Show me the science...
As Massage Therapy educators, we love learning about all things massage therapy, exercise therapy, the use of different modalities, and all types of different manual therapies complementary to what we do. Over the last 8 years, I personally have worked with Chiropractors, Chiropodists, Naturopathic Doctors, Acupuncturists, Structural Integrators, Reiki Masters and energy workers, Osteopaths, personal trainers, Kinesiologists, Thai Massage practitioners, and the list continues. From each of these practitioners I have learned something. Each of them gave me a different viewpoint, a slightly different clinical impression for the same patient based on their knowledge. I am not arrogant enough to think that as a Massage Therapist I can fix every musculoskeletal condition that appears before me. I am not arrogant enough to think that what I learned in massage school gives me the knowledge to always be able to accurately assess a patient. There are many approaches to body work and manual therapy and some may work for a certain person and not for another. Why such variance? Why do some people swear by Chiropractic while others say they don’t believe in it like it’s made up or something (I assure you it exists). Why do I call my Naturopathic Doctor before my Family Doctor but most of my family looks at me like I have 3 heads? Why do Chiropodists spend so much time making custom orthotics while structural integrators say they are a crutch and insist that there are better ways to develop the proper muscles to improve the function of your feet? Are there therapies that are superior to others? Is there enough research to help people decide what the best route is when they are in pain and don’t know who to call? How important is subjective evidence and testimonials? How much of the anecdotal evidence we do have about these types of complementary healthcare services is due to the placebo effect?
Recently, we have come across two online debates between Registered Massage Therapists that made us start to really think about the placebo effect and its role in therapy. One person was questioning the use of cupping and if there was any valid and reliable research surrounding it. The other person had the same issues with Reflexology. Now, I am not an expert in either of these modalities and won’t pretend that I have looked at solid peer reviewed scientific studies about them either. With that said, I am a RMT and without sounding too boastful, I do consider myself somewhat of an expert in this field. But I can tell you that there is also not even close to enough research about the type of work that I do, and claim to be an expert in, and swear to my patients is safe and effective and going to help them. What I know is that when I have a patient, and I properly assess what is going on with the function of their body, I am able to create a treatment plan that if followed, will yield positive results. I also use cupping therapy in my practice and although I am not an expert, I can tell you that the results my patients get is amazing.
Why are certain people so dismissive of therapies that maybe are not right for them if they are giving positive outcomes to other people? Why is subjective information not enough to give some sort of validation to a modality that has shown to be effective? Cupping therapy, along with Reflexology, is not new. Not at all. There is obviously a reason that ancient techniques are being used today and also a reason that some of the most elite athletes swear by these treatments. Whether the effects are real or imagined (placebo) does it matter? Even if objectively the patients physiology has not changed but they are feeling better and have seen positive results when it comes to performance or even their activities of daily living, isn’t the therapy working? I am not saying that there are no physiological effects of manual therapy or that there are no ways to measure objectively what is and is not working. Of course there are. But, if a person invests time, money, and energy into a therapy they believe is going to make them feel better and function better, and it in fact does make them feel and function better, then how important are the objective results? Find me a science class in university that does not discuss the placebo effect. It is science.
Amanda Cooke, RMT