Massage for low‐back pain
Background Low‐back pain (LBP) is one of the most common and costly musculoskeletal problems in modern society. It is experienced by 70% to 80% of adults at some time in their lives. Massage therapy has the potential to minimize pain and speed return to normal function. Objectives To assess the effe...
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| Veröffentlicht in: | Cochrane database of systematic reviews 2015-09, Vol.2015 (9), p.CD001929 |
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| creator | Furlan, Andrea D Giraldo, Mario Baskwill, Amanda Irvin, Emma Imamura, Marta Furlan, Andrea D |
| description | Background
Low‐back pain (LBP) is one of the most common and costly musculoskeletal problems in modern society. It is experienced by 70% to 80% of adults at some time in their lives. Massage therapy has the potential to minimize pain and speed return to normal function.
Objectives
To assess the effects of massage therapy for people with non‐specific LBP.
Search methods
We searched PubMed to August 2014, and the following databases to July 2014: MEDLINE, EMBASE, CENTRAL, CINAHL, LILACS, Index to Chiropractic Literature, and Proquest Dissertation s. We also checked reference lists. There were no language restrictions used.
Selection criteria
We included only randomized controlled trials of adults with non‐specific LBP classified as acute, sub‐acute or chronic. Massage was defined as soft‐tissue manipulation using the hands or a mechanical device. We grouped the comparison groups into two types: inactive controls (sham therapy, waiting list, or no treatment), and active controls (manipulation, mobilization, TENS, acupuncture, traction, relaxation, physical therapy, exercises or self‐care education).
Data collection and analysis
We used standard Cochrane methodological procedures and followed CBN guidelines. Two independent authors performed article selection, data extraction and critical appraisal.
Main results
In total we included 25 trials (3096 participants) in this review update. The majority was funded by not‐for‐profit organizations. One trial included participants with acute LBP, and the remaining trials included people with sub‐acute or chronic LBP (CLBP). In three trials massage was done with a mechanical device, and the remaining trials used only the hands. The most common type of bias in these studies was performance and measurement bias because it is difficult to blind participants, massage therapists and the measuring outcomes. We judged the quality of the evidence to be "low" to "very low", and the main reasons for downgrading the evidence were risk of bias and imprecision. There was no suggestion of publication bias. For acute LBP, massage was found to be better than inactive controls for pain ((SMD ‐1.24, 95% CI ‐1.85 to ‐0.64; participants = 51; studies = 1)) in the short‐term, but not for function ((SMD ‐0.50, 95% CI ‐1.06 to 0.06; participants = 51; studies = 1)). For sub‐acute and chronic LBP, massage was better than inactive controls for pain ((SMD ‐0.75, 95% CI ‐0.90 to ‐0.60; participants = 761; studies = 7)) and function (SMD ‐0.72, 95 |
| doi_str_mv | 10.1002/14651858.CD001929.pub3 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8734598</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1754522176</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5263-39fdf3aac458fa5c09f127a12ce18a759138988a90d23d1253874d2747f495933</originalsourceid><addsrcrecordid>eNqFkM1OAjEUhRujEUSfwISwdDPYn-m03Zgo_iYYN7puLp0WRgeKLUjY-Qg-o0_iTPgJunF1b3JOv3N7EGoT3CUY03OSZpxILru9a4yJoqo7nQ_YHmrWQlIr-zt7Ax3F-IoxyxQVh6hBM0YVU6qJTh8hRhjajvOhU_rF9-fXAMxbZwrF5BgdOCijPVnPFnq5vXnu3Sf9p7uH3mU_MbwCJUy53DEAk3LpgBusHKECCDWWSBBcESaVlKBwTllOKGdSpDkVqXCp4oqxFrpYcasvjG1u7GQWoNTTUIwhLLWHQv9WJsVID_2HloKlXMkKcLYGBP8-t3Gmx0U0tixhYv08aiJ4yiklIqus2cpqgo8xWLeNIVjXzepNs3rTbB1eH9nePXL7bFNlZbhaGRZFaZfaeDMKVf4_3D8pP70biBU</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1754522176</pqid></control><display><type>article</type><title>Massage for low‐back pain</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><source>Cochrane Library</source><creator>Furlan, Andrea D ; Giraldo, Mario ; Baskwill, Amanda ; Irvin, Emma ; Imamura, Marta ; Furlan, Andrea D</creator><creatorcontrib>Furlan, Andrea D ; Giraldo, Mario ; Baskwill, Amanda ; Irvin, Emma ; Imamura, Marta ; Furlan, Andrea D</creatorcontrib><description>Background
Low‐back pain (LBP) is one of the most common and costly musculoskeletal problems in modern society. It is experienced by 70% to 80% of adults at some time in their lives. Massage therapy has the potential to minimize pain and speed return to normal function.
