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Prolonged tension can often cause pain in other parts of the body. For example, headaches are often caused by overly tense muscles in the neck, shoulders, and lower back. Even contracted abdominal muscles can trigger headaches in certain people (a common complaint of women with menstrual difficulties).

For these tension-related conditions, Robert D. Milne, M.D., of Las Vegas, Nevada, an expert on headache relief, finds that massage can break up muscular waste deposits and stimulate circulation. He adds that accumulated metabolic wastes often form "trigger points" within muscles. These are specific areas that are painful to the touch. "They feel like knots or ropes within the muscle and perpetuate muscle tension," explains Dr. Milne. By applying deep pressure to these points, the tension or spasm can often be eliminated.

Massage may be the oldest and simplest form of medical care. Egyptian tomb paintings show people being massaged. In Eastern cultures, massage has been practiced continually since ancient times. A Chinese book from 2,700 B.C., The Yellow Emperor's Classic of Internal Medicine, recommends 'breathing exercises, massage of skin and flesh, and exercises

of hands and feet" as the appropriate treatment for -complete paralysis, chills, and fever. It was one of the principal method of relieving pain for Greek and Roman physicians. Julius Caesar was said to have been given a daily massage to treat neuralgia. "The Physician Must Be Experienced In Many Things," wrote Hippocrates, the father of Western medicine, in the 5th century B. C., "but assuredly in rubbing.. . for rubbing can bind a joint that is too loose, and loosen a joint that is too rigid."

Ayurveda, the traditional Indian system of medicine, places great emphasis on the therapeutic benefits of massage with aromatic oils and spices. It is practiced very widely in India.

Doctors such as Ambroise Pare, a 16th-century physician to the French court, praised massage as a treatment for various ailments. Swedish massage, the method most familiar to Westerners, was developed in the 19th century by a Swedish doctor, poet, and educator named Per Henrik Ling. His system was based on a study of gymnastics and physiology, and on techniques borrowed from China, Egypt, Greece, and Rome.

Physiotherapy, originally based on Ling's methods, was established with the foundation in 1894 of the Society of Trained Masseurs. During World War I patients suffering from nerve injury or shell shock were treated with massage. St. Thomas's Hospital, London, had a department of massage until 1934. However, later breakthroughs in medical technology and pharmacology eclipsed massage as physiotherapists began increasingly to favour electrical instruments over manual methods of stimulating the tissues.

Massage lost some of its value and prestige with the unsavoury image created by "massage parlors." This image is fading as awareness of the value and therapeutic properties of massage grows.

Massage is now used in intensive care units, for children, elderly people, babies in incubators, and patients with cancer, AIDS, heart attacks, or strokes. Most American hospices have some kind of bodywork therapy available, and it is frequently offered in health centres, drug treatment clinics, and pain clinics.

A variety of massage techniques have also been incorporated into several other complementary therapies, such as aromatherapy, reflexology, Rolfing, Hellerwork, and osteopathy.