Review The effect of massage on patients with chronic fatigue syndrome: A systematic review and meta-analysis 2024 Li et al

Abstract

Background:
Chronic fatigue syndrome (CFS) is a long-term and complex chronic disease that seriously affects the physical and mental health and quality of life of patients. Massage, as one of the methods in traditional Chinese medicine, can treat both symptoms and root causes and is widely used to treat CFS. The main purpose is to systematically evaluate the impact of massage therapy on the efficacy and safety of CFS patients, providing a reference for clinical practice.

Methods:
By searching for literature published in PubMed, Cochrane Library, Web of Science, Embase, Wanfang Database, VIP Database, and China National Knowledge Infrastructure Database until November 2023, randomized controlled trial studies were selected according to the established inclusion and exclusion criteria. The Cochrane system evaluation manual was used to evaluate the quality of the included studies, and RevMan5.4 software was used for meta-analysis.

Results:
32 randomized controlled trials were included, with a total of 2594 CFS patients. Meta-analysis showed that the total score of the fatigue scale (FS-14) in the treatment group, MD = −1.59, 95% CI (−1.84, −1.34), P < .00001; Physical fatigue score, MD = −1.30, 95% CI (−1.60, −1.00), P < .00001; Mental fatigue score, MD = −0.84, 95% CI (−0.99, −0.72), P < .0001]; Effective rate [RR = 1.23, 95% CI (1.19,1.28), P < .00001]; all indicators were superior to the control group, Only one study reported adverse reactions, including local swelling, skin bruising, and nausea.

Conclusion:
Our research findings suggest that massage therapy has a significant therapeutic effect on CFS, avoiding adverse reactions and improving fatigue symptoms. Therefore, massage therapy for chronic fatigue syndrome should be further promoted and applied.

Open access, https://journals.lww.com/md-journal...ct_of_massage_on_patients_with_chronic.2.aspx

 

Discussion

CFS patients often feel distressed due to fatigue, joint pain, low sleep quality, and low mood.[51] At present, Western medicine is unable to explain the cause of this disease. However, from the perspective of traditional Chinese medicine, we believe that there are three causes of CFS: Traditional Chinese medicine believes that emotions have a significant impact on the liver, and patients have poor emotions due to various reasons, leading to liver injury, resulting in common manifestations of CFS such as mental depression, chest and rib pain, breathing difficulties, breast and abdominal distension, abnormal bowel movements, and menstrual irregularities; The patient’s careless diet leads to spleen and stomach injury, weakened digestive function, insufficient nutrition supply, and clinical manifestations such as indigestion, bloating, constipation, and physical fatigue; and Traditional Chinese medicine believes that attention, sleep, and other aspects of the human body belong to the management of the heart. Patients often think excessively and damage the heart, resulting in symptoms such as insomnia, excessive dreaming, forgetfulness, lack of concentration, and overreaction to external stimuli.[52]

 

One study reported adverse reactions, including local swelling, skin bruising, and nausea. That must have been a really hard handed massage.

 

That would be no it can't, no it can't, and no it's not. What an odd thing to write.

Although what a perfect example what pragmatic evidence-based trials have become completely useless to the point where none can be trusted as reliable. Not a single one. Anything can be found to do, cause or prevent to do anything no matter how implausible or farcical, as long as you can find some minimal signal of no real significance in the real world.

It's inevitable that in the future every alternative medical practice will go through this. There is nothing preventing homeopathic bathing, astrological healing or bamboo chewing competitions from being found to treat whatever about any condition. It basically amounts to the classical thousand monkeys writing Shakespeare using typewriters, as long as no one actually checks or one cares that all they found is a few valid words then argued that it's good enough since those words can be found in Shakespeare's writings. Words like 'a', and 'the' and so on.

 

As models go, this isn't even worse than the traditional psychosocial view. It's just as much nonsense and assumptions they can't be bothered to falsify but easily could.

 

i do tend to think 'excessively', i mean i am a woman after all & you know how we tend to overthink things, what with our tendency towards hysteria & all.
I must make sure i ask my GP for a referral to cardiology because my heart must be on its last legs by now.
And when i get there, the consultant will no doubt be fascinated to know that the 'heart damage' i have caused myself with all this 'excessive thinking' is the cause of my 'excessive dreaming & forgetfulness'.

You just couldnt make it up could you?



