Complementary Modalities: Body Massage and Acupuncture


            Many researches have been studied about the effectiveness of the Body massage and Acupuncture.  Since both of these procedures has been identified as one of the highly recommended Complementary Alternative Medicine in Health Care Delivery System, these modalities is truly patronized by others to used it as an alternative medicine as procedures in their deviations or alteration in the body.

Many of these individuals has been observed to be feel relief when are committed to this kind of procedure.  Incorporate to these study are the facts and information that would determine the effectiveness of those identified modalities.  These study will:

The study will include variables choices of preference in treatments between men and women.

The study will also show that there is significant research at present that show its effective results and how beneficial this form of treatment could advance the nursing practice.

The study should show a connection and or a relationship, similar in likeness between the two groups of both men & woman.

This study will give credence to the answers we seek to find, showing a correlation of alternative therapies that alter, relieve, or irradiate pain.

A Close Look to Specific Complementary Modalities as Nursing Intervention in Health Care Delivery System: Body Massage and Acupuncture


            Although nurses have always been concerned with the whole person, they are increasingly embracing ideas about health and healing that are very different from those that inform the health care delivery system.  Conceptualizations of health, disease, pain and death vary widely from culture to culture.  The same is true for the therapies or practices designed to promote health, cure disease, ease pain and suffering, and give meaning and dignity to death.  Nurses are progressively incorporating ideas and therapies from other cultures and traditions into their practice.  These therapies include massage, imagery, meditation, acupressure, art and music therapy, tai chi and chi gong exercise, therapeutic touch, prayer and spiritual work.

            A number of terms have been used for the therapies just mentioned, including nonorthodox, unconventional, alternative and complementary.  The Medical Subject Headings (MeSH) of the National Library of Medicine refer to Complementary Therapies, define as “Therapeutic practices which are not currently considered an integral part of conventional allopathic medical practice.  They may lack biomedical explanations but as they become better researched some (physical therapy, diet, acupuncture) become widely accepted whereas others (humors, radium therapy) quietly fade away, yet are important historical footnotes.  Therapies are termed as Complementary when used in addition to conventional treatments and as Alternative used instead of conventional treatment” (National Library of Medicine, 2003).

            Many of us wouldn’t know that there were such CAM or Complementary Alternative Modalities has been proposed in the health care delivery system.  CAM is consist of a large variety of modalities that are based on a set of beliefs different from those allopathic medicine.  Some of these modalities have developed fairly recently such as imagery, while others have been used for thousands of years as component of ancient healing systems.  Some modalities can be used effectively without assistance, while others are more effective when used with guidance from practitioners who have particular knowledge and expertise.  Some of these modalities identified are Body massage and the Acupuncture.  Many patients use these types of care as outpatients.  An understanding of these modalities is important for the nurse because when outpatients use allopathic modalities (use of herbs), the patient may be admitted as inpatients.

            The term Complementary and Alternative Medicine (CAM) was first articulated at the national level in 1996: “Complementary and Alternative Medicine is defined through a social process as those practices that do not form as part of the dominant system for managing health and disease” (Jonas, 1996).

            Massage and Acupuncture are two of the stated CAM that is believes to be useful and effective.  Both of these identified modalities are still intact to health care delivery system.  Many of the individuals who used these kinds of modalities are still questioning what modalities are effective and useful to specific deviations or alterations in the body.  How both of these modalities differentiate from men and women.  As you read this research you will gain knowledge on these identified modalities.

            This study is aimed to determine the factors that contribute why men and women frequently used these kinds of modalities according to their alterations.  What modalities are prepared used by men and women?  What other alterations would suggest that both these modalities is indicated to specific individual.  As you read you will find those answers as the researchers provide a comprehensive research on these study.

Statement of the Problem

1.      What is Complimentary Alternative Modalities or CAM?

2.      Define what is massage and acupuncture as part of the CAM?

3.      Indication of CAM to men and women? How these indication differ from both gender?

4.      What is the importance of CAM in health care delivery system?

5.      Why do men prefer massage therapy to relieve pain as opposed to women who choose acupuncture to relieve pain”?

Purpose of the Study

            This study will determine the preferable alternative modalities in both men and women.  Moreover this identification will further identify or anticipate the clients want in his or her treatment.  Also, after reading this study, you will find out how these identified modalities such as the body massage and the acupuncture helps our body recover from illness and attain optimum level of functioning as individual in this society.

            Aside from those identified purpose above, this study also is to determine what the current perceptions about the identified modalities and why more and more people are seeking alternative therapies rather than seeking traditional methods of surgery or long-term use of medications.


