Will Massage Help Lower Back Pain?

Will Massage Help Lower Back Pain?

Yes, massage therapy has been shown to effectively reduce back pain for a number of people, especially when it is chronic or not related to any major structural defects such as fractures. Various studies indicate that massage therapy tends to give significant short-term pain relief and better functioning, but the effects may diminish with time without consistent care.

Studies and Reviews have provided evidence.

The most extensive one is the Cochrane Review of massage as a treatment for low-back pain (last update 2015), which investigated numerous randomized trials. It found:

• In the short term (acute or low back pain), massage is more effective in reducing pain than no treatment or control measures of an inactive nature.

• In the short term (up to 6 months), in both subacute (4-12 weeks) and chronic (over 12 weeks) low back pain, the most prevalent forms, massage makes pain and function significantly better than usual care or sham.

• Massage has been found to be more effective at relieving pain in short- and longer-term follow-ups than other active methods (such as exercise or physical therapy), but has less reliable results on function improvement.

• Side effects are infrequent, and most of them include short-lived soreness (1.5-25% of participants).

This is supported by more recent systematic reviews (2018-2023) with moderate-certainty evidence that massage provides small-to-moderate short-term pain-relief with chronic low back pain in comparison with no treatments. Other studies record that more than 50 percent of the participants were found to have realized clinically significant changes in some studies.

Massage is recommended by such organizations as the American College of Physicians (ACP) and the American Massage Therapy Association (AMTA) as a treatment option for chronic low back pain. The American College of Physicians' 2017 clinical practice guideline recommends massage as a nonpharmacologic treatment option for acute and subacute low back pain.

The World Health Organization (WHO) issued guidelines in 2023 on chronic primary low back pain that include a conditional recommendation in favor of massage. The WHO notes that massage may provide short-term improvements in pain and function for adults with chronic primary low back pain. The WHO recommends that when massage is offered, it should be considered as part of a broader suite of effective treatments based on a biopsychosocial assessment, not as a single intervention in isolation (which is truly holistic).

How Massage Helps

Massage acts in a number of different ways:

• Loosens rigorously tense muscles and minimizes spasms, which can lead to pain.

• Enhances blood circulation, vital nutrients, and the elimination of metabolic wastes.

• Releases endorphins, which are the natural painkillers of the body.

• Reduces stress and tension, which can increase back pain perception or, in some cases, contribute to the pain.

NOTE ON ENDORPHINS: While endorphin release is commonly cited as a mechanism for massage's pain-relieving effects, the direct evidence is limited. One study found a moderate 16% increase in beta-endorphin levels lasting about 1 hour after connective tissue massage. However, the exact mechanisms by which massage reduces pain are still being researched and likely involve multiple pathways including mechanical effects, neurological responses, and psychological factors.

Such techniques as Swedish, deep tissue, myofascial release, or relaxation massage can all work since there is no one best kind of massage, but a combination of therapeutic massage and exercise is recommended by many professionals.

Important Considerations

It is not a miracle cure: Most of the benefits are short or medium-term, and massage is often most effective when received as part of a comprehensive treatment plan over a period such as 6-8 weeks.

Not advisable for all: Do not use, or use with caution and medical guidance, when your pain is the result of acute injury, infection, cancer, fracture, or severe disc problems. Always consult with your doctor in these situations.

Select certified therapists: Choose licensed professionals experienced in treating back pain. Search ABMP directory

The effects do not manifest uniformly: Practically all people may feel relief, but the degree and timeline varies. Some experience dramatic improvement after the first session; others may require multiple sessions. Just as it takes time to develop pain, tension, and restrictions in connective tissue, it also takes time to release and restore proper tissue mobility.

In lower back pain that is chronic in nature, massage is a safe, evidence-based treatment that many have found beneficial. Massage has been shown to provide short-term pain relief and functional improvements for many people. It's worth considering as part of a comprehensive pain management approach. Discuss with your healthcare provider to determine if it's appropriate for your specific case.

SOURCES PROVIDED:

Boyd C, et al. Use of Massage Therapy for Pain, 2018-2023: A Systematic Review. JAMA Netw Open. 2024;7(7):e2423507.

Boyd C, et al. JAMA Netw Open. 2024.

Kaada B, Torsteinbø O. Increase of plasma beta-endorphins in connective tissue massage. Gen Pharmacol. 1989;20(4):487-9.

Field T. Massage therapy research review. Complement Ther Clin Pract. 2014;20(4):224-9.

World Health Organization. WHO guideline for non-surgical management of chronic primary low back pain in adults in primary and community care settings. Geneva: WHO; 2023.

Qaseem A, Wilt TJ, McLean RM, Forciea MA. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017;166(7):514-530.

Furlan AD, Giraldo M, Baskwill A, Irvin E, Imamura M. Massage for low-back pain. Cochrane Database Syst Rev. 2015;(9):CD001929.