Following a single 30-minute session of traditional Thai massage, people experiencing back pain associated with myofascial trigger points showed significant increases in heart rate variability, pressure pain threshold and body flexibility as well as significant decreases in pain intensity, anxiety and muscle tension, according to recent research.

The study, “The immediate effects of traditional Thai massage on heart rate variability and stress-related parameters in patients with back pain associated with myofascial trigger points,” involved 36 people with back pain associated with myofascial trigger points. Twenty of the subjects were female and 16 were male, with a mean age of about 23 years.

Inclusion criteria were chronic back pain, lasting longer than 12 weeks, and one or more trigger points in the upper or lower back. For nearly 90 percent of the subjects, the most painful trigger point was found in the lower back. Exclusion criteria included any history of disease or other disorder that might affect the subject’s heart rate variability.

Study participants were randomly assigned to either the treatment group or the control group. Those in the treatment group received one 30-minute session of traditional Thai massage. Subjects were in the prone position during this session, and the practitioner focused solely on the back muscles. The type of Thai massage used in this study involved “Sen Sib,” or the 10 meridian lines.

“The pressing technique employed in [traditional Thai massage] uses the body weight of the massage therapist to apply gentle, gradually increasing pressure through the therapist’s thumb, fingers or palms,” state the study’s authors. “Pressure is applied until the patient starts to feel slight discomfort, after which this pressure is maintained for five to 10 seconds at a time. This sequence can be repeated several times for each massage point.”

Subjects in the control group were instructed to relax quietly for 30 minutes in the prone position, in the same environment as the subjects who received traditional Thai massage.

Outcome measures for this study were heart rate variability, pain intensity, muscle tension, pressure pain threshold, anxiety and body flexibility. Each of these measures was assessed before and after the single session of traditional Thai massage or control-group relaxation.

Results of the research revealed that immediately following one 30-minute session of traditional Thai massage, participants had significant increases in heart rate variability, pressure pain threshold and body flexibility, along with significant decreases in self-reported pain intensity, anxiety and muscle tension. Among subjects in the control group, no significant changes were observed.

“Findings from this present study suggest that [traditional Thai massage] onto the back muscles of patients with back pain associated with [myofascial trigger points] is effective in increasing cardiac parasympathetic activity and decreasing sympathetic activity,” state the study’s authors. “Associated effects of these changes, as observed in this study, are: decreased pain and related increased pressure pain threshold, and decreased muscle tension and feeling of stress.”

Authors: Vitsarut Buttagat, Wichai Eungpinichpong, Uraiwon Chatchawan and Samerduen Kharmwan.

Sources: Division of Physical Therapy, Faculty of Associated Medical Sciences, and Department of Rehabilitation Medicine, Faculty of Medicine at Khon Kaen University in Khon Kaen, Thailand. Originally published in the Journal of Bodywork & Movement Therapies (2011) 15: 15-23.

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