- March 5, 2025
- Andrea Winzer, MSc, LMT, BCTMB
- Special Population
Massage therapy offers several potential benefits for individuals with diabetes, including improved blood circulation, reduced neuropathic pain, and lower blood glucose levels. Research suggests that techniques like Swedish massage, reflexology, and Thai foot massage can help manage symptoms such as numbness, tingling, and mobility issues. Additionally, massage promotes relaxation, reduces stress, and enhances overall well-being, which can support better glycemic control. While findings are promising, further research is needed to fully understand the optimal techniques and long-term effects of massage for diabetes management.
Table of Contents
Key Takeaways
- Studies suggest Swedish massage, reflexology, and other bodywork techniques can support glycemic control by improving circulation and cellular glucose uptake.
- Techniques targeting the lower extremities may help reduce numbness, tingling, pain, and mobility issues caused by diabetic neuropathy.
- Since stress can negatively impact blood sugar levels, massage therapy may aid in overall diabetes management by lowering anxiety and improving well-being.
- Enhanced blood flow from massage therapy can aid in tissue health and potentially assist in healing diabetic foot ulcers and other complications.
- While existing studies show promising results, further research is required to better understand the best massage methods, pressure levels, and treatment durations for diabetic clients.
Understanding Diabetes And Its Impact
Summarizing results from several research studies, we can identify several key benefits of massage therapy for the diabetic client to guide our clinical practice.
Diabetes mellitus is a serious public health concern, currently affecting more than 422 million people globally.1 This chronic metabolic disease is characterized by consistently elevated blood glucose levels caused by an inability of the body to either effectively produce or utilize the hormone insulin.
Over time, increased blood sugar levels can lead to serious, potentially life-threatening complications including heart disease, stroke, kidney failure, blindness or amputations of legs and feet.2 In the U.S., more than 37 million people live with diabetes, and another 96 million adults are affected by prediabetes.
Rising Prevalence and Contributing Factors
Diabetes is currently the eighth leading cause of death in the U.S., and the prevalence rates have been steadily rising over the past 20 years due to risk factors such as poor nutrition, high-calorie diets, obesity, sedentary lifestyle, and prolonged stress.3
In addition, recent research suggests that the COVID-19 pandemic may also have caused a rise in diabetes risk. One study found that 28% of individuals recovering from COVID-19 infection were more likely to develop diabetes in the month after the infection.4 Another research study conducted with veterans in Germany found that individuals were about 40% more likely to develop diabetes up to one year after their COVID-19 infection compared to a control group. The likelihood of being diagnosed with diabetes was correlated with the severity of the COVID-19 infection, as patients in need of hospitalization showed triple the risk in comparison to a control group.5
The Role Of Massage Therapy In Diabetes Care
No matter what reasons eventually lead to a diabetes diagnosis, massage therapists need to be aware of the high prevalence rates of this chronic disease and learn to recognize associated symptoms and complications with which clients may present.
Using evidence-based therapies and current research to inform their clinical practice, massage therapists can play an important role in offering services to their diabetic clients that support them in managing their condition and achieving a better quality of life.6
Effects On Blood Glucose And Well-Being
When it comes to working with clients affected by diabetes or prediabetes, massage therapy has been shown to potentially provide numerous benefits. A systematic review of available research data conducted in 20017 suggests that Swedish massage supports the decrease of blood glucose levels in different client populations, both children and adults.
In addition, clients reported reductions in anxiety, depression, stress, and headaches and improvements in sleep and overall well-being. HbA1c levels (the average blood glucose levels over the past three months) decreased in most patients unless their glycemic control was influenced by other risk factors, such as extreme obesity or insulin injections.
Diabetic neuropathy of the lower extremities and associated symptoms of numbness, tingling, itching, pain or restless legs improved in most clients after applying massage therapy specifically focused on the lower extremities.
Bodywork Therapies and Diabetes Management
Another systematic review from 20208 evaluated the effects of bodywork therapies on changes in blood glucose levels (both fasting glucose levels and long-term glucose levels), improvements in clinical symptoms such as neuropathic pain, foot ulcers, back pain, or range of motion in joints as well as overall quality of life.
