To the Editor:
We enthusiastically read Dr. Alpert's recent editorial on the potential therapeutic benefits of massage.
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We found it encouraging that massage likely has real anatomical and physiological benefits, and look forward to recommending it to our numerous patients with both acute and chronic musculoskeletal discomfort.- Alpert JS
Is massage a beneficial intervention? [Online ahead of print].
Am J Med. 2022; (Mar 7])https://doi.org/10.1016/j.amjmed.2022.01.059
We also benefitted from Dr. Weil's closing comments highlighting the need for human touch, and its potential to stimulate release of oxytocin. Neither of us has training in massage therapy, but we do know how to perform a physical examination—and Dr. Weil's comments suggest there may well exist therapeutic benefit in doing so. Increasingly, clinicians reduce the physical examination's worth to sensitivities, specificities, and likelihood ratios. Dr. Weil's comments on the release of oxytocin and Dr. Alpert's broader comments on the benefits of human touch force us to question the wisdom of this reductionist approach.
Finally, we would like to point out one more parallel between the physical examination and massage therapy. Abraham Verghese
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popularized the characterization of the physical examination as ritual, and massage therapy also contains many features often associated with ritual: distinctive clothing, laying on of hands, choreographed movements, specialized language, and submission. Like other rituals, the physical examination and massage therapy provide an opportunity for abrupt departure from quotidian responsibilities. This departure creates a time and space for stillness, repose, and meaningful connection—all of which restore and rejuvenate. In caring for both ourselves and others, we ought not overlook the wide-ranging benefits of human touch.References
- Is massage a beneficial intervention? [Online ahead of print].Am J Med. 2022; (Mar 7])https://doi.org/10.1016/j.amjmed.2022.01.059
- The physical examination as ritual: social sciences and embodiment in the context of the physical examination.Med Clin North Am. 2018; 102: 425-431
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Funding: None.
Conflicts of Interest: None.
Authorship: MT and JM are jointly responsible for the conception, analysis, and drafting of this article. The views expressed are solely those of the authors and do not reflect the official policy or position of the US Army, US Navy, US Air Force, the Department of Defense, or the US Government.
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Published by Elsevier Inc.
