Massage Therapy for Pain

Survey of the Pertinent Literature

Massage Therapy is a form of alternative medicine that is intended to relieve pain and tension, and to increase blood circulation (Collinge, 2000). It involves the act of kneading, stroking, pressing, and moving of joints and muscles. There are many different kinds of massage therapy, including, deep tissue massage, Swedish massage, sports massage, manual lymph drainage, shiatsu, and neuromuscular massage. Most of these types of massage are used supposedly to relieve pain and pressure by helping to improve the function of the body, thereby improving the body's ability to heal itself.

Massage Therapy is one of the oldest practiced forms of alternative medicine. It has beendated back to ancient Greek, Roman, and Chinese medical texts as far back as, if not before,the 4^th century. Hippocrates said, "The physician must be acquainted with many things and assuredly with rubbing" (Massage Therapy). Since that time, there has been much research performed to test the most effective and beneficial forms of massage therapy, though many of these studies have given conflicting results.

Though the introduction of modern medicine had put the practice on the back burner for some time, it is still greatly present, especially in European countries. In Germany, massage therapy is even covered by medical insurance (Collinge, 2000). Here in the United States, a trend of holistic medicine use has brought massage therapy back in the recent years. There are now an estimated 50,000 massage therapists in practicing in the U.S. (Collinge, 2000).Massage therapy accounts for 18% of the 425 million visits made to alternative healthcare providers each year (Facts about Massage). Each year, between 2 and 4 billion dollars are spent on visits to massage therapists and practitioners, from a total of about 75 million visits each year (Facts about Massage). These days, family practitioners and chiropractors often recommend massage treatment as a complement to medical treatment. For the first time, massage therapy was officially offered as a core medical service in the 1996 Summer Olympic Games (Facts about Massage). 

Massage therapy for back pain is one of the most popular and common reasons to go to a massage therapist. Deep tissue massage, among other techniques, has become quite popular in this age of holistic medicine. Despite this popularity and recognition, there is little evidence that massage therapy actually heals. In particular, the research conducted on massage for the treatment of back pain has been contradictory. Cochrane Review searched Medline, Embase, Cochrane Controlled Trials Register, Healthstar, CINAHL and Dissertation abstracts from 1966 to 1999 for randomized, quasi-randomized or controlled clinical trials that studied the use of any type of massage as a treatment for nonspecific low back pain to assess the effects of massage therapy for non-specific low back pain (Furlan, Brosseau, Welch, Wong, 2001). Based on the studies reviewed, insufficient evidence was found to recommend massage as treatment for non-specific low back pain (Furlan et al., 2001). 

However, in a study conducted at the Health and Performance Centre, University of Guelph, in Guelph, Ontario, patients with sub-acute low-back pain were shown to benefit from massage therapy. In this study, 107 patients were divided into four groups: comprehensive massage therapy, which included soft-tissue manipulation, remedial exercise and posture education; soft-tissue manipulation only; remedial exercise with posture education only; and a placebo of sham laser treatment (Preyde, 2001). Data were collected at baseline, after treatment and at 1-month follow-up and consisted of the Roland Disability Questionnaire (RDQ), the McGill Pain Questionnaire (PPI and PRI), the State Anxiety Index and the Modified Schober test (lumbar range of motion) (Preyde, 2001). Statistically significant differences were noted after treatment and at follow-up. The comprehensive massage therapy group had improved function (mean RDQ score 1.54 v. 2.86-6.5, p < .001), less intense pain (mean PPI score 0.42 v. 1.18-1.75, p < .001) and a decrease in the quality of pain (mean PRI score 2.29 v. 4.55-7.71, p = .006) compared with the other 3 groups (Preyde, 2001). These scores were evaluated, and used to help determine the effectiveness of the different kinds of therapy. At 1-month follow-up 63% of subjects in the comprehensive massage therapy group reported no pain as compared with 27% of the soft-tissue manipulation group, 14% of the remedial exercise group and 0% of the sham laser therapy group (Preyde, 2001). So, according to this study, massage proved to be quite affective when used to treat acute back pain, although in many cases was not able to remove the pain completely. 

One study revealed that more than 90% of most low back pain was muscular in nature (Willette). This was concluded from the result of a study of 10,000 low-back-pain sufferers, who worked with the Washington Schools of Medicine, John Hopkins University, and the Seattle Veterans Hospital (Willette). The testers consisted of 23 panel doctors and scientists, who concluded that the pain [patients] experienced was due to soft tissue, which includes muscles, tendons, and ligaments. Muscular injuries and "imbalances" are often difficult to detect (Willette). From this study, doctors concluded that one of the best ways to treat this type of pain is to get a "soft tissue release", which is a form of deep tissue massage. It has been reported to be about 90% effective in improving the condition, although there is about a 60% chance of the condition returning (Willette). 

Through these studies and many others, massage therapy has been suggested to help with the healing process and relief of pain, but the significance of this relief has yet to be scientifically determined. While some studies show great results in pain reduction, others showed little to no evidence that the massage therapy was the cause of any kind of reduction. Despite the lack of scientific evidence, massage therapy continues to be a popular and comforting form of both relaxation and healing in the field of alternative medicine. 

Literature Cited

Collinge, W. (2000). Massage Therapy. Retrieved March 16, 2001 from the World Wide Web:
htty://altmedicine.about.com/health/altmedicine/cs/massagebodywork/index.htm. 20 paragraphs.

Furlan, A.D., Brosseau, L., Welch, V., Wong, J. (2001). Massage for Low-Back Pain (Cochrane Review). The
Cochrane Library. Retrieved March 16, 2001 from the World Wide Web: http://www.updatesoftware.com/abstracts/abOO1929.htm. 8 paragraphs.

Massage Therapy. (2001). WebMD. Retrieved March 16, 2001 from the World Wide Web:
hftp://mv.webmd.com/content/article/1680.51641. 29 paragraphs.

National Certification Board for Therapeutic Massage and Bodywork. (2001). Facts About Massage. Retrieved
March 16, 2001 from the World Wide Web: http://www.ncbtmb.com/factsaboutmassage.htm. 25 paragraphs.

Preyde, M. (2000). Effectiveness of Massage Therapy for Sub-acute Low-Back Pain: A Randomized Controlled
Trial. CMAJ. Retrieved March 16, 2001 from the World Wide Web: http://www.cma.ca/cmai/vol-162/issue-
13/1815.htm. 30 paragraphs.

Willette, A. (2001). Low-Back Pain. Retrieved March 16, 2001 from the World Wide Web:
http://www.bodyinbalance.com/back pain.htm. 39 paragraphs.

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