Many of the reviewed studies show improvement in all areas and the authors concluded that bodywork can most definitely play a major role in relieving diabetes-related symptoms; however, more research needs to be conducted to further determine the influence of the type of bodywork, the length of treatment and the intensity of pressure as well as the client’s unique condition and diabetes diagnosis.
Massage Modalities for Diabetes
Additional studies have shown the effectiveness of Swedish massage in reducing blood glucose levels in children with diabetes9 as well as the benefits of reflexology treatments to the reduction of blood glucose levels in elderly clients with type 2 diabetes.10
Chatchawan, et al.11 conducted a study on how Thai foot massage affected the balance of diabetic clients suffering from peripheral neuropathy.
Due to the loss of sensations on the plantar surfaces, diabetic patients frequently experience difficulties with body balance and the perception of movement. In this randomized parallel-controlled trial, the authors could show that by applying pressure along the Thai meridian lines of the foot and leg, range of motion of the feet, sensations as well as balance significantly improved. The study therefore suggests that this treatment approach could offer a viable alternative method used in home health care as well as in clinical settings when treating diabetic clients.
Addressing Health Disparities In Diabetes Care
According to the American Diabetes Association,12 diabetes disproportionally affects disadvantaged racial and ethnic minorities, socioeconomically underserved populations as well as uninsured individuals in the U.S. African Americans, Native Americans and Hispanics all suffer from higher levels of health burdens caused by diabetes and associated comorbidities and generally exhibit poorer glycemic control and more serious adverse diabetes-related health outcomes.
In the first pilot study of its kind conducted with African Americans suffering from diabetes, Edwards & Palmer13 utilized a combination of massage therapy and acupressure to examine the effects of bodywork on blood pressure, heart rate, blood flow, skin temperature, oxygen saturation, HbA1c (long-term blood glucose levels), and insulin level as well as overall well-being. The authors observed immediate effects on blood pressure, skin temperature and heart rate even though not all measures reached clinical significance.
Despite the promising results, larger randomized controlled studies are needed to further assess the health benefits of massage therapy as a useful adjunct to allopathic care for this population.
Key Benefits Of Massage Therapy For Diabetic Clients
Summarizing results from several research studies, we can identify several key benefits of massage therapy for the diabetic client to guide our clinical practice14:
• Increased blood flow and overall circulation may support the cellular intake of glucose from the bloodstream into the cells, affecting glycemic control on both fasting glucose and HbA1C.
• Myofascial stimulation can help increase tissue elasticity and reduce fascial restrictions, thereby increasing a client’s mobility and range of motion.
• Manual stimulation of the tissues can also contribute to an increased blood flow in the tissues, supporting the healing process of wounds, including foot ulcers.
• Neural manipulation can support a decrease in pain and may help restore nerve functionality and sensation for diabetic clients suffering from neuropathy.
• Relaxation can help reduce anxiety and depression associated with diabetes and support clients in an overall sense of increased well-being and health.
MTF Delivers Massage to Underserved Diabetes Patients
Through community grants, the Massage Therapy Foundation is committed to bringing therapeutic massage to people in need, including to those suffering from diabetes who cannot afford massage therapy treatments.
In 2010 and 2019, the MTF funded a project that delivered massage therapy for diabetes to underserved urban and rural indigenous regions and local indigenous communities in Mexico. The goal of the project was to enhance the skills of local massage therapists and to teach self-care massage techniques to clients and their families.
According to Leslie Korn, PhD, MPH, the director of this project, massage tailored to individuals affected by diabetes combined with education for continuous self-care significantly enhances overall well-being of individuals in these communities.
To learn more about the benefits of medical massage for diabetes and the project supported by the MTF of bringing massage therapy to indigenous communities in Mexico, visit cwis.org/massage-treatment-of-diabetes.
What the MTF Does for You
The Massage Therapy Foundation is a 501(c)3 providing support to the massage therapy profession. Since 1990, MTF has provided over $1 million in research grants studying the science behind therapeutic massage.
