Before deciding on spine surgery, consider massage for back pain

Jul 6 2011
For many Americans who have back pain and spasms due to sitting long hours at their desks, a massage may seem like a long shot when it comes to pain alleviation.

However, that is exactly what healthcare practitioners would recommend, since one of the basic tenets of the orthopedic profession is that conservative pain treatments should be exhausted before sending a patient to the operating table.

Of course, in certain cases such as traumatic injuries, surgery may be unavoidable, but even athletes who experience back pain are typically sent to the disabled list first to see if rest, hot and cold compresses or massages can bring lasting relief.

A study published in the July issue of the Annals of Internal Medicine revealed that both structural and relaxation massage therapy may ease chronic low back pain and improve an individual's daily function.

For the purposes of the study, researchers from Group Health Research Institute recruited 400 people who had had back pain for at least three months. All of the patients had "nonspecific" pain, meaning that there was no identifiable pathology underlying the pain, such as degenerative disc disease or herniated disc.

All participants were assigned to either of three groups - one that offered structural massage, one that relied on relaxation (Swedish) massage and one in which the subjects received standard care with painkiller medications.

After interviewing the patients 10 weeks into their once-a-week treatments, the researchers found that more than 33 percent of individuals in either of the massage groups reported significant relief of back pain, while only about 4 percent of standard care patients said the same.

Similarly, daily functioning was substantially better among the massage group than the controls. This was defined as spending fewer days in bed, being more active and using fewer anti-inflammatory medications.

"We found the benefits of massage are about as strong as those reported for other effective treatments: medications, acupuncture, exercise and yoga," said study leader Daniel C. Cherkin, PhD, a senior investigator at Group Health Research Institute. He added that "people who have persistent back pain may want to consider massage as an option."

One of the surprising outcomes of the study was that relaxation massages were shown to offer similar benefits to structural massage. The latter relies on targeting specific pain-sensitive soft tissues like muscles and ligaments, and typically requires more training on the part of the therapist. However, the study showed that massages that simply promote relaxation throughout the body are equally effective.

Overall, the researchers stressed that the importance of these findings stems from the fact that chronic back pain is among the most common reason for doctor's visits, disability, absenteeism and presenteeism, which is a term that describes people who show up to work but are less productive because of their discomfort.

Moreover, treatments for back pain - from doctor's visits to medications to surgeries - drive up healthcare costs, so the study suggest that massages may be an effective and economical way to reduce this public health problem.