Objectives
To assess the effects of massage therapy for people with non‐specific LBP.
Search methods
We searched PubMed to August 2014, and the following databases to July 2014: MEDLINE, EMBASE, CENTRAL, CINAHL, LILACS, Index to Chiropractic Literature, and Proquest Dissertation s. We also checked reference lists. There were no language restrictions used.
Selection criteria
We included only randomized controlled trials of adults with non‐specific LBP classified as acute, sub‐acute or chronic. Massage was defined as soft‐tissue manipulation using the hands or a mechanical device. We grouped the comparison groups into two types: inactive controls (sham therapy, waiting list, or no treatment), and active controls (manipulation, mobilization, TENS, acupuncture, traction, relaxation, physical therapy, exercises or self‐care education).
Data collection and analysis
We used standard Cochrane methodological procedures and followed CBN guidelines. Two independent authors performed article selection, data extraction and critical appraisal.
Main results
In total we included 25 trials (3096 participants) in this review update. The majority was funded by not‐for‐profit organizations. One trial included participants with acute LBP, and the remaining trials included people with sub‐acute or chronic LBP (CLBP). In three trials massage was done with a mechanical device, and the remaining trials used only the hands. The most common type of bias in these studies was performance and measurement bias because it is difficult to blind participants, massage therapists and the measuring outcomes. We judged the quality of the evidence to be "low" to "very low", and the main reasons for downgrading the evidence were risk of bias and imprecision. There was no suggestion of publication bias. For acute LBP, massage was found to be better than inactive controls for pain ((SMD ‐1.24, 95% CI ‐1.85 to ‐0.64; participants = 51; studies = 1)) in the short‐term, but not for function ((SMD ‐0.50, 95% CI ‐1.06 to 0.06; participants = 51; studies = 1)). For sub‐acute and chronic LBP, massage was better than inactive controls for pain ((SMD ‐0.75, 95% CI ‐0.90 to ‐0.60; participants = 761; studies = 7)) and function (SMD ‐0.72, 95% CI ‐1.05 to ‐0.39; 725 participants; 6 studies; ) in the short‐term, but not in the long‐term; however, when compared to active controls, massage was better for pain, both in the short ((SMD ‐0.37, 95% CI ‐0.62 to ‐0.13; participants = 964; studies = 12)) and long‐term follow‐up ((SMD ‐0.40, 95% CI ‐0.80 to ‐0.01; participants = 757; studies = 5)), but no differences were found for function (both in the short and long‐term). There were no reports of serious adverse events in any of these trials. Increased pain intensity was the most common adverse event reported in 1.5% to 25% of the participants.