MTF founded and publishes an open-access, peer-reviewed scientific journal and provides many educational resources for massage therapists, educators, and students. MTF also provides community service grants to populations in need of therapeutic massage who would otherwise lack access.
About the Author
Andrea Winzer, M.Sc., LMT, BCTMB, holds a master’s degree in ecology and is a board certified massage and bodywork therapist. She practices CranioSacral Therapy and offers a variety of holistic treatment modalities with a focus on the integration of body-mind-spirit, release of physical and emotional trauma from the body, and supporting mental health therapies through trauma-sensitive bodywork. She wrote this article on behalf of theMassage Therapy Foundation.
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Footnotes:
1. World Health Organization. (2023). Diabetes. Health Topics. who.int/health-topics/diabetes#tab=tab_1
2. Centers for Disease Control and Prevention. (2022). Diabetes Report Card 2021. Diabetes Data and Statistics. cdc.gov/diabetes/library/reports/reportcard.html
3. Centers for Disease Control and Prevention. (2022). Diabetes Fast Facts. Diabetes Basics. cdc.gov/diabetes/basics/quick-facts.html
4. Harvard Medical School. (2022, July 1). Diabetes risk increases after COVID-19 diagnosis. Harvard Health Publishing. health.harvard.edu/diseases-and-conditions/diabetes-risk-increases-after-covid-19-diagnosis
5. Watson, C “Diabetes risk rises after Covid, massive study finds.” Nature. 2022. doi.org/10.1038/d41586-022-00912-y
6. Hawk, C, Ndetan, H, Evans, MW, Jr. „Potential role of complementary and alternative health care providers in chronic disease prevention and health promotion: an analysis of National Health Interview Survey data.”Preventive Medicine,54(1), 18–22. 2012. doi.org/10.1016/j.ypmed.2011.07.002
7. Ezzo, J, Donner, T, Nickols, D, Cox, M. “Is massage useful in the management of diabetes? A systematic review.” Diabetes Spectrum, 14(4), 218–224. 2001. doi.org/10.2337/diaspect.14.4.218
8. Bayat, D, Mohammadbeigi, A, Parham, M, Mehrandasht, A, Hashemi M, Mahlooji, K, Asghari, M. “The Effect of Massage on Diabetes and its Complications: A Systematic Review.” Crescent Journal of Medical and Biological Sciences Vol. 7, No. 1, Jan. 2020, 22–28. cjmb.org/uploads/pdf/pdf_CJMB_413.pdf
9. Sajedi, F, Kashaninia, Z, Hoseinzadeh, S, Abedinipoor, A. “How effective is Swedish massage on blood glucose level in children with diabetes mellitus?”Acta Medica Iranica,49(9), 592–597. 2011.
10. Sari, LT, Wibisono, W, Renityas, NN. “The effectiveness of reflexology massage to the reduction of blood sugar level of elderly with type 2 diabetes mellitus.” Journal of Ners and Midwifery, 9(2), 142–147. 2022. doi.org/10.26699/jnk.v9i2.art.p142-147
11. Chatchawan, U, Eungpinichpong, W, Plandee, P, Yamauchi, J. “Effects of Thai foot massage on balance performance in diabetic patients with peripheral neuropathy: a randomized parallel-controlled trial.”Medical science monitor basic research,21, 68–75. 2015. doi.org/10.12659/MSMBR.894163
12. Meneghini, LF, Fortmann, AL, Clark, TL,Rodriguez, K. Making inroads in addressing population health in underserved communities with type 2 diabetes.” Diabetes Spectrum, 32(4), 303–311. doi.org/10.2337/ds19-0010. 2019.
13. Edwards, BG, & Palmer, J. “Effects of massage therapy on African Americans with type 2 diabetes mellitus: A pilot study.” Complementary Health Practice Review, 15(3), 149–155. doi.org/10.1177/1533210110390024. 2010.
14. Gialelis, J. “Five Ways Massage Improves Diabetes Care.” massagemag.com/5-ways-massage-improves-diabetes-care-33522. 2015.
