Massage may relieve back pain more effectively than drugs and therapy

THE QUESTION Chronic back pain can be difficult to treat. How might massage therapy compare with the standard treatment of painkillers, muscle relaxants or anti-inflammatory drugs and physical therapy?

THIS STUDY involved 401 adults (average age was in the mid-40s) who had chronic and moderately severe low back pain with no identified cause. They were randomly assigned to receive usual care or to have about a one-hour massage each week for 10 weeks. Massages were either the most common type, intended to relax the muscles, or a more specialized structural massage, which uses techniques to release tension in specific tissues and joints. At the end of treatment, all groups registered improvement, on average. The improvement was greater among those who had gotten massages, with virtually no differences between the two types of massage. Massage recipients reported less pain and better ability to go about their daily activities than did those who had been given standard care. They spent less time in bed and missed fewer days of work. People in the massage groups also had made fewer doctor visits for back pain. After a year, however, there was little difference between the massage groups and the usual-care group.

WHO MAY BE AFFECTED? People with chronic low back pain, one of the most common reasons people see a doctor. It can be the result of a mechanical or structural problem (such as a muscle spasm or ruptured disk), an injury or another medical condition. Back pain also can result from infection and even stress. Often a cause is never found.

CAVEATS Much of the data, such as pain assessments, came from the participants’ responses on questionnaires. People in the usual-care group knew that others were getting massages, which may have affected assessments of their own treatment.

FIND THIS STUDY July 5 issue of Annals of Internal Medicine (

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Linda Searing

The research described in Quick Study comes from credible, peer-reviewed journals. Nonetheless, conclusive evidence about

a treatment's effectiveness is rarely found in a single study. Anyone considering changing or beginning treatment of any kind should consult with a physician.