Effect of Massage on Chronic Low Back Pain

Americans are increasingly seeking care from massage therapists for relief of chronic back
pain. However, while initial studies suggest that massage is beneficial for back pain, we
have no information about which of the many types of massage is most helpful. We will be
conducting a study that compares two distinct therapeutic massage protocols with each other
and with usual care for treating chronic back pain. This study is designed to determine which
of these massage protocols will be most effective in reducing pain and increasing
functionality in people with low back pain. 399 Group Health members with non-specific low
back pain lasting at least 3 months will be randomized to one of the two massage groups or to
a control group that receives no treatment beyond their usual care. Massage therapists will
provide each participant with 10 treatments over 10 weeks. The primary outcomes, function and
bothersomeness of low back pain, will be assessed before treatment begins and 10, 26 and 52
weeks after randomization by interviewers who do not know which treatment the participant
received. The results of this study will clarify the value of two different types of massage
for treating one of the most common, challenging, and expensive health problems plaguing
developed countries. The findings will help physicians make informed and confident referrals,
consumers and insurers make safe and cost-effective choices, and massage schools make
responsible curriculum decisions.

Inclusion Criteria:

- 20 through 64 years of age

- members of Group Health Cooperative health plan

- low back pain lasting at least 3 months

Exclusion Criteria:

- non-mechanical causes of back pain (e.g., sciatica, systemic/visceral disease,
pregnancy, spondylolisthesis, spinal stenosis, cancer, recent vertebral fracture)

- inappropriate candidate for massage (active open skin lesions, conditions exacerbated
by increased circulation, recent strokes or heart attacks, compromised immune system,
systemic edema, hypersensitivity to touch or loss of sensation, recent surgery, active
contagious infection)

- characteristics complicating the interpretation of findings (e.g., involved with
litigation or compensation claim, severe or progressive neurological deficit, back
surgery within last 3 years, receiving other back treatment)

- unable to speak or read English

- had massage for any reason in prior 12 months