Jane, S.W., Chen, S.L., Wilkie, D.J., Lin, Y.C., Foreman, S.W., Beaton, R.D., . . . Liao, M.N. (2011). Effects of massage on pain, mood status, relaxation, and sleep in Taiwanese patients with metastatic bone pain: A randomized clinical trial. Pain, 152, 2432–2442.

To compare the efficacy of massage therapy to a social attention condition in Taiwanese patients with cancer with bone metastases

• A five-day, two-group trial with a pre/post-test design was used.
• The experimental intervention was 45 minutes of massage; condition control was caring therapist for a comparable amount of time.

• The sample was 72 patients with cancer with bone metastasis.
• Mean patient age was 50 years.
• The sample was 42% male and 58% female.
• The sample was Taiwanese, age 18 or older, oriented x3 (alert and normal), Chinese-speaking and reading, radiologically diagnosed with bone metastasis via bone scan, and reporting moderate bone pain of at least 4 on a 0–10 scale.
• Patients were excluded if they were regularly receiving massage therapy, were undergoing surgeries or procedures during admission, or had allodynia, thrombocytopenia, spinal cord compression syndrome, deep vein thrombosis, or other contraindications to massage therapy.

• Single site
• Inpatient setting
• Five hospital oncology units

• Patients were undergoing the active treatment phase of care.
• The study has clinical applicability for end-of-life and palliative care.

The study was a randomized, controlled clinical trial.

• Present Pain Intensity (PPI) – Visual Analog Scale (VAS)     
• Mood VAS
• Relaxation VAS
• Sleep VAS
• Symptom Distress Scale
• Demographic and medical profiles

• Pre- to postintervention effects: No statistical significance was shown in individual patients.
• Results from MANCOVAs showed statistically significant intervention effects on pain, mood, and relaxation VASs, but not the sleep VAS.
• There was a significant linear group by time effect on relaxation VAS in both groups: F (1, 69) = 10.39, p = 0.002, indicating a different pattern of change in relaxation VAS change scores between the groups.

This trial documented therapeutic effects of massage on improving pain intensity, mood status, and muscle relaxation in patients with metastatic bone pain. The study has clinical implications supporting massage therapy and other medical modalities for optimal improvement in patients with cancer with bone metastases.

• The study had a small sample, with less than 100 participants.
• The patient population was heterogeneous.
• The study involved a short course of therapy.
• The study lacked multidimensional measurement of pain and patient binding.

Massage therapy may play an important role in cancer bone pain, sleep, and, mood.