Authors' conclusions
We have very little confidence that massage is an effective treatment for LBP. Acute, sub‐acute and chronic LBP had improvements in pain outcomes with massage only in the short‐term follow‐up. Functional improvement was observed in participants with sub‐acute and chronic LBP when compared with inactive controls, but only for the short‐term follow‐up. There were only minor adverse effects with massage.</description><identifier>ISSN: 1465-1858</identifier><identifier>ISSN: 1469-493X</identifier><identifier>EISSN: 1465-1858</identifier><identifier>EISSN: 1469-493X</identifier><identifier>DOI: 10.1002/14651858.CD001929.pub3</identifier><identifier>PMID: 26329399</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Acute Pain ; Acute Pain - therapy ; Adult ; Back disorders ; Bias ; Chronic Pain ; Chronic Pain - therapy ; Complementary & alternative medicine ; Humans ; Insurance medicine ; Intervention ; Low Back Pain ; Low Back Pain - therapy ; Manipulation, Spinal ; Manual therapy ; Massage ; Massage - adverse effects ; Massage - methods ; Medicine General & Introductory Medical Sciences ; Mixed duration ; Musculoskeletal conditions ; Non‐specific low back pain ; Orthopaedics & trauma ; Randomized Controlled Trials as Topic ; Return to Work ; Review Type ; Rheumatology ; Sick Leave ; Target condition ; Treatment</subject><ispartof>Cochrane database of systematic reviews, 2015-09, Vol.2015 (9), p.CD001929</ispartof><rights>Copyright © 2015 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5263-39fdf3aac458fa5c09f127a12ce18a759138988a90d23d1253874d2747f495933</citedby><cites>FETCH-LOGICAL-c5263-39fdf3aac458fa5c09f127a12ce18a759138988a90d23d1253874d2747f495933</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26329399$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Furlan, Andrea D</creatorcontrib><creatorcontrib>Giraldo, Mario</creatorcontrib><creatorcontrib>Baskwill, Amanda</creatorcontrib><creatorcontrib>Irvin, Emma</creatorcontrib><creatorcontrib>Imamura, Marta</creatorcontrib><creatorcontrib>Furlan, Andrea D</creatorcontrib><title>Massage for low‐back pain</title><title>Cochrane database of systematic reviews</title><addtitle>Cochrane Database Syst Rev</addtitle><description>Background
Low‐back pain (LBP) is one of the most common and costly musculoskeletal problems in modern society. It is experienced by 70% to 80% of adults at some time in their lives. Massage therapy has the potential to minimize pain and speed return to normal function.
Objectives
To assess the effects of massage therapy for people with non‐specific LBP.
Search methods
We searched PubMed to August 2014, and the following databases to July 2014: MEDLINE, EMBASE, CENTRAL, CINAHL, LILACS, Index to Chiropractic Literature, and Proquest Dissertation s. We also checked reference lists. There were no language restrictions used.
Selection criteria
We included only randomized controlled trials of adults with non‐specific LBP classified as acute, sub‐acute or chronic. Massage was defined as soft‐tissue manipulation using the hands or a mechanical device. We grouped the comparison groups into two types: inactive controls (sham therapy, waiting list, or no treatment), and active controls (manipulation, mobilization, TENS, acupuncture, traction, relaxation, physical therapy, exercises or self‐care education).
Data collection and analysis
We used standard Cochrane methodological procedures and followed CBN guidelines. Two independent authors performed article selection, data extraction and critical appraisal.
Main results
In total we included 25 trials (3096 participants) in this review update. The majority was funded by not‐for‐profit organizations. One trial included participants with acute LBP, and the remaining trials included people with sub‐acute or chronic LBP (CLBP). In three trials massage was done with a mechanical device, and the remaining trials used only the hands. The most common type of bias in these studies was performance and measurement bias because it is difficult to blind participants, massage therapists and the measuring outcomes. We judged the quality of the evidence to be "low" to "very low", and the main reasons for downgrading the evidence were risk of bias and imprecision. There was no suggestion of publication bias. For acute LBP, massage was found to be better than inactive controls for pain ((SMD ‐1.24, 95% CI ‐1.85 to ‐0.64; participants = 51; studies = 1)) in the short‐term, but not for function ((SMD ‐0.50, 95% CI ‐1.06 to 0.06; participants = 51; studies = 1)). For sub‐acute and chronic LBP, massage was better than inactive controls for pain ((SMD ‐0.75, 95% CI ‐0.90 to ‐0.60; participants = 761; studies = 7)) and function (SMD ‐0.72, 95% CI ‐1.05 to ‐0.39; 725 participants; 6 studies; ) in the short‐term, but not in the long‐term; however, when compared to active controls, massage was better for pain, both in the short ((SMD ‐0.37, 95% CI ‐0.62 to ‐0.13; participants = 964; studies = 12)) and long‐term follow‐up ((SMD ‐0.40, 95% CI ‐0.80 to ‐0.01; participants = 757; studies = 5)), but no differences were found for function (both in the short and long‐term). There were no reports of serious adverse events in any of these trials. Increased pain intensity was the most common adverse event reported in 1.5% to 25% of the participants.
