Massage helps back pain

BMJ Group News

What do we know already?

Each year around 5 million people go to their GP with back pain. Several treatments seem to help, including exercises, painkillers, and spinal manipulation. People often try several treatments before they find something that works for them.

A new study has looked at whether massage can help people with long-term back pain.

What does the new study say?

Two kinds of massage helped with long-term back pain. Some people had relaxation massage, which uses a fairly light touch to help people feel relaxed. Others had structural massage, which aims to correct abnormalities in muscles and other soft tissue. Added to the treatment people were already getting, both types helped people get on with their lives and be less bothered by back pain.

At the start of the study, the average rating people gave to their level of disability was 11, on a scale from 0 to 23, with higher scores meaning more disability. After having an hour of massage every week for 10 weeks, the average disability score among people having relaxation massage fell to 6. Disability fell to 6.5 among people having structural massage.

People who didn't have massage, but carried on getting the usual care from their doctor, rated their disability at 9 points after 10 weeks. Usual care could mean any treatment recommended by a doctor, including painkillers, anti-inflammatory drugs, muscle relaxants, or physiotherapy.

Although there was an immediate benefit to massage, after 26 weeks there was no obvious difference between massage and usual care. After a year, everyone rated their disability at around 6 or 7 points, whether they'd had massage or not. This suggests that massage helps in the short term, but over longer periods people tend to recover from back pain without it.

The study looked at 400 people aged between 20 and 65.

How reliable is the research?

A slight problem with the study is that, compared with the people who continued seeing their usual doctor, the people having massage were getting more treatment and spending more time with health professionals. This could have given them extra reassurance and led them to expect an improvement in their back pain. This would have biased the study in favour of massage.

As well as massage, people were given exercises to do at home. These could also have contributed to the improvements people saw.

Everyone in the study had had back pain for more than three months, and people with some more serious types of back pain, such as sciatica, were excluded. So, the results don't apply to all kinds of back pain.

What does this mean for me?

The study suggests that massage may be worth trying if you have back pain that has lasted longer than three months.

Other treatments for back pain include exercises, painkillers, therapy to help you cope with pain, and spinal manipulation. Stronger painkillers and drugs to relax your muscles may help, but can cause side effects.

Doctors usually advise people with a bad back to keep active. Resting can mean you get stiff and your muscles get weaker.