Massage relieves, but does not cure, chronic low-back pain

Current trends suggest massage has become a popular treatment option for chronic low-back pain. Massage, among the earliest known tools for treating pain, can promote muscle relaxation, improved circulation and general feelings of well-being. And it doesn’t involve surgery or prescription pill bottles. Massage feels great. But is it a cure?

Probably not – but it is effective at reducing pain and improving function, says Dr. Andrea Furlan, who is the evidence-based practice coordinator at the Institute for Work & Health. Furlan has published a new systematic review that looks at the effectiveness of massage versus other non-surgical therapies for non-specific chronic low-back pain. This type of back pain lasts for more than three months.

The review, published in the January 2008 edition of The Spine Journal, showed that massage was most effective when combined with education and exercise, and when administered by a licensed therapist. The review considered four high-quality studies published between 2003 and 2006. There was also some evidence that acupressure was better than massage, though this requires further investigation. Acupressure is a technique that involves putting physical pressure on acupuncture points rather than using needles.

Massage is not a miracle intervention, Furlan said. Massage was found to decrease pain and increase function. It did not, however, appear to provide a cure for chronic pain.

Part of the challenge with assessing treatments for chronic low-back pain is in the diagnosis. We still have wide variation in the way that we diagnose this kind of pain, Furlan explained. If we knew for certain that a patient was suffering from a muscle spasm, for example, then massage would be an excellent intervention. But it can be difficult to be that specific. The results of our review were most likely diluted by differences in diagnoses.

Furlan adds that the therapeutic effects of massage should not be discounted. Soft-tissue massage does help with pain management, mainly through mental and physical relaxation. Previous studies have shown that the initial cost of massage therapy – close to $75 per hour – is offset by reduced spending on subsequent visits to health-care providers, pain medications, and other back-care services. Patients atisfaction is invariably high.

Massage is a pleasant, hands-on therapy with multiple benefits to the patient, Furlan said. We see improvements in function, pain, quality of sleep and muscle relaxation. Plus, patients almost always leave with the sense of having been treated well.

Source: At Work, Issue 53, Summer 2008: Institute for Work & Health, Toronto