Massage Therapy for Pain: An Honest Look at the Current Evidence

Massage therapy is one of the most widely used complementary approaches for pain, so it is reasonable for patients to ask what the research actually shows. In 2024, a team led by Selene Mak published a systematic review in JAMA Network Open that mapped the systematic review evidence on massage therapy for painful conditions published between 2018 and 2023.

The findings call for measured interpretation. From 129 systematic reviews identified, 17 reviews covering 13 health conditions met criteria for mapping with formal certainty-of-evidence ratings. No conclusion achieved a high-certainty rating, and seven conclusions were rated as moderate certainty. Where moderate-certainty evidence existed, it generally favoured massage therapy over some comparison conditions, but evidence that massage outperforms other active treatments was rare.

It is important to understand what these ratings mean. Low-certainty evidence is not evidence of no effect; it reflects the practical difficulties of studying hands-on therapies, including small trial sizes, the impossibility of blinding practitioners, variation in techniques and dosage, and inconsistent comparison groups. Many patients report meaningful relief from massage, and the review does not contradict that experience. What it shows is that the research base has not yet matured to the point where strong claims can be made with confidence.

For patients, the practical message is balanced: massage therapy remains a low-risk option that may help with pain and is often valued as part of a broader care plan. The strongest overall pain-management evidence continues to support active approaches such as exercise, with massage positioned as a complement rather than a standalone solution. Honest communication about this evidence helps set realistic expectations and supports better shared decisions.

Key findings

• The review mapped systematic reviews published from 2018 to 2023 examining massage therapy for painful adult health conditions, identifying 129 reviews and mapping 17 covering 13 conditions.
• No conclusions were rated as high-certainty evidence, and seven conclusions reached moderate certainty, reflecting limitations in trial design common to hands-on therapies.
• Moderate-certainty conclusions generally favoured massage therapy over some comparators for certain conditions, while evidence that massage is superior to other active therapies was rare.
• Low certainty does not mean massage is ineffective; it means the current research base cannot yet support strong, confident claims in either direction.
• The authors called for more rigorous trials with better comparators, larger samples, and standardised outcome reporting.

Clinical relevance

Rehabilitation clinics benefit from framing massage therapy accurately: as a valued, low-risk complement within a broader active care plan, with expectations grounded in the current certainty of evidence rather than overstated claims.

Prepared by the Volt Health team as an educational summary of the cited publication. It is not medical advice; assessment and treatment decisions should always be made with a qualified health professional.