            There is no significant relationship between men prepared modalities to women’s prepared alternative CAM.

Theoretical Framework

This study utilized Abraham Maslow’s theory of Human Needs wherein human needs are rank on an ascending scale according to how essential the needs are for survival.  The five levels in ascending order are physiologic needs (needs such as air, food, water, shelter, rest sleep, activity and temperature maintenance are crucial for survival), Safety and security needs (both physical and physiological aspect like physical environment and its relationship), Love and belonging needs (includes giving and receiving attention), self-esteem needs (feelings of independence, competence, self respect and appreciation), and lastly, self actualization (the innate need to develop one’s potential).

            This theory shows relevance to the study because it can serve in such a way that it can be a basis or evaluative measures regarding the person’s state of health.  Loss or absence of these needs may produce alteration in health or presence of illness.  The occurrence of body pain might affects the clients physiological needs thus making them prone to illness.  Our body needs rest for quite sometime, we need also a good diet, sleep and rest for us to live in this world health and attain optimum level of functioning.

Literature Review

            The term Complementary and Alternative Medicine (CAM) was first articulated at the national level in 1996: “Complementary and Alternative Medicine is defined through a social process as those practices that do not form as part of the dominant system for managing health and disease” (Jonas, 1996).

            Many people in the United States are using Complementary and Alternative Modalities (CAM) to promote health and assist with healing from illness.  The widely used term “Complementary and Alternative Medicine” refers to interventions that are complementary (they can be used with traditional interventions and thus complement them) as well as alternative (not included in the scope of traditional medical care).  However, the reality is that people without medical degrees practice many of these modalities.  Therefore, many nurses are using the term “complementary and alternative modalities” since it is more inclusive.

            One would hope, as we move into a new millennium, traditional medicine would embrace a newer method to relieve pain. If science can put a man on the moon, or a vessel up into the space, clearly this research study will show the effectiveness of an alternative therapy in relieving pain”. By seeking out these answers, we can advance our nursing practice through knowledge, education and raising the standards of care through integrative practice.
Moreover, many people benefit from acupuncture or massage therapy, and from one who has experienced an alternative treatment first hand, the question that is daunting is; “does everything need to be scientific or evidence based for a treatment to be effective?

            There is a personal interest to learn how to apply this knowledge and integrate alternative therapy into the nursing practice, which would enhance the practice by providing additional quality care.  Former National Institutes of Health (NIH) research director Bausell takes on the entire complementary and alternative medicine (CAM) industry, shining a bright, scientifically trained light upon its claims of often-miraculous cures. By explaining in lengthy detail how to interpret true scientific data, he exposes the underbelly of pseudoscientific research that feeds mass media’s hence, the publics desire”.

            Massage is the stimulation of the skin and underlying tissues for the purposes of increasing circulation and inducing a relaxation response.  Massage and the use of touch have long been part of nursing practice.  More recently, the benefits have been more precisely identified and categorized as physical, mental-emotional, and spiritual.  Physically, massage relaxes muscles and releases lactic acid that accumulates during exercise.  It can also improve the flow of blood and lymph, stretch joints, and relieve pain and congestion.  Massage is thought to release body toxins and stimulate the immune system, thereby helping the body combat disease. In the mental-emotional area, massage can relieve anxiety and provide a sense of relaxation and well being.  Spiritually, it provides a sense of harmony and balance.  He individuals receiving massage may enter a meditative state, thus relaxing and expanding their awareness.

Lawrence, as reported by White (1988), has defined massage as the

“kneading, manipulation or application of methodical pressure and friction to the body.”

This technique is instinctive, as it is a natural response to rub our own aches and pains.  Hippocrates, in the fifth century B.C., was one of the first to describe massage as a therapeutic intervention.

As with the other non-pharmacological methods, little is known about the mechanism by which massage produces analgesia.  Jacobs (1960) suggested that massage interrupts the pain cycle by two peripheral effects.  The mechanical pressure of massage on superficial venous and lymphatic channels improves circulation directly, reducing the pain associated with edema.  Second, massage causes capillary and , if strong enough, arteriole dilation through some unknown reflex mechanism.  This further improves circulation.

More recently, Day Mason, and Chesrown (1987), evaluated the effects of massage on plasma beta-endorphin level in 21 healthy adults before and after a 30 minute back massage.  They found no significant differences in plasma beta-endorphin levels but recommended a similar study be carried out on those suffering acute or chronic pain.

