Massage involves acting on and manipulating the patient's body with pressure (structured, unstructured, stationary, and/or moving), tension, motion, or vibration done manually or with mechanical aids. Target tissues may include muscles, tendons, ligaments, skin, joints, or other connective tissue, as well as lymphatic vessels, and/or organs of the gastrointestinal system. Massage can be applied with the hands, fingers, elbows, forearm, and feet. There are over eighty different massage modalities.  The most cited reasons for introducing massage have been patient demand and perceived clinical effectiveness.