Here are a couple of articles pertaining to massage and it's affects on pathologies that we deal with at Rē

• Chronic Low Back Pain Eased by Massage

• A Review of the Evidence for the Effectiveness, Safety, and Cost of Acupuncture, Massage Therapy, and Spinal Manipulation for Back Pain

• Massage Therapy for Osteoarthritis of the Knee

• Effectiveness of Massage Therapy for Subacute Low-back Pain

Chronic Low Back Pain Eased by Massage

Massage is an effective treatment for chronic low back pain, according to a research study conducted by the Center for Health Studies in Seattle, Washington. In a comparison of massage, acupuncture and self-care, a 10-week program of massage therapy was found to be most effective of the three. The study, "A Randomized Trial Comparing Acupuncture, Therapeutic Massage and Self-Care Education for Chronic Low Back Pain," was completed in late 2000. Researchers compared the effects of acupuncture, massage and self-care education on 262 adults, aged 20 to 70. Participants in the massage group and the acupuncture group could have up to 10 sessions during the 10-week study period. Those in the acupuncture group received acupuncture, electrical stimulation, heat, cupping, herbs and exercise suggestions.

Self-care participants were given two videos and a book with information about back pain, techniques to control and prevent pain, and suggestions for dealing with emotional problems that can accompany chronic pain.Pre- and post-treatment assessments included: a Roland Disability Scale (a questionnaire that measures ability to function); SF-12 physical and mental health summary scales; exercise and worry level assessments; and estimates on care costs. Assessments were taken at intervals of four, 10 and 52 weeks.Massage was found to be the most helpful therapy at the end of the 10-week treatment period, in all assessment criteria. Acupuncture ranked higher than self-care only in higher satisfaction with care and less use of pain medication at the end of 10 weeks.After one year, those who had participated in the massage group still reported the greatest benefit from the 10-week treatment period, as compared to those who were in the acupuncture or self-care groups. Researchers also said there were noted improvements at the end of one year in the self-care group, in the areas of symptom, function and decreased worry about back problems."This study suggests that massage has benefits that become apparent within 10 weeks and persist at least one year," the researchers wrote. As well, those in the massage group had 40 percent fewer back-pain-related visits to a physician and 40 percent fewer medication refills than those in the other two groups."The finding that the benefits of massage persist well beyond the last treatment, and the suggestion of possible reductions in subsequent health care utilization, make massage a high priority for further study," the authors wrote.- Source: Group Health Cooperative of Puget Sound Center for Health Studies, Seattle, Washington. Authors: Daniel C. Cherkin, Ph.D.; David Eisenberg, M.D.; Karen J. Sherman, Ph.D.; William Barlow, Ph.D.; Ted J. Kaptchuk, O.M.D.; Janet Street, R.N., Richard A. Deyo, M.D. Originally published in Archives of Internal Medicine, April 23, 2001, Vol. 161, No.8.

 

In 1997, the National Institutes of Health convened a nonadvocate, multidisciplinary panel to evaluate the effectiveness of acupuncture. The panel concluded that, although basic research has begun to elucidate the mechanisms of action of acupuncture and promising results have emerged from clinical studies of acupuncture for treatment of postoperative dental pain, the value of acupuncture for the treatment of back pain was inconclusive.[2] Since that report, 1 further meta-analysis and 2 additional trials have evaluated acupuncture. These and an additional 14 trials are reported by Cherkin and colleagues. In the largest trial, 626 patients with low back pain that had persisted for at least 6 weeks after a physician visit were randomly assigned to receive acupuncture, massage, or self-educational materials. Both treatment protocols prescribed used of herbs. After 8 weeks, they found that acupuncture was less effective than massage.[3] This finding may be economically important to patients because at least two thirds of visits resulted from self-referrals and less than one third of visits to acupuncturists and massage therapists was covered by insurance.[4]

Furline and coworkers[5] recently independently reviewed massage therapy for chronic back pain. They looked at randomized or quasirandomized trials investigating the use of any type of massage (using the hands or a mechanical device) as a treatment for nonspecific low back pain (LBP). Nine publications reporting on 8 randomized trials were included. Three had low and 5 had high methodologic quality scores. Massage was compared with an inert treatment (sham laser) in 1 study that showed that massage was superior, especially if given in combination with exercises and education. In the other 7 studies, massage was compared with different active treatments. The researchers showed that massage was inferior to manipulation and transcutaneous electrical nerve stimulation; massage was equal to corsets and exercises; and massage was superior to relaxation therapy, acupuncture, and self-care education. The beneficial effects of massage in patients with chronic LBP lasted at least 1 year after the end of the treatment.

In summary, Cherkin and coworkers found that massage might be beneficial for patients with subacute and chronic nonspecific LBP, especially when combined with exercises and education. More studies are needed to assess the effect of massage on return-to-work and to measure longer-term effects to determine cost-effectiveness of massage as an intervention for LBP.[5] However, in a world that is "running" ever faster and with arthritic patients trying to keep up, it is likely that evidence-based medicine will have little impact on patient choices.[6] The good news is that it does not seem to be harmful (perhaps safer than the medications we give with large placebo effects),[7] but both physicians and patients will need to make rational choices on whether to alter their lifestyle (more exercise, weight loss) or just keep paying to keep up with the rat race.[8]

References

Massage Therapy for Osteoarthritis of the Knee

A Randomized Controlled Trial

Adam I. Perlman, MD, MPH ; Alyse Sabina, MD ; Anna-Leila Williams, PA-C, MPH ; Valentine Yanchou Njike, MD ; David L. Katz, MD, MPH

Arch Intern Med. 2006;166:2533-2538.

Background  Massage therapy is an attractive treatment option for osteoarthritis (OA), but its efficacy is uncertain. We conducted a randomized, controlled trial of massage therapy for OA of the knee.

Methods  Sixty-eight adults with radiographically confirmed OA of the knee were assigned either to treatment (twice-weekly sessions of standard Swedish massage in weeks 1-4 and once-weekly sessions in weeks 5-8) or to control (delayed intervention). Primary outcomes were changes in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and functional scores and the visual analog scale of pain assessment. The sample provided 80% statistical power to detect a 20-point difference between groups in the change from baseline on the WOMAC and visual analog scale, with a 2-tailed of .05.

Results  The group receiving massage therapy demonstrated significant improvements in the mean (SD) WOMAC global scores (–17.44 [23.61] mm; P<.001), pain (–18.36 [23.28]; P<.001), stiffness (–16.63 [28.82] mm; P<.001), and physical function domains (–17.27 [24.36] mm; P <.001) and in the visual analog scale of pain assessment (–19.38 [28.16] mm; P<.001), range of motion in degrees (3.57 [13.61]; P = .03), and time to walk 50 ft (15 m) in seconds (–1.77 [2.73]; P<.01). Findings were unchanged in multivariable models controlling for demographic factors.

Conclusions  Massage therapy seems to be efficacious in the treatment of OA of the knee. Further study of cost effectiveness and duration of treatment effect is clearly warranted.

Trial Registration  clinicaltrials.gov Identifier: NCT00322244

Author Affiliations: Institute for Complementary and Alternative Medicine, University of Medicine and Dentistry of New Jersey, Newark (Dr Perlman); Yale Prevention Research Center, Yale University School of Medicine, Derby, Conn (Drs Sabina, Njike, and Katz and Ms Williams).