Massage for pain: an overview of systematic reviews.

Introduction
This article is aimed at critically evaluating the evidence for or against the effectiveness of massage therapy on pain. Design: Review of systematic reviews.

Material and methods
Six databases were searched from their inceptions to June 2013. Systematic reviews (SRs) of randomised controlled trials (RCTs) of any type of manual massage (MM) with any type of pain as the outcome measure were considered eligible. The methodological quality of the included SRs was assessed using the Oxman criteria.

Results
Thirty-nine SRs met the inclusion criteria. Most of them were of high methodological quality. Twenty-one SRs arrived at equivocal conclusions (of these 13 were of high quality); 13 drew positive conclusions (of these 10 were of high quality); and 5 arrived at negative conclusions (of these 2 were of high quality). Unanimously positive conclusions were reached for cancerrelated pain, dysmenorrhea, labor pain, low back pain, neck pain and shoulder pain. Negative conclusions were drawn for tension-type headache, fibromyalgia and irritable bowel syndrome.

Conclusions
A wide variety of MM techniques were examined, including acupressure, aromatherapy, classical massage, connective tissue, Deep Transversal Friction Massage, ischemic compression, lymphatic drainage, myofascial, reflexology, Shiatsu, soft tissue massage, Thai massage and Tui na. The majority of high quality SRs showed moderate effectiveness of MM in the management of certain types of pain.