a community of practitioners
Interesting, but let's see what the Cochran Reviews said about massage: http://www.cochrane.org/reviews/
- Mechanical neck pain
Overall, the quality of the studies was poor and the number of participants in most trials was small. …Therefore, no firm conclusions could be drawn and the effectiveness of massage for improving neck pain and function remains unclear.
Insufficient evidence to draw conclusions about the possibility that massage and touch interventions are effective for dementia or associated problems
- Promoting growth and development of preterm and/or low birth-weight infants
Evidence that massage for preterm infants is of benefit for developmental outcomes is weak and does not warrant wider use of preterm infant massage.
-There has been quite a lot of research on massage for long-term back pain. But the studies don't give clear answers about whether it works. .. overall, the research isn't good enough to say whether massage can help long-term back pain or not.
- We don't know whether massage helps pain caused by a slipped disc. There isn't any research to tell us.
-There's no research to say how baby massage can help women who have postnatal depression.
-We can't say if baby massage works because there hasn't been enough research.
-Some people try massage therapy for carpal tunnel syndrome. But there hasn't been any good research to say whether or not it works.
And so on...
So we have to be careful on what we mean by evidence-based medicine here. Most evidence-based study is based on some strict criteria, while massage therapy is more of a personal and some of the benefits cannot simply be measured mechanically.
In my opinion Evidence Based Practice is critical for the advancement of our profession, especially for those who want to be a part of the American health care system. I understand that some therapists do not want to go there, and that's fine--I'm speaking about those who do. EBP makes the most sense for massage because, as you point out Bodhi, it is a three pronged approach, taking into account the patient/client preferences and clinical experiences as well as using best available evidence.
The first step is to get research literacy into the schools so that new graduates can evaluate research and use it appropriately. Then we need massage therapists to actually conduct research. At least in this country, most research having to do with massage is being conducted by other health care professionals--as the principal investigator. That too needs to change and requires massage therapists to have a higher level of education. The result of research is the evidence, and who better to conduct it than those who were trained in it?
I always am intrigued by research having an undergrad degree in biology but there is also the other side of it that I have seen with a friend who works in it for a big university and gets millions of dollars from drug companies. She tells me horror stories of people in her office throwing out results that they didn't like and scary things like that.
I also wonder how you can really track the changes from a massage accurately. If you teach one technique to 10 massage therapists and they do it on one person it will feel different from each person and on each person. How do you track anything then really?
It is just big guesses but people want to know more about what works and what doesn't before they try things like massage for different conditions. I need to know more about how research is done and how to interpret it all because otherwise it is meaningless.
Hmmmm, why is it, that unless it can be proven "scientifically", it must not be viable. Massage (to me) is such an individual experience. I would question the intent behind EBM, is it just monetary (to be more readily accepted by the insurance companies) or is it to find techniques/modalities that consistently provide clients with positive results. I would think that answer would then be used to skew the data to favor which ever outcome was wanted.