|
Michele Preyde is a PhD student in the Faculty
of Social Work, University of Toronto, and a member of the College of Massage
Therapists of Ontario, Toronto, Ont.
Background: The effectiveness of massage
therapy for low-back pain has not been documented. This randomized
controlled trial compared comprehensive massage
therapy (soft-tissue manipulation, remedial exercise and posture
education), 2 components of massage therapy and
placebo in the treatment of subacute (between 1 week and 8 months)
low-back pain.
Methods: Subjects with subacute low-back pain
were randomly assigned to 1 of 4 groups: comprehensive massage
therapy (n = 25), soft-tissue manipulation only (n =
25), remedial exercise with posture education only (n = 22)
or a placebo of sham laser therapy (n = 26). Each subject
received 6 treatments within approximately 1 month. Outcome measures
obtained at baseline, after treatment and at 1-month follow-up
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).
Results: Of the 107 subjects who passed
screening, 98 (92%) completed post-treatment tests and 91 (85%)
completed follow-up tests. 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 < 0.001), less intense pain (mean PPI score
0.42 v. 1.18-1.75, p < 0.001) and a decrease in the
quality of pain (mean PRI score 2.29 v. 4.55-7.71, p = 0.006)
compared with the other 3 groups. Clinical significance was evident
for the comprehensive massage therapy group and the
soft-tissue manipulation group on the measure of function. 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.
Interpretation: Patients with
subacute low-back pain were shown to benefit from massage
therapy, as regulated by the College of Massage
Therapists of Ontario and delivered by experienced massage
therapists.
CMAJ • June 27, 2000; 162 (13)
© 2000 Canadian
Medical Association or its licensors Go
to http://www.cmaj.ca/