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TV program alleges that massage causes stroke, but where is the evidence?

Today Tonight, a channel 7 television program, made serious allegations in November 2006 about the safety of massage therapy. It was alleged on national television that massage therapy regularly causes stroke (1).

The program was about a lady in her twenties who tragically suffered a stroke and became paralysed from the neck down. The lady had a seated massage five days earlier by an experienced massage therapist. The program also publicised the launch of a public fund raising campaign to financially assist the tragedy that fell upon this lady.

Healthcare practitioners know from clinical experience that no words can ever describe such a tragedy, not only for the person concerned but also for family members and close friends. It was a noble act that Today Tonight publicised this fund raising campaign, and hopefully the response from the Australian community will be a generous one.

In keeping with the custom of these commercial television-programs, someone had to be a scapegoat for the tragedy. Such programs are notorious as being masters of the 'blame game'. As complementary medicine services are used by about 25% of the Australian population, of which massage therapy is the most popular service, then why not blame this tragedy on massage therapy?

By doing so, it would attract a greater viewing audience which is helpful for the program's ratings, as well as expose the publicity campaign to a wider audience. So why not? The drawback of such an approach is that it would cause fear and anxiety amongst users of massage therapy, and raise doubts about the safety of massage, but in the mind of commercial television, so what?

Of all the complementary medicine services in Australia, there is no doubt that massage therapy is very safe. In the interests of accurate information, the allegations made about massage therapy need to be clarified:

Allegation: Doctors believe her condition may have been caused by a simple massage gone wrong.

Fact: No evidence was produced by any doctor proving the causal relationship between massage and the stroke. No doctor appeared on the program to make this claim. It was the reporter who made this allegation to viewers. In the interests of public safety, why did a doctor not appear on television and directly tell viewers if this was really the case?

Allegation: The company had a masseuse available...

Fact: The massage therapist was a male, not a female.

Allegation: ... doctors believe (the massage) may have set off a tragic chain of events.

Fact: Which doctors believed this? Was it the treating physician or a general comment made by a doctor on the end of a telephone who was presented with a hypothetical scenario?

Why did none of the doctors appear on the program and make this claim?

Allegation: ... the cause was a massage on her back behind the neck.

Fact: No evidence was provided to support this allegation. If there is substantiating evidence to underpin this allegation, then why was it not produced?

Allegation: ... doctors see about one case a month of a massage causing serious injury.

Fact: In 2002-2003 the Victorian Department of Human Services funded a research project into the practice of naturopathy and western herbal medicine in Australia. The research was conducted through La Trobe University. The research project took 2 years to complete, involved 21 researchers and cost $198,000.

Part of the research involved seeking data from doctors on the adverse events that are caused by complementary medicine practitioners, including massage therapists. The researchers found that the seriousness of adverse events from massage therapy was about the same as Reiki, a modality where the therapist's hands are placed very lightly on or near the client. In other words, this Government funded research project found that massage is just about as safe as reiki (2).

While the researchers did recommend that naturopathy and western herbal medicine be regulated under statute, massage therapy was not recommended for statutory regulation as it is very safe.

In 2002, a survey of ATMS massage therapists was conducted by the University of Sydney (3). The research found that 34.4% of adverse reactions from massage therapy were skin reactions, 31.2% were of the headaches/nausea/digestive type, 15.1% involved muscular reactions and the remainder consisted of bruising, emotional reactions and exacerbation of symptoms. The research did not find any reports of stroke, or any other serious adverse event.

Other facts also show that massage therapy does not cause serious injury. ATMS is the largest massage therapy professional association, with a current membership of about 7,000 massage therapy practitioners nationally. The University of Sydney survey estimated that ATMS members conduct about 1.2 million consultations per annum (3). Despite this massive number of massage consultations being conducted each year, in the period 1990-2005 the ATMS professional indemnity master policy insurer did not receive any claims pertaining to massage and stroke (4). If the allegations made on television were of any substance, then close to 200 claims would have been made in this 15 year period. Yet, not a single claim was made.

Further the ATMS Complaints Committee has been established to handle complaints from patients about ATMS members. In the period 1995-2006, the ATMS Complaints Committee did not receive even a single complaint about massage therapy and stroke or any other serious physical injury (4). This is despite about 10 million massage consultations being conducted during this period.

The State and Territories Departments of Health take their responsibility very seriously to protect Australians from harmful practices. If it were the case that massage therapy caused stroke or serious injury, then the practice of massage therapy would be either stopped or restricted. But nothing could be further from the truth. The Departments of Health have expressed no desire to regulate the practice of massage therapy as it does not pose a public safety threat.

These facts ridicule the allegation that massage therapy causes stroke or serious injury on a monthly basis.

Allegation: (the massage) ... was unusually rough.

Fact: The massage therapist gave a light massage. At no stage was the elbow used during the massage as was portrayed on television.

Allegation: The industry as a whole is not regulated in Australia.

Fact: Self-regulation has been the regulatory model for massage therapists for the last decade. The Australian National Training Authority's National Health Training Package has standardised the educational training of massage therapists throughout Australia.

Many TAFEs teach massage therapy. It is curious that if there was no regulation of massage therapy, as was alleged by the program, then why would a government funded institution be involved in the teaching of massage?

Further safeguards lie in the fact that the Health Care Complaints Commissions of each State and Territory has the legal authority to investigate complaints about massage therapists. Additionally, the ATMS Complaints Committee can take action against massage therapists, including expulsion from the Society.

Additionally, the oils used by some massage therapists are regulated by the Therapeutic Goods Administration, which is part of the Commonwealth Department of Health and Ageing. Oils listed on the Australian Register of Therapeutic Goods must conform to the manufacturing requirements of the Code of Good Manufacturing Practice.

Massage therapy plays a very important part in the healthcare of many Australians. The attack on massage therapy to a national viewing audience is clearly unsubstantiated, unjustified and unfounded. As researchers have found, and the facts show, the safety of massage therapy is beyond any doubt.


(1) Yahoo 7 News. Accessed on 10 November 2006.

(2) Bensoussan A, Myers SP, Scott R, Cattley T. Risks associated with the practice of naturopathy and western herbal medicine. In Lin V, Bensoussan A, Myers SP, McCabe P, Cohen M, Hill S, Howse G. The practice and regulatory requirements of naturopathy and western herbal medicine. Melbourne: La Trobe University, School of Public Health, November 2005.

(3) Hale A. National Survey of Remedial Therapists. National Workforce Survey Data of the Australian Traditional-Medicine Society. Sydney: School of Behavioural and Community Health Sciences, University of Sydney, 2002.

(4) Khoury R. Submission by the Australian Traditional-Medicine Society to the School of Public Health, La Trobe University report The Practice and Regulatory Requirements of Naturopathy and Western Herbal Medicine November 2005. Meadowbank, Sydney: Australian Traditional-Medicine Society, October 2006.
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Author:Khoury, Raymond
Publication:Journal of the Australian Traditional-Medicine Society
Geographic Code:8AUST
Date:Dec 1, 2006
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