Chronic low back pain can be a challenge to treat, but new research suggests that massage therapy may provide some relief.

“Current medical guidelines actually recommend massage therapy prior to the use of opioid medications for lower back pain,” explained William Elder, the study’s principle investigator. “Yet even with those guidelines, physicians and nurse practitioners are not recommending massage therapy,” said Elder. He’s with the University of Kentucky’s departments of family and community medicine and clinical services.

Low back pain is a common problem, and for most people, it’s short-lived. But for about 15 percent of people with low back pain, the problem becomes chronic and lasts more than three months, the study authors said. There aren’t a lot of effective treatment options for chronic back pain, and physicians often prescribe opioid painkillers such as OxyContin or Percocet to ease the pain. But those drugs come with a risk of addiction.

Other possible treatments include exercise, steroid injections, behavior changes, chiropractic, acupuncture and surgery, according to the U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases.

Massage for Back Pain

The new study sought to simulate real-world back pain and treatment. Researchers asked physicians to recommend massage for people with chronic back pain. Just over 100 study volunteers were then paired with an approved, experienced massage therapist in their area who assessed the problem and created a treatment plan. The study participants received 10 treatments, which they set up directly with their therapist.

More than half of the participants had less pain after 12 weeks and many continued to report reduced pain after three months.

The research also showed that massage therapy worked better with patients aged 50 years and older, although younger people benefited, too.

“These results are exciting because it shows that most doctors can refer their patients for massage as a treatment. It’s applicable to the real world,” said Elder. “Some medical providers have taken interest in massage, but most don’t know which type would be helpful. We learned that just referring the patient to a massage therapist and letting them work to select the therapy is effective,” he added.

Dr. Anders Cohen, the neurosurgery division chief at The Brooklyn Hospital Center in New York City, recommends massage therapy to his patients as part of what he calls a comprehensive treatment plan.

“Massage is great way to break up adhesions and is great for soft tissue,” Cohen said. “If the back pain is a soft tissue issue, such as muscles and ligaments, it works great. Plus, there is the bonus of therapeutic touch.”

Reasons for Varying Back Pain Care

Patients in the study received the massage therapy free of charge. But, cost could also explain why some physicians recommend opioids instead. Cohen noted that massage prices vary, and may not be covered under some insurance plans. Study co-author Niki Munk is a licensed massage therapist who’s with the Indiana University School of Health and Rehabilitation Sciences. She said the researchers saw that massage needs to occur regularly when someone begins treatment to reduce the pain.

Munk added that more research is needed on the ideal pain maintenance schedule. But the study authors think that once a level of comfort has been achieved, people can continue to manage their back pain through regular massage therapy on a schedule that fits their needs, such as once a month or every other month.

Munk also noted that selecting the right therapist is important.

“Look for a masseuse that you can establish a therapeutic relationship with over time,” she recommended. “Chronic low back pain is a complex issue that can’t be cured from just a one-hour massage. Find a therapeutic massage clinic and ask questions about the therapist, such as their initial training and continuing education. Also, make sure that the therapist sets up a treatment plan that will work for you,” Munk said.

The study was published online recently in the journal Pain Medicine.

SOURCES: William Elder Jr., Ph.D., professor, family and community medicine and clinical services, University of Kentucky, Lexington; Niki Munk, Ph.D., L.M.T., assistant professor, health sciences, Indiana University School of Health and Rehabilitation Sciences, Indianapolis; Anders Cohen, M.D., division chief, neurosurgery, The Brooklyn Hospital Center, New York City; March 14, 2017, Pain Medicine, online

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