A pilot study found that six weeks of massage therapy, with a focus on myofascial trigger points, helped improve several of the psychological factors commonly associated with tension-type headache (TTH).

The study, “Changes in Psychological Parameters in Patients with Tension-type Headache Following Massage Therapy: A Pilot Study,” involved 16 subjects, all of whom reported episodic or chronic TTH for six months or more prior to the study.

A TTH is described by the study’s authors as a dull, aching headache, often linked to stress, anxiety and depression. Study participants reported having such headaches for four or more hours at a time. These subjects ranged in age from 28 to 56, with an average age of about 44 years.

Each study participant was assigned to receive a structured and replicable massage sequence, focusing on myofascial trigger points and directed at cervical and cranial musculature.

The study started with a three-week baseline period, during which no massages were performed. Baseline measures were taken twice during this baseline period. Then a six-week massage period began, during which subjects received two 45-minute massages per week. Outcomes measures were evaluated after massages six and 12, then again three weeks after the final massage.

During the massage period, all evaluations occurred either prior to the massage session or on a day when no massage was performed, in order to avoid the measurement of any immediate effects from massage therapy.

The State Trait Anxiety Inventory was used to assess anxiety levels, and the Beck Depression Inventory measured symptoms of depression. The Perceived Stress Scale was used to evaluate the degree to which specific real-life scenarios are appraised as stressful, and the Daily Stress Inventory addressed the relationship between stressful life events and stress-related disorders, such as TTH.

Results of the study revealed all of these psychological measures improved during and after the massage period. According to the authors, state anxiety levels “approached a significant decrease compared to baseline,” by the end of the massage period. As for trait anxiety, it decreased as the study progressed, with a statistically significant decrease showing up after massage 12 and the lowest scores appearing three weeks after the final massage.

A statistically significant decrease in scores on the Beck Depression Inventory, which translates to lower levels of depressive symptoms among subjects, occurred across the study’s time frame.

It was not until the final evaluation, three weeks after the last massage, that researchers measured a statistically significant decrease in perceived stress, as compared to baseline scores. The Daily Stress Inventory revealed a statistically significant drop in the number of events considered stressful by the last week of the massage period.

“Psychological distress is frequently acknowledged in patients with TTH,” state the study’s authors. “From this pilot study, significant reductions across the study timeframe were observed in stress, anxiety and depression for subjects with TTH who received massage therapy.”

Authors: Albert Moraska and Clint Chandler.

Sources: School of Nursing, University of Colorado Health Sciences Center, Denver, Colorado; and Boulder College of Massage Therapy, Boulder, Colorado. Originally published in the Journal of Manual & Manipulative Therapy (2009) 17 (2): 86-94.

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