When acupuncture points also called as acupoints, are massaged with cold (ice massage), afferent stimulation is thought to activate brain stem mechanisms that are known to exert descending inhibitory influences on pain signals.  The afferent stimulation achieved with ice massage of an acupoint is thought to be higher intensity than when other areas of the body surface are similarly treated.  Therefore the analgesic effect is greater.

Massage therapy relieves pain through (1) Prevents formation of adhesions, (2) decreases blood pressure, (3) Increases lymphatic flow, (4) Increases blood flow, (5) Provides relaxation, (6) Loosens scar tissue.  There has been identified different techniques of massage. And these include the following: (1). Ischemic compression, (2) Deep friction massage, (3) Rolfing

Deep fiction massage is a method delivers deep massage transversely across tissue fibers over a very small area.  The purpose is to relieve pain; free adhesions break up scar tissue and restore mobility.  It is believed to relieve pain by causing traumatic hyperemia, stimulating mechanoreceptors, and increasing tissue perfusion.  Ischemic compression was made for the treatment of trigger and tender points.  The technique involves sustained pressure over the painful area for a period of about 90 seconds.  It is believed that the ischemic pressure causes a reactive traumatic hyperemia that inactivates the trigger or tender point

Massage techniques include the back rub, a very traditional part of care, frequently given to clients on bedrest confined to wheelchairs and before hours of sleep.  Also, techniques of stimulating the skin to increase circulation during bathing are massage techniques.  These basic massage techniques are taught to student nurses and are included in texts of fundamentals of nursing skill (Perry & Potter, 1994).  Nurses are skilled in the basic massage movements of effleurage (long, soothing strokes) to increase circulation and tapotement (stimulating rapid percussive movements) and petrissage (kneading motions) for stimulation.

In previous years, back massage was a routine aspect of nursing care of hospitalized clients.  However, this is no longer as common as in the past.  Research by Smith, Kemp, Hemphill, and Vojir (2002) compared the pretest and port test ratings of pain, symptom distress, sleep and anxiety in patients who received therapeutic massage and those who did not.  The research results showed that mean scores of pain and symptom distress were significantly improved for the massage group.

Massage is an inexpensive; reasonably easy-to-learn technique but requires much time to perform.  However, because of its simplicity, family members can carry out the treatment with relatively little instruction.  At present, objective evidence of the therapeutic value of massage is scare.

            Another treatment modalities as stated in the Traditional Chinese Medicine or TCM is Acupuncture.  Traditional Chinese Medicine or TCM is based on the premise that the body’s vital energy or qi circulates through pathways or meridians and can be accessed and manipulated through specific anatomical points along the surface of the body.  Disease is described as an imbalance or interruption in the flow of qi.  The focus of the acupuncture treatment is to restore balance and free flow of qi in order to help the body to heal itself.  This is achieved by the insertion of fine, sterile needles into specific points along meridians, in various areas of the body.  Once inserted, the needles may be heated, stimulated by a mild electrical current or manipulated manually.

            According to NIH “there is sufficient evidence of acupuncture’s value to expand its use into conventional medicine and to encourage further studies of its physiology and clinical value” (Acupuncture, 1997).  Research has shown that acupuncture is effective in relieving postoperative pain and nausea associated with pregnancy and chemotherapy (Acupuncture, 1997).  Acupuncture appears to be effective in a wide variety of conditions including stroke, headache, chronic low back pain, menstrual cramps, muscle pain, carpal tunnel syndrome, addiction, asthma and pregnancy-associated nausea.

            Nurses with a holistic orientation often use a variety of self-care practices in their own lives.  The relative health and well-being of the nurse constitutes a vital force in the healing process.  Body massage and acupuncture are both modalities that can be used by the nurses to his or her client.  But of course, in order for the nurse render this kind of health care, he or she must know first its principle and uses of those identified modalities which requires advance training.  In addition to having the requisite skill, nurses must be familiar with the legal scope of nursing under which they practice.  A good example of these are the protocol in California states that (Sparber, 2001):

            “Complementary and Alternative techniques for reducing pain such as focused breathing and relaxation, massage, guided imagery, humor, music, and distractions, as well as medication therapy for reducing pain (conventional therapy).  The more complex complementary and alternative therapies become part of advanced education and nursing practice, frequently in the context of continuing education workshops or seminars; examples include acupressure, aromatherapy, massage, yoga and reflexology.  Acupressure and chiropractic require licenses to practice in California.  Applied kinesiology, herbal therapy, homeopathy and ayurveda usually require formal education preparations and practice, and in some instances these therapies have private certification.