<apologies to any Chinese forum members or readers, i dont mean to ridicule your culture, i certainly dont want to disrespect or offend you. But really... if thinking too much caused cardiac damage then we'd all be dead surely, oh & who decides how much is too much? i mean surely any scientist working on a problem or strategising lawyer ought to be having an MI? I cant take it seriously at all>

 

incidentally, i find deep tissue massage from the osteopath really helpful

in terms of being relaxing particularly head neck & shoulder massage i find quite energising (in the short term). But it does nothing for my overall condition

 

I assume for the very severe any form of massage is counter indicated and would lead to a worsening of their condition.

 

In the past when I was still well enough to work part time, I saw at different times an osteopath and a shiatsu practitioner. I saw the osteopath for specific issues with my back and neck, and that seemed to also help with headaches. The shiatsu practitioner I saw when I was trying anything and everything, and subjectively felt better for a week or so after each session. I stopped the shiatsu when the practitioner stopped her clinical work in favour of training other practitioners.

However, though both seemed to give a transient reduction in some of my symptoms, neither had any conspicuous impact on my underlying condition. Further neither gave me any tools that I could take away to manage my symptoms myself. Now I am considerably worse, I suspect the energy and financial costs of either would not be worth any potential short term benefit.

I have not checked up on the time periods involved in the studies reviewed, but I suspect any self reported improvements would not like the CBT and GET studies be seen to last longer term.

 

I’ve had a lot of acupuncture, I love it. It did help my ME/FM it helped my immune system respond to infections more vigorously, I don’t know how but I didn’t change either my thought quantities or eating habits following a session so, not that. I’d have acupuncture still but I’m too unwell to attend/recover from appointments.

Acupuncture helped me, very much like going for a swim in the ocean or consuming healthy broths, or having a sauna or sunbathing or hitting the right supplement combo, or having osteopathy from a responsible practitioner (of which there are fewer than you’d hope) or doing gentle yoga that is actually gentle (a rare thing indeed). Or cannabis for pain and mental relief or pharmaceuticals to address outcomes of illnesses. But it’s not going to reset the disease process. Like everything else it requires stamina and recovery time.


@JohnTheJack is right, you need physical therapy to counter the effects of this illness. But pushing back on the after effects of illness isn’t the same as addressing the process.

Anyway, yeah blaming a person’s sickness on their own bad behaviours of living or unskillful practice of thoughts surpasses all models linguistic and military boarders.

But I will say massage actually seems to be one of those things that people with ME really struggle to benefit from in the way others do. So before any other aspects of my condition deteriorated I discovered I couldn’t have a massage without four days of pain afterwards which kinda defeats the point. I could possibly manage to go for a an aromatherapy ‘massage’ where certain essential oils (not most of them because you know scents…) were put into a carrier oil and rubbed over my skin as a sort of fancy moisturising treatment but can’t actually have the massage part, so not a massage.

But a massage is a lovely thing so it’s quite spectacular that this guy has managed to be so obnoxious that they make it seem like a revolting suggestion as a treatment.

Plus I’m pretty sure at least as far back as the 2000s maybe 80s/90s too everyone was all about having massages for ME & Co because human touch is known to have health benefits generally and because everyone thinks if our muscles aren’t doing their job properly maybe they just need a helping hand from someone else, to kick start them into proper functioning. Also using massage fits well with the hyper sensitivity hypothesis as exposure therapy. Anyway it went nowhere because it’s basic.

 

This probably is the core of the problem, why evidence-based medicine is largely useless: it's possible to feel better in general, without affecting the actual problem, being no better off in the end. You're better, but also you're not better. They're both true. The former is temporary, the latter is the chronic nature of the problem.

All of this therapeutic recreation plays into the same, as this study does. They're all things that most people would enjoy generically, that are then tried as specific treatments to specific problems. Anyone participating in those would feel a bit better, but it changes nothing at all to their condition. By making "feel a bit better" equivalent to "improvement in the condition, and thus a net benefit", this only serves as distraction.

No one put this method better than Futurama, this entire misguided approach in a nutshell:

 

Ha!
Perfect.
Every word you said too.

 

"Avoiding adverse reactions". I think it's a big jump to say massage is safe for pwME. We know that in very severe ME any kind of touch can be excruciating.

My own experience is, that in the early years of trying anything, I had massage and reflexology (feet). Both of these made me feel significantly worse and I wouldn't try them again.