Limitations of this review
This umbrella review, like any other research, has its limitations,
and these need to be acknowledged in the context of the
findings. Firstly, while all attempts were made to interrogate
and access all relevant literature, it is possible some publications
may have been missed in the search process. This is
especially relevant for CAM topics, as publications in other
languages, originating from countries where English may not
be a first language, such as the People’s Republic of China
and India, may not be captured in Western databases. Secondly,
as there was a lack of clarity around the type, use, and
comparators of massage therapy in these systematic reviews,
the heterogeneity made it impossible to combine the findings
across all included systematic reviews and come to an absolute
conclusion. Thirdly, one of the recurrent issues when interpreting
these systematic review findings was the imperfect
primary research designs included in these reviews. Several of
the primary research studies had poor evaluations with several
methodological issues (such as lack of adequate descriptions
of interventions and poor long-term follow-up).