Despite the early acceptance of acupuncture as an alternative therapy in most Asian and European countries, acupuncture did not receive the same degree of attention in he United Sates until the early 1970s.

A report by James Reston of the New York Times, which described his own experience with pain and nausea relief with acupuncture after undergoing an appendectomy in china, prompted widespread interest in acupuncture in the United States.  Since then, the national Institutes of health (NIH) has funded several projects to study the mechanisms of acupuncture.  In 1998, after reviewing current acupuncture-related literature, a panel of experts from NIH concluded that acupuncture is effective in two conditions: Post operative or post chemotherapy nausea and dental pain.  In addition, the panel also concluded that acupuncture “may be effective” in a few other conditions as an adjunct treatment or an acceptable alternative therapy, which can be included in a comprehensive management program.

Massage therapy helps you relax, re-align and rejuvenate. There are many positive aspects to receiving massage therapy on an ongoing basis, and with the busy lives we lead, we can all benefit from a little stress-management. More Americans are turning to therapeutic massage treatment to provide relaxation, relieve tension associated with the daily stresses of their busy lives, or simply to help maintain good health and achieve a balanced lifestyle.  There are so many healthy benefits to receiving massage therapy on a regular basis: Relieves Stress, Encourages Relaxation, Improves Posture, Improves Circulation, Helps Manage Pain, Relaxes Muscles.  Recent scientific research also proves that massage therapy increases immune function, decreases stress levels and reduces recovery time.  Not only will massage therapy help alleviate the previously mentioned conditions, but it also has positive effects on men suffering from heart disease, as well as poor circulation.

Acupuncture is a well known for the control of pain, acupuncture benefits a wide variety of disorders. Respiratory disorders such as sinusitis, common cold, bronchitis and asthma can be effectively treated with acupuncture.  Conjunctivitis, (pink eye), nearsightedness and cataracts are a few of the eye disorders acupuncture benefits. Toothache can be reduced through acupuncture. Neurological and musculoskeletal disorders including paralysis following stroke, frozen shoulder or Tennis elbow, sciatica and osteoarthritis are also treatable with acupuncture.  With certain health conditions, acupuncture can be effective enough to reduce or eliminate the need to take drugs to control pain or symptoms. Additional benefits of acupuncture are faster recovery from injuries, decreased symptoms of stress and improved circulation.  Acupuncture benefits the strengthening of the immune system function, which through treatment is better able to withstand colds, minor infections, and flu.  Post-surgical nausea and vomiting can also be reduced through acupuncture. Many post-surgical patients find that acupuncture treatment is effective in increasing energy, and brings a sense of vitality. It also benefits the individual through a sense of restoring a sense of “normal self” after surgery or illness.  Often used as a form of preventative medicine, acupuncture is beneficial in preventing illness from occurring. Many people receive acupuncture without suffering from any particular malady or ailment. Treatment strengthens general constitution, and can correct a feeling of being unwell although there is no physical disorder, imbalance or illness in the traditional Western medicine sense.

Methodologies: Design and Sampling

            The researchers used qualitative research method to further identify and interpret the study.  Since qualitative research is associated with the naturalistic inquiry, which explores the subjective and complex experiences of human beings.  Qualitative research investigates “the human experience as it is lived through careful collection and analysis of narrative, subjective materials” (Polit & Hungler, 1999).  The appropriate research design and sampling methods proposed for this research is qualitative study, which will be collecting data to address the research questions. Careful consideration to the type of questions was given in order to protect the “integrity, interpretability, and clinical utility of the results”.

            The number of participants will be randomly selected between genders. The study participants and sample size would be subject to groups of four families each within the population stratum.  This sample size will include equal number of men and women who experienced pain and have participated in using in an alternative therapy.  There is less chance of bias when“ the sample includes an appropriate number of cases from both strata” (Polit & Beck, 2006, p.262).  The study population consists of men and women between the ages of 45 yrs to 70 yrs old who experience pain and have chosen to use alternative methods to relieve or reduce their pain.  However, in a qualitative study, “many researchers believe that anything posted electronically is in the public domain and therefore can be used without consent for purpose of research”. (Polit & Beck, 2006, p.90).

