A study, reported early in 2004 in Psychotherapy and Psychosomatics, raised questions about the long-term effectiveness of massage therapy for the treatment of chronic pain. The study of 129 patients experiencing diffuse pain for at least 3 months found that chronic pain may worsen after massage treatments, especially if the patient is depressed.

Lead researcher Dan Hasson, RN, an acupuncturist, noted that diffuse chronic pain is a common problem and hard to treat. Studies of mental relaxation and massage have been inconclusive in determining which course of treatment works best. Therefore, Hasson's study examined massage versus mental relaxation. Of the 129 patients, half received 30-minute massages (1 or 2 times a week) during the 5-week study. The remaining patients listened to a mental relaxation tape 2 times a week.

"During the treatment, there was a significant improvement in all 3 main outcome measures: self-rated health, mental energy, and muscle pain in the massage group," said Hasson. At the 3-month follow-up, the results were quite different. The massage group reported significantly worse pain. The relaxation group did not report changes in symptoms. The patients with increased muscle pain reported less mental energy as well as feelings associated with depressed moods. Hasson concluded that his study supports the theory that depression and lower mental energy are related to long-term worsening of chronic pain.