Massage Therapy for Idiopathic lowback pain

What the research says...

Massage therapy has gained recognition as a potential treatment option for idiopathic low back pain. Several studies have explored the effectiveness of massage therapy in managing various types of pain, including chronic low back pain. Miake-Lye et al. conducted an evidence map that highlighted the potential benefits of massage for persistent back pain (Miake-Lye et al., 2019). However, the study calls for a more detailed approach into researching this topic, as well as caution for all physicians and medical providers that would apply such therapeutic modalities. Lee at al. performed a meta-analysis focusing on the effects of massage on pain relief, indicating positive outcomes (Lee et al., 2015). Additionally, Cherkin et al. compared traditional Chinese medical acupuncture, therapeutic massage, and self-care education for chronic low back pain, showing that massage therapy provided significant benefits (Cherkin et al., 2001).

A systematic review and meta-analysis was conducted on the efficacy, cost-effectiveness, and safety of complementary and alternative medicine for neck and low-back pain, including massage therapy as a treatment option (Furlan et al., 2012). Kumar et al. also emphasized the effectiveness of massage therapy for nonspecific low back pain in their systematic review of systematic reviews (Kumar et al., 2013). These studies collectively suggest that massage therapy can be a valuable nonpharmacological treatment for chronic low back pain.

One study investigated the effectiveness of deep tissue massage for low back pain in comparison to a combination therapy with non-steroidal anti-inflammatory drugs, demonstrating the potential benefit of massage therapy as a standalone treatment (Majchrzycki et al., 2014). Additionally, a recent meta-analysis showed massage therapy to be more effective than inactive controls (sham therapy or no treatment at all) for chronic low back pain in the short term (Field, 2021).

In conclusion, the current research supports the use of massage therapy as a promising approach for managing idiopathic low back pain. Studies have consistently shown positive outcomes in terms of pain relief and functional improvement. Massage therapists can benefit from incorporating these findings into their practice to provide effective care for individuals suffering from chronic low back pain.

Reviewed by Predrag Jancic, MD

References

Massage for Pain: An Evidence Map

“…The three RCTs that evaluated massage reported that this therapy is effective for subacute and chronic back pain. Initial studies suggest that massage is effective for persistent back pain; very low SOE.Lee (2015) A28 Focused solely on massage as the intervention; 12/12 includes relevant to massage; Quality Score: 9Style: body massage, foot reflexology, aroma massage; Provider: not provided; Co-interventions: none; Duration: provided; Comparators: providedCancer painThe authors report that massage therapy largely reduced cancer pain in patients in 12 studies. Comparing massage therapy with no treatment or conventional care, massage therapy was effective in relieving pain in cancer patients.…”

Isomi M Miake-Lye, Selene Mak, Jason Lee et al. 2019

The Journal of Alternative and Complementary Medicine

Meta-Analysis of Massage Therapy on Cancer Pain

Cancer pain is the most common complaint among patients with cancer. Conventional treatment does not always relieve cancer pain satisfactorily. Therefore, many patients with cancer have turned to complementary therapies to help them with their physical, emotional, and spiritual well-being. Massage therapy is increasingly used for symptom relief in patients with cancer. The current study aimed to investigate by meta-analysis the effects of massage therapy for cancer patients experiencing pain. Nine electronic databases were systematically searched for studies published through August 2013 in English, Chinese, and Korean. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) and Cochrane risk-of-bias scales. Twelve studies, including 559 participants, were used in the meta-analysis. In 9 high-quality studies based on the PEDro scale (standardized mean difference, −1.24; 95% confidence interval, −1.72 to −0.75), we observed reduction in cancer pain after massage. Massage therapy significantly reduced cancer pain compared with no massage treatment or conventional care (standardized mean difference, −1.25; 95% confidence interval, −1.63 to −0.87). Our results indicate that massage is effective for the relief of cancer pain, especially for surgery-related pain. Among the various types of massage, foot reflexology appeared to be more effective than body or aroma massage. Our meta-analysis indicated a beneficial effect of massage for relief of cancer pain. Further well-designed, large studies with longer follow-up periods are needed to be able to draw firmer conclusions regarding the effectiveness.

