Parkinson’s disease is a central nervous system disorder affecting movement. As nerve cells in the brain become damaged, dopamine levels drop, and sufferers experience a range of symptoms like tremors, stiffness, balance loss, and slow movement.
There is no cure for Parkinson’s disease, but many people living with this disorder are provided with treatment recommendations from their healthcare providers, such as medications and physical exercise. Some research also suggests that massage might benefit those experiencing various symptoms like discomfort, muscle spasms, sleep disturbance, and pain.
If you’re living with uncomfortable side effects related to Parkinson’s disease, explore massage therapy as an option to potentially experience relief.
Stress, Anxiety, and Depression
Many people with Parkinson’s Disease experience depressive symptoms, stress, apathy, and anxiety related to their condition. While such symptoms can often be managed with psychotherapy, medication, and lifestyle changes, some patients might experience relief with massage therapy.[1]
According to the systematic literature review, patients experienced non-motor symptom improvements in anxiety and depression with multiple massage techniques, including classical deep therapeutic massage, Thai massage, traditional Japanese ‘Anma’ massage, and neuromuscular therapy.
In general, massage therapy has also been shown to reduce psychological and physiological stress in some people[2]. Research by psychologists from the University of Konstanz found that just 10 minutes of rest or a head and neck massage might be all it takes to feel more relaxed and less stressed.
Muscle Stiffness and Rigidity
As dopamine levels drop in your body due to nerve cell damage in the brain, the balance of muscles relaxing and extending is disrupted. This can result in muscle rigidity and stiffness, which are among the most common symptoms associated with Parkinson’s disease.
While studies have shown that rigidity is one of the most challenging symptoms to reduce[3], it was achieved during massage therapy for a patient seeking temporary respite.
A 63-year-old patient with long-term Hoehn-Yahr Stage 4 Parkinson’s disease received massage therapy treatments five times over six weeks. Researchers used a SPES/SCOPA motor impairments rating scale to measure rigidity, enabling them to gauge treatment effectiveness.
With focused, intentional treatment, muscle rigidity was temporarily reduced. Massage therapists performed a Swedish massage for 10 minutes along the left arm and hand, with static contact, muscle squeezing, and movement therapy at the arm and hand. This therapy resulted in decreased rigidity and increased generalized patient relaxation.
Tremors
According to the Parkinson’s Foundation, 70% to 90% of people with Parkinson’s disease experience tremors at some point in their lives[4], with it being one of the most troublesome symptoms. While a range of treatment options exist to assist with tremor management, such as medication, anticholinergics, and deep brain stimulation (DBS), some people experience relief with massage therapy[5].
According to a case report, results of a patient experiencing tremors related to their long-standing Parkinson’s disease experienced a reduction in resting and postural tremors. In the case control study, one group listened to relaxing music while the other received two 45-minute neuromuscular therapy treatments (NMT) per week for four weeks. Tremor scores improved in the NMT group compared to the control group.
After a 10-minute Swedish massage focused on the left hand and arm with static contact, deep stroking, and muscle squeezing, they also experienced decreased tremors and increased generalized relaxation.
Constipation
Constipation is one of the most common non-motor symptoms experienced by people with Parkinson’s disease. It’s caused by the deterioration of neurological pathways responsible for the peristaltic reflex, resulting in slow colonic transit time and decreased bowel movement frequency.
It’s believed that up to 67% of people with Parkinson’s disease experience constipation[6], which can be painful, distressing, and debilitating. Symptoms and dysfunction can also be exacerbated through poor diet, weakness, fatigue, and decreased mobility.
Current constipation management techniques include increased fluid intake, a high-fiber diet, dietary modifications, and pharmacological treatment. However, some patients with Parkinson’s disease have experienced specific improvements with abdominal massages combined with lifestyle changes.
Fourteen patients forming part of a qualitative study were taught how to perform abdominal massage and were visited once weekly for six weeks to discuss their experiences with the massage techniques. Four members of the intervention group reported bowel problem improvements and advantages, such as:
- Reduced or no constipation
- More regular bowel movements
- Less bloating
- Less straining
- Increased sense of bowel movements occurring
- More relaxed
- More comfortable
- Easier bowel movements
- Reduced laxative use
- Increase in motivation to reengage in social activities
Many of those who didn’t experience relief chose to utilize alternative methods rather than carry on with abdominal massages, such as lifestyle improvements. Overall, study participants reported abdominal massage as a pleasant and relaxing experience that positively impacted them physically and emotionally.
