Does massage work for lower back pain?
Nearly everybody likes a good massage. But besides feeling good and being relaxing, does massage provide health benefits? It's claimed that it can relieve all sorts of paineverything from arthritis pain to migrainesthough it has been hard to prove this. That's why a large new well-designed study on massage for back pain, funded by the National Institutes of Health (NIH) and published in the Annals of Internal Medicine in July 2011, deserves attention.
The study included 400 people who had chronic "nonspecific" low back painmeaning it had no identified cause, such as a fracture or herniated disk. One group received relaxation (Swedish) massage, another got structural massage (focusing on specific muscles, tendons and ligaments potentially related to the pain), and the third group just continued with their usual care (whatever that was).
The massages lasted about an hour and were done once a week. After 10 weeks, two out of three people in both massage groups reported substantially reduced pain and improved mobility, compared to only one in three in the control group. Four months later, those who had gotten the massages still fared better than those who did not, but the difference was less. Another six months later, though, any benefits were pretty much gone.
It was somewhat surprising that relaxation massage worked as well as structural massage. But that's good news, according to the researchers, since it is more widely available and usually less expensive than more specialized forms (though also less likely to be covered by insurance).
Despite the positive results, the study left unanswered questions:
- How does massage compare to other treatments, such as exercise, yoga, medication or acupuncture? The study did not compare them, but one of the researchers suggested that the benefits of massage are as strong as those reported for these other effective therapies.
- Would fewer or shorter sessions have been as beneficial? On the other hand, if the weekly massages had continued, would improvements have increased, leveled off or lessened over time?
- The massage therapists in the study were all trained and licensed. Would therapists with less training, or even your spouse or a friend, have been as effective?
- Were the benefits due to the placebo effect? That is, if people expect the massage to help, it's more likely to do so. The way to rule this out is to do a placebo-controlled study, in which the subjects don't know if they are getting the treatment (that is, a real massage) or a placebo (a sham massage), and then the results are compared. But it's hard to fool people with a "fake" massage. Any kind of hands-on work by a seemingly caring person in a relaxing environment might be just as effective as a real massage.
Bottom Line: Massage and Back Pain
If you have chronic back pain, consider getting a few massage sessions. Many health professionals practice massagephysical therapists, osteopaths and, of course, licensed massage therapists.
Source: Originally published in The University of California, Berkeley Wellness Letter (October 2011)