Sook-Hyun Lee, Jong-Yeop Kim, Seung Geun Yeo et al. 2015

Integr Cancer Ther

Randomized Trial Comparing Traditional Chinese Medical Acupuncture, Therapeutic Massage, and Self-ca

“…Symptom bothersomeness for the massage group at 1 year was 1.7 points lower than in the acupuncture group. The magnitude of the benefit of massage in this study (3.0 points on the Roland Disability Scale at 10 weeks) is double that found by other studies using the Roland Disability Scale and reporting significant effects of exercise 19 and cognitive-behavioral interventions 20,21 for chronic low back pain. *Data are given as mean (SD).…”

Daniel C. Cherkin1, David M. Eisenberg2, Karen J. Sherman3 et al. 2001

Arch Intern Med

A Systematic Review and Meta-Analysis of Efficacy, Cost-Effectiveness, and Safety of Selected Comple

Background. Back pain is a common problem and a major cause of disability and health care utilization. Purpose. To evaluate the efficacy, harms, and costs of the most common CAM treatments (acupuncture, massage, spinal manipulation, and mobilization) for neck/low-back pain. Data Sources. Records without language restriction from various databases up to February 2010. Data Extraction. The efficacy outcomes of interest were pain intensity and disability. Data Synthesis. Reports of 147 randomized trials and 5 nonrandomized studies were included. CAM treatments were more effective in reducing pain and disability compared to no treatment, physical therapy (exercise and/or electrotherapy) or usual care immediately or at short-term follow-up. Trials that applied sham-acupuncture tended towards statistically nonsignificant results. In several studies, acupuncture caused bleeding on the site of application, and manipulation and massage caused pain episodes of mild and transient nature. Conclusions. CAM treatments were significantly more efficacious than no treatment, placebo, physical therapy, or usual care in reducing pain immediately or at short-term after treatment. CAM therapies did not significantly reduce disability compared to sham. None of the CAM treatments was shown systematically as superior to one another. More efforts are needed to improve the conduct and reporting of studies of CAM treatments.

Andrea D. Furlan, Fatemeh-Maleknejad Yazdi, Alexander Tsertsvadze et al. 2012

Evidence-Based Complementary and Alternative Medicine

The effectiveness of massage therapy for the treatment of nonspecific low back pain: a systematic re

“…There is emerging evidence that massage may be an effective treatment option for treating low back pain when compared to placebo or sham therapies and other interventions (such as relaxation techniques) in improving short-term pain and disability. The role of massage as a moderately effective nonpharmacological treatment option has also been discussed by Chou et al and Imamura et al as a recommendation for chronic low back pain therapy. …”

Saravana Kumar, Kate Beaton, Tricia Hughes 2013

IJGMJ

Deep Tissue Massage and Nonsteroidal Anti-Inflammatory Drugs for Low Back Pain: A Prospective Random

“…Objective. To investigate whether chronic low back pain therapy with deep tissue massage (DTM) gives similar results to combined therapy consisting of DTM and non-steroid anti-inflammatory drugs (NSAID). Design. Prospective controlled randomized single blinded trial. Settings. Ambulatory care of rehabilitation. Participants. 59 patients, age 51.8 ± 9.0 years, with chronic low back pain. Interventions. 2 weeks of DTM in the treatment group (TG) versus 2 weeks of DTM combined with NSAID in the control group (CG). Main Outcome Measures. Visual analogue scale, Oswestry disability index (ODI), and Roland-Morris questionnaire (RM). Results. In both the TG and the CG, a significant pain reduction and function improvement were observed. VAS decreased from 58.3 ± 18.2 to 42.2 ± 21.1 (TG) and from 51.8 ± 18.8 to 30.6 ± 21.9 (CG). RM value decreased from 9.8 ± 5.1 to 6.4 ± 4.4 (TG), and from 9.3 ± 5.5 to 6.1 ± 4.6 (CG). ODI value decreased from 29.2 ± 17.3 to 21.4 ± 15.1 (TG) and from 21.4 ± 9.4 to 16.6 ± 9.4 (CG). All pre-post-treatment differences were significant; however, there was no significant difference between the TG and the CG. Conclusion. DTM had a positive effect on reducing pain in patients with chronic low back pain. Concurrent use of DTM and NSAID contributed to low back pain reduction in a similar degree that the DTM did.…”

Marian Majchrzycki, Piotr Kocur, Tomasz Kotwicki 2014

The Scientific World Journal

Massage Therapy Research Review

“…In a meta-analysis on 25 trials (3096 participants), massage was more effective than inactive controls for chronic low back pain in the short term but not in the long-term (Farber et al, 2016). Surprisingly, however, when compared to active controls, massage was more effective for pain reduction in both the short term and long-term.…”

Tiffany Field 2021

IJPRR