Motor Function and Gait
Motor function in humans describes the motor system, which forms part of the nervous system, controlling voluntary movement. The brain, spinal cord, and nerves are part of our motor function. People with Parkinson’s disease experience a range of motor deficits, including speech, gait disturbance, impaired handwriting, and grip force[7].
A systematic review and meta-analysis exploring the effectiveness of therapeutic massage for improving motor symptoms in Parkinson’s disease[8] found that therapeutic massage was more effective than the control group interventions for improving motor symptoms.
While it wasn’t able to significantly improve the quality of daily living, it improved motor function through manipulation techniques on the muscles of different body parts. Gait improvements were also commonly reported through the stimulation of neck muscles.
The review outlined that manipulating limbs and trunks was pivotal to experiencing results. One massage therapist performed massage by thumb and thenar eminence of the hand on the paraspinal muscle, resulting in muscle relaxation and anti-rigidity. Another performed a head and facial massage, paying particular attention to the muscle used for chewing, expressing, and swallowing. This resulted in improved swallowing and speech functions.
After a thorough review of the available evidence, researchers were able to determine that therapeutic massage improved the overall condition and motor function better than control measures.
Therapeutic massage is not a primary treatment option for Parkinson’s disease. However, it might be a worthwhile complementary treatment for people experiencing uncomfortable and painful symptoms related to their reduced motor and non-motor functions, such as muscle stiffness and rigidity, constipation, mental health, and tremors.
References
1. ‘Massage therapy as a complementary treatment for Parkinson’s disease: A Systematic Literature Review’ by Efthalia Angelopoulou, Maria Anagnostouli, George P. Chrousosc, and Anastasia Bougea. Complementary Therapies in Medicine, Volume 49, March 2020, 102340
2. Maria Meier, Eva Unternaehrer, Stephanie J. Dimitroff, Annika B. E. Benz, Ulrike U. Bentele, Sabine M. Schorpp, Maya Wenzel, Jens C. Pruessner. Standardized massage interventions as protocols for the induction of psychophysiological relaxation in the laboratory: a block randomized, controlled trial. Scientific Reports, 2020; 10 (1) DOI: 10.1038/s41598-020-71173-w
3. ‘Massage Therapy Treatment and Outcomes for a Patient with Parkinson’s Disease: a Case Report’ by Yolanda Casciaro, BSc, RMT. Int J Ther Massage Bodywork. 2016 Mar; 9(1): 11–18.
4. Parkinson’s Foundation – Page reviewed by Dr. Jun Yu, Movement Disorders Fellow at the University of Florida, a Parkinson’s Foundation Center of Excellence
5. ‘Massage Therapy Treatment and Outcomes for a Patient with Parkinson’s Disease: a Case Report’ by Yolanda Casciaro, BSc, RMT. Int J Ther Massage Bodywork. 2016 Mar; 9(1): 11–18.
6. D. McClurg, K. Walker, P. Aitchison, K. Jamieson, L. Dickinson, L. Paul, S. Hagen, A.-L. Cunnington, “Abdominal Massage for the Relief of Constipation in People with Parkinson’s: A Qualitative Study”, Parkinson’s Disease, vol. 2016, Article ID 4842090, 10 pages, 2016. https://doi.org/10.1155/2016/4842090
7. Moustafa AA, Chakravarthy S, Phillips JR, Gupta A, Keri S, Polner B, Frank MJ, Jahanshahi M. Motor symptoms in Parkinson’s disease: A unified framework. Neurosci Biobehav Rev. 2016 Sep;68:727-740. doi: 10.1016/j.neubiorev.2016.07.010. Epub 2016 Jul 12. PMID: 27422450.8. Kang Zhiran, Xing Hua, Lin Qiang, Meng Fanchao, Gong Li, ‘Effectiveness of therapeutic massage for improving motor symptoms in Parkinson’s disease: A systematic review and meta-analysis.’ Frontiers in Neurology, Volume 13, 2022