CR: Should you try massage for back pain?

Should You Try Massage for Back Pain?
How a rubdown compares with other treatments like physical therapy and acupuncture
By Consumer Reports
July 21, 2016

A soothing massage might feel relaxing, but could it have real health benefits, too? Documented in early Egyptian tomb paintings and Chinese writings from as far back as 2700 B.C., massage involves a range of techniques for rubbing the body to relieve muscle tension and pain. For example, Swedish massage employs long strokes and kneading movements, and deep tissue massage uses focused, intense pressure in tight or painful areas.

Today, Americans are increasingly turning to massage. According to the National Center for Health Statistics, the proportion of Americans who got massage therapy increased by 38% between 2002 and 2012. Users typically seek out a trained massage therapist (not a medical doctor) and can spend anywhere from $40 to $250 or more per hour, depending on where they live, the type of massage, and the setting. (Expect to pay more at a fancy spa.)

Does It Work?
“Limited research suggests that massage therapy might ease lower back pain—a condition that affects eight in 10 adults at some point in their lives,” says Consumer Reports chief medical adviser Marvin M. Lipman, M.D. For example, a 2015 review of 25 small to midsized clinical trials conducted by researchers with the independent Cochrane Library. It found that among people with lower back pain lasting more than four weeks, massage provided better relief than either no treatment or a “placebo” treatment—such as lightly touching the skin.

Massage therapy also appeared to relieve discomfort better, on average, than treatments like acupuncture, traction, and relaxation exercises. Most important, when compared to no treatment or a placebo treatment, massage improved functions such as walking ability, sleep, and other important components of daily life.

The studies reviewed were small (124 people, on average), notes Andrea Furlan, M.D., Ph.D., the review’s lead author and a scientist at the Institute for Work & Health in Toronto. “I really believe massage is effective,” she says, “but we need bigger and better-designed clinical trials before we can be sure.”

So, how might massage ease discomfort? Scientists haven’t pinpointed a mechanism, but they think it might stimulate nerves that mute pain signals. Another theory suggests that massage may trigger the release of pain-reducing hormones called endorphins.

Research suggests that massage may have benefits beyond pain relief. For instance, a 2010 analysis of 17 clinical trials found that it may help relieve depression.

“Trying massage for back pain probably won’t hurt, and might help,” says Lipman. But if you try it, tell your practitioner beforehand about medical conditions you have and medicine you take. Massage isn’t appropriate for everyone. People taking blood thinners, such as warfarin (Coumadin or generic), for example, should avoid deep tissue massage because intense pressure could cause bruising.

Do you get massages to relieve back pain?
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What to Know If You Go
• Most states regulate massage therapists; requirements can vary. It’s best to work with practitioners who are certified by a national organization, such as the National Certification Board for Therapeutic Massage and Bodywork.

• Some health insurance policies cover a limited number of massages if prescribed by a physician, but massage therapy is not covered by Medicare.