Massage Improves Function, Reduces Pain and Anxiety Associated with Subacute Low-Back Pain
"Effectiveness of massage therapy for subacute low-back pain" was conducted by Michele Preyde, a Ph.D. student in the Faculty of Social Work at the University of Toronto and a member of the College of Massage Therapists of Ontario. It was originally published in the Canadian Medical Association Journal.
Ninety-eight subjects with an average age of 46 participated in the study. Each subject complained of subacute low-back pain lasting anywhere from one week to eight months, and 60 percent of the participants said their pain lasted longer than three months.
Subjects were randomly assigned to one of four groups: comprehensive massage therapy, which included soft-tissue manipulation, remedial exercise and posture education; soft-tissue manipulation only; remedial exercise and posture education only; or a placebo of sham laser therapy. Each participant received six treatments in one month.
Members of the comprehensive massage-therapy group received half-hour massages aimed at promoting circulation and relaxation of spasm or tension, through techniques such as friction, trigger-point and neuromuscular therapy. This group’s members were also taught to perform stretches for the trunk, hips and thighs, including flexion and modified extension in a pain-free range. Each stretch, held for about 30 seconds, was performed twice per session for related areas and more often for affected areas. The comprehensive massage-therapy group was also encouraged to exercise for general mobility and overall fitness, through walking, swimming, aerobics or another sport. They also received a brief education on posture and body mechanics at work and in day-to-day activities.
Participants placed in the soft-tissue manipulation group received the same massage as those in the comprehensive massage-therapy group, but no additional treatments. Subjects in the remedial exercise group underwent the same exercise and education components as the comprehensive massage-therapy group, but did not receive massage. The control group was given sham low-level, infrared laser therapy with a laser that appeared to work but did not.
Subjects’ functionality, pain, anxiety and lumbar range of motion were evaluated before the first session, after the last session and a month after treatment had ended.
The Roland Disability Questionnaire was used to assess participants’ level of functionality when performing daily tasks. The McGill Pain Questionnaire measured intensity of pain and quality of pain. Lumbar range of motion was evaluated with the Modified Schober test, and the State Anxiety Index measured subjects’ present levels of anxiety.
"Soft-tissue manipulations were shown to have considerable benefit, and the addition of remedial exercise and posture education was shown to improve the clinical results moderately," states the study’s author. "Comprehensive massage therapy seemed to have the greatest impact on pain scores but was only marginally better than soft-tissue manipulation alone for improving function."
All subjects in the comprehensive massage-therapy group reported levels of pain decreased in intensity from the study’s start to finish, an outcome that did not occur for any other group. At the end of treatment, and at follow-up, the comprehensive massage-therapy group had significantly lower levels of anxiety than the control group, whereas no other group did.
One month after the treatment had ended, 63 percent of the comprehensive massage-therapy group reported no pain, as compared with 27 percent of the soft-tissue manipulation group, 14 percent of the exercise group and none of the control group.
"Both the comprehensive massage therapy group and the soft-tissue manipulation group showed clinical significance for the improvement of function," states the study’s author. "Massage therapy that is based on physiology and emphasizes the soft-tissue manipulation component of treatment was found to be effective in the nonpharmacological management of subacute low-back pain."
– Source: College of Massage Therapists of Ontario. Author: Michele Preyde. Originally published in the Canadian Medical Association Journal, 2000, Vol. 162, pp. 1,815-1,820.