Massage beats meds for lower back pain

Massage therapy may be better than medication or exercise for easing low back pain in the short term, a new government-funded study suggests.

Seattle researchers recruited 401 patients, mostly middle-aged, female and white, all of whom had chronic low back pain.

Those who received a series of either relaxation massage or structural massage were better able to work and be active for up to a year than those getting "usual medical care," which included painkillers, anti-inflammatory drugs, muscle relaxants or physical therapy, the researchers found. Lead study author Daniel Cherkin, director of Group Health Research Institute, said he had expected structural massage, which manipulates specific pain-related back muscles and ligaments, would prove superior to relaxation or so-called Swedish massage, which aims to promote a feeling of body-wide relaxation.

Structural massage, which focuses on soft-tissue abnormalities, requires more training and may be more likely to be paid for by health insurance plans, which may equate it with physical therapy, said Cherkin.

"I thought structural massage would have been at least a little better, and that's not the case," Cherkin said. "If you're having continuing problems with back pain even after trying usual medical care, massage may be a good thing to do. I think the results are pretty strong."

The study, funded by the National Center for Complementary and Alternative Medicine, part of the U.S. National Institutes of Health, is published in the July 5 issue of Annals of Internal Medicine.

Participants were randomly assigned to one of the three groups: structural massage, relaxation massage or usual care. Those in the massage groups were given hour-long massage treatments weekly for 10 weeks.

At 10 weeks, more than one-third of those who received either type of massage said their back pain was much better or gone, compared to only one in 25 patients who received usual care, the study said. Those in the massage groups were also twice as likely in that period to have spent fewer days in bed, used less anti-inflammatory medication and engaged in more activity than the standard care group.

Six months out, both types of massage were still linked to improved function, Cherkin said, but after one year, pain and function was almost equal in all three groups.

Noting that most Americans will experience low back pain during their lifetime, Cherkin said another benefit of massage is its relative safety.

"Maybe one of 10 patients felt pain during or after massage, but most of those thought it was a 'good pain,'" he said. "A good massage therapist will be in tune with the patient and will ask what hurts."

One of the study's weaknesses was that those who were assigned to usual care knew that others were receiving massage therapy and may have been disappointed to be excluded, tainting their reported improvement, said Dr. Robert Duarte, director of the Pain and Headache Treatment Center at North Shore-LIJ Health System in Manhasset, N.Y.

"I think massage therapy can be useful for patients with back pain, but more as a . . . supplemental therapy," Duarte added.