The report is a product of the VA/HSR Evidence Synthesis Program.

Evidence Map of Massage Therapy and Acupressure for Non-Painful Health Conditions

Takeaway: Medical massage therapy is a widely accepted complementary and integrative health modality for the treatment of certain health conditions and is increasingly being used in medical settings. Of the 14 systematic reviews of medical massage therapy for non-painful conditions published July 2017 to July 2024 and included in this evidence map, one review reported high certainty of evidence that abdominal massage therapy has a potential beneficial effect on functional constipation, while three reviews concluded with moderate certainty of evidence that massage therapy or acupressure has a potential beneficial effect on sleep quality in cancer patients and in people with chronic kidney disease, and depression in individuals living with dementia. None of the included systematic reviews reported serious adverse events. More high-quality research is needed to provide a stronger evidence base for the effect of massage therapy and acupressure on a wider range of non-painful adult health conditions, particularly those of priority to VA.

Medical massage therapy is a widely accepted complementary and integrative health modality for the treatment of certain health conditions and is increasingly being used in medical settings. Since 2016, the number of medical massage therapy users and visits in VHA has dramatically increased.

In response to VHA stakeholders who were interested in the evidence on massage therapy for non-painful conditions, HSR's Evidence Synthesis Program (ESP) Center in Los Angeles conducted a review to create an evidence map. The ESP team searched bibliographic databases (e.g., PubMed, CINAHL) for systematic reviews published July 2017 to July 2024 that examined the efficacy or effectiveness of massage therapy delivered by health professionals for non-painful adult health conditions. Reviews had to focus on medical massage therapy or acupressure delivered by a health professional for non-painful adult health conditions and formally assess the certainty of evidence.

Summary of Findings

Of 190 relevant publications, the ESP investigators identified 14 eligible systematic reviews of medical massage therapy and/or acupressure. These reviews covered nine health conditions, including sleep and mental health conditions in persons with cancer, dry eye disease, dementia, functional constipation, hypertension, kidney disease, post-burn pruritus (persistent itching after a burn injury), pregnancy, and pre-operative anxiety.

• One review reported high certainty of evidence that abdominal massage therapy has a potential beneficial effect on functional constipation.
• Three reviews concluded, with moderate certainty of evidence, that acupressure and auricular acupressure (which uses acupressure points in the ear to affect other parts of the body) improve sleep quality in cancer patients, that acupressure improves sleep quality in people with chronic kidney disease, and that medical massage therapy reduces depression in individuals living with dementia.
• Seven reviews collected evidence about adverse events; no serious adverse events were reported.
• Half of the reviews focused on symptom improvements in specific conditions; the other reviews focused on outcomes in specific populations.
• Of the 14 included reviews, six focused on medical massage therapy, four focused on acupressure, and two focused on auricular acupressure. Two reviews included more than one intervention.

Implications

While this evidence map presents the certainty of evidence for medical massage therapy and acupressure’s benefit on nine non-painful adult health conditions, more high-quality randomized controlled trials are needed to provide a stronger evidence base to assess the effect of medical massage therapy and acupressure on a wider range of adult health conditions, particularly those of priority to VA.

Limitations

As is the case in all systematic reviews, all the potentially eligible evidence might not have been identified, and the ESP team did not independently reevaluate the primary studies included in the eligible systematic reviews. Also, massage therapy is a broad term that includes many styles and techniques, emphasizing the importance of clearly defining what is considered medical massage therapy.

Future Research

Studies that address limitations of existing research are needed for conditions of priority to VA that do not have at least moderate-certainty evidence supporting the use of medical massage therapy. More research is also needed on long-term effects and the impact of treatment frequency or duration, as well as more detailed reporting of adverse events to inform statements about the safety of massage therapy for non-painful health conditions

Citation:

Mak S, Allen J, Begashaw M, De Vries G, Severin J, Miake-Lye I, Shekelle P. Evidence Map of Massage Therapy and Acupressure for Non-Painful Health Conditions. Washington, DC: Evidence Synthesis Program, Health Systems Research, Office of Research and Development, Department of Veterans Affairs. VA ESP Project #05-226; 2025.

To view the full report, go to https://www.hsrd.research.va.gov/publications/esp/reports.cfm. (This report is available via Intranet only.)

How can VA leadership work with the ESP? Nominations for systematic review topics may be submitted to the program at any time. When you submit a topic nomination form, ESP Coordinating Center staff will work with you to determine the appropriate research approach and ESP product to address your questions of interest. Topics are selected and assigned to an ESP Center based on program capacity and alignment with VA national goals.

This Management Brief is provided to inform you about recent HSR findings that may be of interest. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs. If you have any questions or comments about this Brief, please email CIDER. The Center for Information Dissemination and Education Resources (CIDER) is a VA HSR Resource Center charged with disseminating important HSR findings and information to policy makers, managers, clinicians, and researchers working to improve the health and care of Veterans.

This report is a product of VA/HSR's Evidence Synthesis Program (ESP), which was established to provide timely and accurate synthesis of targeted healthcare topics of particular importance to VA managers and policymakers; and to disseminate these reports throughout VA.

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