            The researcher uses an face-to-face interview in order to gather from those respondents that re necessary to the study.  But, before the researcher conduct interview, the researcher provide first an Informed Consent to be sign by or client, explaining to them that they are subjected to the researcher’s study, thus this also protects the clients confidentiality.  People have a right to make an informed decision to participate in an actual study. Therefore, “the broad principle in the Belmont Report concerns justice. The principle includes participant’s right to fair treatment and their right to privacy” (Polit & Beck, 2006, p.90).  “Virtually all research with humans constitutes an intrusion into personal lives; therefore, researchers should ensure that research is no more intrusive than it needs to be and that the participant’s privacy is maintained throughout the study”. “Participants have the right to expect that any data they provide will be kept in the strictest confidence” (Polit & Beck, 2006, p.91).  Qualitative studies “involve efforts to tightly control various aspects of the research”. The researcher controls the relationships between the dependent and independent variables by eliminating anything that could taint alter or skew the essence of the study and its focus.

Data Collection and Analysis

As said by others, “Men are not as used to nurturing themselves and taking care of themselves as women are,” it is said also that men has this anxiety of societal perception that they are supposed to be tough and hard, not needing outside support – a fear that their masculinity may in some way be attacked or jeopardized.  In some cases, they may fear being touched, especially by a male or female  massager.  They might have fear that sexual feelings might come up during a session, whether with a male or female therapist.  But then male are more prepare for having massage rather than acupuncture as to relieve in pain.  In addition to this, male is very inpatient individual, they don’t want to wait for so long as for the acupuncture session which will take for many hours each sessions, they might be feel bored in the procedure.  On the other hand, massage is the most comfortable procedure for men because it make use of the body, men are tend to be more relax when they are in the massage procedure.  Since men are the one who works daily, wherein all of the muscle in the body is used, by the end of the day, they might feel tired and exhausted, a good massage is enough to relieve the stress and pain experience by the men.

There are also some men who use also acupuncture, but the female uses acupuncture more.  Female tend to be very patient and want to have a peace and calm environment They find acupuncture as peaceful as possible.  Since massage is also beneficial in female especially those who is pregnant women who is experiencing back pain.  But most of the women today prepared to have acupuncture as means of relieving their pains.


            Both of these modalities are very useful if the client want to have an alternative medicine.  Such modalities, a client can save money from buying drugs for their alterations or deviations, and also saves him from the adverse reactions of these drugs that might give him or her allergic reactions to his or her body.  Unlike those identified modalities, we can surely tell that is safe and natural.  Of course to attain those matter, a health care provider must be trained very well or attend a specialized educational program for these alone.


Acupuncture. (1997). NIH Consensus Statement Online. 15(5): 1-34. Retrieved April 7, 2003, from

Bausell, R.B. (2007). The Truth about Complementary and Alternative Medicine., (p.368). illus. Oxford, (9780195313680). 615.5.

Day, J.A., Mason, R.R. & Chesrown, S.E. (1987). Effects of Massage on Serum Level of Beta-Endorphin and Beta-Lipotropin in Healthy Adults. Physical Therapy, 67(6), 926 – 930

Jacobs, M., (1960). Message for the Relief of Pain: Anatomical and Physiological Considerations. American Physical Therapy Association, 40 (2), 93 – 98

Jonas, W. B. & Levin, J. S. (2000). Essentials of Complementary and Alternative Medicine. Philadelphia, PA: Lippincott.

National Library  of Medicine (2003). Medical Subject Headings: Complementary Therapies, Retrieved February 24, 2004 from http://www/

Perry, A.G. & Potter, P.A. (1994). Clinical Nursing Skills and Techniques 3rd edition. St. Louis: Mosby.

Polit, D.F., & Beck, C.T. (2006). Essentials of Nursing Research: Methods, Appraisal, and Utilization (6th Ed). Philadelphia: Lippincott Williams & Wilkins.

Polit, D. F., and Hungler, B. P., (1999), Nursing Research: Principles and Methods 5th edition, Philadelphia: Lippincott

Polit, D.F., Beck, C.T., and Hungler, B.P. (2001). Essential of Nursing Research: Method, Appraisal, and Utilization 5th edition. Philadelphia: Lippincott

Smith, M.C., Kemp, J., Hemphill, L., & Vojir, C.P. (2002). Outcome of Therapeutic Massage for Hospitalized Cancer patients. Journal of Nursing Scholarship, 34, 257 – 262

Sparber, A. (2001).  State Boards of Nursing and Scope of Practice of Registered Nurses Performing Complementary Therapies. Online Journal of Issues in Nursing, 6 (3), Article 10.

White, J.A., (1988). Touching with intent: Therapeutic massage. Holistic Nursing  Practice, 2 (3), 63 – 67


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