Comfortably thumbed

Whether projected with a clinical or relaxation slant, massage doesn't only feel good, but can be good for your health, too. Historically, it played an integral part in body maintenance: Chinese acupressure, Indian ayurveda, Japanese shiatsu, Thai and other Southeast Asian manipulations have been charted for centuries; likewise in Europe and the Middle East, with steaming, scraping and rub-downs in bathhouses. One of the most recent studies of the efficacy of massage, produced last year by Seattle's Group Health Research Institute, showed the therapy may be better than medication or exercise for easing lower back pain in the short term. Other research-backed benefits include a heightened immune system, a drop in the stress hormone cortisol, immediate relief for advanced cancer patients, and alleviation of pain and anxiety for post-surgery patients. The common belief that having a massage after working out improves muscle blood flow and helps get rid of lactic acid is a point of contention. A 2009 study by Queen's University, Canada, found that massage impairs blood flow to the muscle after exercise, therefore also impairing the removal of lactic acid. But there's no doubt about the pain-relieving properties of massage. Dr Kenneth Sun Lun-kit, a specialist in orthopaedics and traumatology at the Hong Kong Orthopaedic & Spine Centre, says massage is medically beneficial. 'It is a physical treatment to relieve muscle tension and stiffness in the early stage of musculoskeletal pain management,' he says. 'It makes use of the 'gate control theory' to ameliorate muscle and fascia [tissue layer between skin and muscle] pain.' The gate control theory is the idea that physical pain is not a direct result of activation of pain receptor neurons, but rather its perception is modulated by interaction between different neurons. Massage is believed to be effective as it suppresses pain sensations where nerve fibres enter the spinal cord, which sends impulses on to the brain. 'Massage works on a holistic level,' says Kathryn Cousins, treatments manager at The Oriental Spa at the Landmark Mandarin Oriental. 'Even basic massage techniques stimulate each of the body's systems, resulting in a feeling of true well-being ... On a different level, care and touch from a therapist during a massage adds to feeling of self-worth and being nurtured, which allows for a feeling of well-being after treatment.' Clinical psychologist Dr Melanie Bryan adds that massage helps people get away from their thoughts. 'It allows people to become more attuned to their bodies - areas of tightness, stiffness, pain and other stress-related physical difficulties,' she says. But is there one massage technique that's better than the others? Registered physiotherapist and traditional Chinese medicine practitioner Kerry Fung Wai-yip says each style of massage has its own special benefits, if applied correctly. He says acupoint or shiatsu massage can stimulate acupuncture points and achieve a balancing effect on the body; oil or aromatherapy massage can help soothe and calm; Thai massage is good for stretching muscles and improving joint mobility; Chinese massage improves one's general condition; and sports or deep-tissue massage is good for muscular recovery. It all depends on what you're after. For energising the body and mind, Cousins recommends Swedish or Thai massage; for soothing the body and reducing stress, try aromatherapy massage. Tobias Lee, a physical/manual therapist at The Body Group, tailor-makes treatments after talking to and examining his clients. His method, based on therapeutic sports massage and performed with oil, tends to be vigorous. 'I move in and out of trigger point release work when I discover congestion in tough fibres - or knots, as some people call them. Deep tissue work is done when necessary,' he says. 'I treat around 85 to 100 people a month, with sports-related issues, postural pain, pregnancy discomfort and for stress. It affects 99.9 per cent of my clients.' In the back pain study by Seattle's Group Health Research Institute, lead study author and institute director Daniel Cherkin was surprised that, for up to a year, relaxation massage or structural massage worked better than the 'typical' medical approach of drugs and physical therapy. At The Oriental Spa, Cousins says guests with specific concerns are usually treated with massage in conjunction with another form of therapy, such as physiotherapy and acupuncture. Guests are also advised to disclose medical information to therapists to ensure the correct treatment is being given. Sun advises that massage should only be done with medical consent following a diagnosis, and should not be the only means of pain management. He's also wary of unnecessarily strong massage: orthopaedic surgeons, he says, occasionally encounter cases of broken bones in areas that have been weakened by undiagnosed bone tumours after strong massage. 'I would recommend only gentle massage,' says Sun. 'Many think forceful massage is an effective way to relieve their muscle pain. In fact it can do more harm than good, since repetitive trauma to the muscle may lead to fibrosis and even more tightness and pain.' Fung says that this 'no pain, no gain concept' is a myth. Lee agrees: '[Strong massage] can hurt if the person is not warmed up, and make them tense their muscles even more, thus fighting against the therapist.'