Is it conceivable that massage can provide more effective relief from low back pain than medication? A new study published in the Annals of Internal Medicine suggests this therapy might indeed alleviate back pain better in the short term than traditional interventions of medicine, bed rest or exercise.
The investigation conducted by the Group Health Research Institute in Seattle involved 400 patients who had low back pain, the majority of which were middle aged, Caucasian and female. Researchers found those who were given a series of relaxation massage or structural massage were better able to work and be active than those who were given traditional medical care, such as pain pills, muscle relaxants or physical therapy.
According to The New York Times, the study’s participants were randomly divided into three groups: structural massage, relaxation massage and traditional care. Patients in the massage groups received one hour of therapy weekly for 10 weeks.
At the conclusion of the 10 week period, over one-third of the patients who were given massage therapy reported their pain was much improved or eliminated completely, as opposed to only one in 25 patients who were given traditional care. Furthermore, patients in the massage groups were twice as likely to have spent fewer days in bed rest, used less pain pills and participated in more activity than the traditional care group.
Lead author Daniel Cherkin was surprised by the fact that structural massage did not prove superior to relaxation massage in relieving pain. Structural massage involves manipulating specific back pain related muscles and ligaments, while relaxation massage, otherwise known as Swedish massage, involves inducing body-wide relaxation.
The beneficial effects of the massage seemed not only to be experienced during the 10-week therapy period, but also to linger for a time following the cessation of therapy. Evidence of this lingering effect was manifested by the fact that the massage groups continued to display improved function six months after the study’s onset. At the one year mark, however, no significant differences were found in the three groups.
Although the researchers were uncertain of massage therapy’s exact mechanism of action for easing back pain, they voiced several theories. One suggestion was that it either stimulated tissue locally or produced a general central nervous system response. Another speculation was that merely spending time in a relaxing environment and feeling cared for might have been responsible for the improvement. An additional factor to consider is the subjectivity that is impossible to eliminate in such studies. Patients in the control group were aware that the other groups were receiving massage and this knowledge may have caused them to discount their own progress.
It should be reiterated that the study suggests rather than proves the benefit of massage for back pain. Also, some members of the American medical community not associated with the research have expressed reluctance to accept the suggested benefits as being valid.
Conversely, the study’s authors offered their assessments of its import. Cherkin characterizes the results as being “pretty strong.” He states the massage was tested on patients who did not improve using the standard medical approach to back pain treatment. He feels that massage therapy is a reasonable thing to try for anyone getting insufficient relief from this malady. The coauthor, Dr. Richard Deyo, feels that massage appears to provide clinicians with another choice for managing the challenging medical problem of chronic low back pain.