Massage a Real Deal Option for Chronic Low Back Pain

Think massage is just for relaxation? Research shows the benefits are much deeper. Plus, tips on how to make massage therapy work for you.

People with chronic low back pain have a variety of proven nonsurgical treatments to choose from: medications, physical therapy, and exercise, to name a few. A 2017 study suggests another therapy be highly considered: massage. In a first-of-its-kind study, researchers used a “real world” approach as opposed to conducting the study in a controlled setting.

More than 50 percent of the study participants reported, “clinically meaningful improvement” in their low back pain after their massage therapy program, wrote co-first authors William G. Elder, PhD, Family and Community Medicine at the University of Kentucky, and Niki Munk, PhD, LMT, School of Health and Rehabilitation Sciences at Indiana University-Purdue University Indianapolis.

“Clinical massage therapy appears to be effective for low back pain, and patients should discuss with their provider and consider clinical massage therapy before trying highly problematic opioid medications,” says Dr. Elder, who was the lead researcher of the study.

Woman having a massage treatment on her back."Clinical massage therapy appears to be effective for low back pain" Photo Source:

A Closer Look at the Study
The research team collaborated with primary care providers in Kentucky who referred patients for 10 massage sessions with licensed massage therapists in the community over a 12-week period. The massage therapists crafted specific massage therapy recommendations based on the specific patient’s needs.

The participants were measured before they started their massage program, at the close of the 12-week program, then at 24 weeks after the start of the program.

At 12 weeks, 54.1 percent showed clinically meaningful improvement in their chronic low back pain. At 24 weeks, 75 percent of patients who showed improvement at 12 weeks retained their improvement.

The researchers discovered some key insights related to patients’ age, weight, and medication regimen:

  • Adults age 50 and over were more likely to have clinically meaningful improvement in their chronic low back pain as a result of massage therapy.

  • Obese patients had good results from massage, but the benefit didn’t hold over time.

  • Patients who reported taking opioid pain medication did report reduced pain as a result of the massage treatment, but they were two times less likely to have clinically meaningful change when compared to patients not taking opioids.

While Dr. Munk, who is a licensed massage therapist, says she expected the patients to have positive results from the course of massage treatment, some aspects of the study results surprised her.

“I was a little surprised that the baby-boomer generation was more likely to have better results,” Dr. Munk says.

Dr. Munk hypothesizes that older people may have a different perspective on pain tolerance. She also wonders if older people had heightened perceptions of pain relief, since older people likely have had more time with the condition and may be more accustomed to living with pain.

Massage Drawbacks and Expectations
While the study suggests that massage can provide meaningful pain relief to people with chronic low back pain, it is not a quick fix. Dr. Munk says people should level-set their expectations by taking into consideration how long they’ve lived with their condition when they go to their first massage.

“If you’ve had a condition for 10-15 years, the likelihood that a one-hour session will fix it is probably not realistic,” Dr. Munk says.

Dr. Munk notes that massage, given its foundation as a muscular treatment, should be viewed as a maintenance therapy—not a short-term approach.

“Muscular patterns develop, and the body goes back to patterns its used to and needs to be retrained,” she says. “Like a pill that wears off after a few hours, and you need to take another dose for relief, it may take several sessions to get the work to ‘hold.’”

Another consideration patients need to understand is the cost of massage, as most health insurance plans do not cover the therapy. Investing in massage is a personal decision that requires weighing pros and cons. If massage therapy can help you manage your chronic back pain without the need for spine surgery or other more significant treatments, you may find it is worth the out-of-pocket cost.

Tips on Making Massage Work for You
If your doctor recommends massage therapy, establishing a comfortable and trusting therapeutic relationship is important. Ask your doctor if he or she recommends a massage therapist in the community.

Dr. Elder and Dr. Munk also suggest asking the following questions to any prospective massage therapist before your first session:

1. Are you a licensed massage therapist?

2. What kind of training and education have you received?

3. How long have you been practicing?

4. Do you work with other health care professionals?

5. Have you had further education in other condition-specific areas (such as back and neck pain)?

6. Do you stay current on advancements in the massage therapy field and any specific medical conditions you focus on?

Chronic low back pain can take a major toll on your life. Fortunately, many nonsurgical treatments can help you manage the pain. While you may think massage is just a relaxing indulgence, the results of this study suggest massage is a legitimate option to help reduce pain. Ask your doctor if massage is a treatment worth exploring for your specific condition.

Updated on: 05/14/19
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