Massage for back pain: almost evidence-based!

Low back pain is a huge health problem, and massage therapists claim to get good results when treating low-back pain. Indeed, low back treatments are the bread and butter of the profession. I guess that about 75% of massage purchases are for back pain. The amount of money that patients around the world spend on massage for back pain must be simply huge, certainly at least in the tens of millions annually and probably much more. As with chiropractic care, massage therapists might not have much of a business model if people didn’t have low back pain.

So it had better work!

And, fortunately, the evidence seems to suggest that it does. Over 20 years, an accumulation of scientific evidence has been adding up to a nice conclusion: that massage therapy probably does work for low back pain. That’s the finding of a comprehensive review of the science, from a 2008 review by Furlan et al.

Massage is beneficial for patients with subacute and chronic non-specific low-back pain in terms of improving symptoms and function … The beneficial effects of massage in patients with chronic LBP are long lasting (at least one year after end of sessions).

That glowing conclusion was based on just 13 trials (about 1600 participants), and the best of data of the lot is merely okay. But massage “wins” anyway. Massage mostly performed quite well in these tests. And, better yet, the results were also positive in the more rigourous tests.

The largest study of massage for low back pain ever done was published in 2011, and its very credible authors — medical back pain experts Daniel Cherkin and Richard Deyo, in particular — did conclude that “Massage therapy may be effective for treatment of chronic back pain, with benefits lasting at least 6 months,” but those results were uncertain due to a major flaw, and somewhat overstated. It seems to me that the results actually damn massage with faint praise. If massage is good for back pain, shouldn’t the results have been a more a bit more impressive? Despite its “positive” results, this study is a bit of a mood dampener.

So, is massage therapy for low back pain “proven” to be effective? Ha! Obviously not by a long shot. But the science is off to a good start — much better than most other popular low back pain therapies. It’s genuinely promising. 

Does Massage Therapy Work?

by Paul Ingraham, Vancouver, Canada

Remedial Massage in Work Related Stress, Pain and Discomfort

In modern society with high rhythm life style and stressful work environment, for many people, work poses primarily psychological and emotional demands, instead of physical demands, and the pace of work is more and more dictated by patients, clients, customers and so on. Work related musculoskeletal injuries (MSI) have become a serious problem in workplace in different occupations such as healthcare professions, police and teachers. Existing researches have provided strong support for the effects of remedial massage for chronic low back pain, shoulder pain and headache.

The practice of massage therapy has been defined as the assessment of soft tissue and joints of the body and the treatment and prevention of dysfunction, injury, pain and physical disorders of the soft tissue and joint by manual and physical methods to develop, maintain, rehabilitate or augment physical function to relieve pain and promote health. Massage therapy had been describe as having 4 principal goals of treatment: (1) to promote relaxation and wellness; (2) to address clinical concerns; (3) to enhance posture, movement, and body awareness; and (4) to balance and “move” subtle energy reported that people who received massage therapy had significantly reduced back pain symptoms comparing with the control group. Massage therapy is recognized as a safe therapeutic modality without risks or adverse effects. However, there are contraindications, such as applying massage over an area with acute inflammation, skin infection, nonconsolidated fracture, burn area, deep vein thrombosis or active cancer tumor. So it is important for a massage therapist to take a detailed case history and determine the best form of treatment before performing the massage for the clients .

Remedial massage is also an effective intervention to reduce work related anxiety, depression and improve job satisfaction and work place morale. In a recent study in Healthcare professions in Canada, A few researchers reported that people in different age groups from 20 to 62 years showed a significant decrease in back pain severity after 4 weeks massage therapy. Meanwhile several study showed a trend toward improvement of quality of life and job satisfaction associated with the massage intervention.  Massage also may save money by reducing health care provider visits, the use of pain medications.