Do you, a loved one, or a client need support related to PTSD? You or someone you are concerned about can get help through the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA), which has a National Helpline — 1-800-662-HELP (4357) that is free, confidential, 24/7, 365 days a year. This helpline provides treatment referral and information service in English and Spanish for individuals and families facing mental and/or substance use disorders.

About the Author

Jolie Haun, PhD, EdS, LMT, completed a National Institutes of Health, National Center for Complementary and Integrative Health post-doctoral fellowship in whole systems research at the University of Arizona’s College of Medicine in the Department of Family and Community Medicine. Currently, Haun is a Research Health Scientist at the Veterans Health Administration, James A. Haley Veterans Hospital, in Research Service. She wrote this article on behalf of the Massage Therapy Foundation.