July 5, 2011 -- Massage therapy may provide more relief for patients with chronic low back pain than thought -- at least in the short term -- according to a new study in the Annals of Internal Medicine.
Researchers affiliated with the Seattle-based Group Health Research Institute divided a total of 401 chronic low back pain patients into three groups. One of the groups served as a control group, with no changes in care, while those in the other two groups received either relaxation massage or structural massage.
After 10 weeks of therapy, one in three patients receiving either type of massage said their back pain was reduced, while only one in 25 of those on standard care reported the same relief. Massage patients also reported improved physical function, fewer days in bed, more activity and decreased use of anti-inflammatory medications.
"This seems to offer clinicians another option for managing a challenging group of patients," said study coauthor Dr. Richard Deyo, professor of evidence-based family medicine at Oregon Health and Science University in Portland. "Some patients are eager to avoid medications, injections, or surgery, and this may offer some relief."
Whether the reported benefits actually point to a therapeutic benefit to massage -- or are simply an example of the placebo effect -- has yet to be determined. And while the benefits of massage therapy appeared to last up to six months after the beginning of treatment, they tended to dissipate after a year.
Doctors pointed to this latter finding as evidence that the benefits of massage for low back pain were, at best, transitory.
"The data does not fit with most of what is known about low back pain," said Dr. Donlin Long, professor of neurosurgery at The Johns Hopkins Hospital in Baltimore, Md. "We have data from nearly 2,000 patients collected in a nationwide study which showed no lasting benefit with any [physical therapy], manipulation, and massage... I've used massage for years and what is does is relieve muscle pain while the patient improves spontaneously, but only in a well-chosen few."
Part of the problem may be that while massage addresses muscular issues, many cases of chronic low back pain involve skeletal and nerve problems as well.
"It is difficult to conceive that massage therapy would have long term benefit," said Dr. Gunnar Andersson, an orthopedic surgeon at Rush-Presbyterian-St. Luke's Medical Center in Chicago. "More likely the benefit is one of short term decrease in pain and associated increase in function."
Still, for those affected by low back pain -- the second most common neurological ailment in the United States and the most common cause of job-related disability, according to the National Institutes of Health -- even the temporary benefits of massage may be time and money well spent. This is particularly the case, Andersson said, if the relief from massage reduces the amount of painkillers a patient must take.
"If you can achieve a decrease in the use of medication by providing massage therapy, then I'm all in favor of that," Andersson said. "A number of patients with chronic back pain today are in my opinion over-medicalized and are taking a large number of medications, some of which are narcotic and some of which have significant side effects and costs."