Authors' conclusions
We have very little confidence that massage is an effective treatment for LBP. Acute, sub‐acute and chronic LBP had improvements in pain outcomes with massage only in the short‐term follow‐up. Functional improvement was observed in participants with sub‐acute and chronic LBP when compared with inactive controls, but only for the short‐term follow‐up. There were only minor adverse effects with massage.</description><subject>Acute Pain</subject><subject>Acute Pain - therapy</subject><subject>Adult</subject><subject>Back disorders</subject><subject>Bias</subject><subject>Chronic Pain</subject><subject>Chronic Pain - therapy</subject><subject>Complementary & alternative medicine</subject><subject>Humans</subject><subject>Insurance medicine</subject><subject>Intervention</subject><subject>Low Back Pain</subject><subject>Low Back Pain - therapy</subject><subject>Manipulation, Spinal</subject><subject>Manual therapy</subject><subject>Massage</subject><subject>Massage - adverse effects</subject><subject>Massage - methods</subject><subject>Medicine General & Introductory Medical Sciences</subject><subject>Mixed duration</subject><subject>Musculoskeletal conditions</subject><subject>Non‐specific low back pain</subject><subject>Orthopaedics & trauma</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Return to Work</subject><subject>Review Type</subject><subject>Rheumatology</subject><subject>Sick Leave</subject><subject>Target condition</subject><subject>Treatment</subject><issn>1465-1858</issn><issn>1469-493X</issn><issn>1465-1858</issn><issn>1469-493X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>RWY</sourceid><sourceid>EIF</sourceid><recordid>eNqFkM1OAjEUhRujEUSfwISwdDPYn-m03Zgo_iYYN7puLp0WRgeKLUjY-Qg-o0_iTPgJunF1b3JOv3N7EGoT3CUY03OSZpxILru9a4yJoqo7nQ_YHmrWQlIr-zt7Ax3F-IoxyxQVh6hBM0YVU6qJTh8hRhjajvOhU_rF9-fXAMxbZwrF5BgdOCijPVnPFnq5vXnu3Sf9p7uH3mU_MbwCJUy53DEAk3LpgBusHKECCDWWSBBcESaVlKBwTllOKGdSpDkVqXCp4oqxFrpYcasvjG1u7GQWoNTTUIwhLLWHQv9WJsVID_2HloKlXMkKcLYGBP8-t3Gmx0U0tixhYv08aiJ4yiklIqus2cpqgo8xWLeNIVjXzepNs3rTbB1eH9nePXL7bFNlZbhaGRZFaZfaeDMKVf4_3D8pP70biBU</recordid><startdate>20150901</startdate><enddate>20150901</enddate><creator>Furlan, Andrea D</creator><creator>Giraldo, Mario</creator><creator>Baskwill, Amanda</creator><creator>Irvin, Emma</creator><creator>Imamura, Marta</creator><creator>Furlan, Andrea D</creator><general>John Wiley & Sons, Ltd</general><scope>7PX</scope><scope>RWY</scope><scope>ZYTZH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20150901</creationdate><title>Massage for low‐back pain</title><author>Furlan, Andrea D ; Giraldo, Mario ; Baskwill, Amanda ; Irvin, Emma ; Imamura, Marta ; Furlan, Andrea D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5263-39fdf3aac458fa5c09f127a12ce18a759138988a90d23d1253874d2747f495933</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Acute Pain</topic><topic>Acute Pain - therapy</topic><topic>Adult</topic><topic>Back disorders</topic><topic>Bias</topic><topic>Chronic Pain</topic><topic>Chronic Pain - therapy</topic><topic>Complementary & alternative medicine</topic><topic>Humans</topic><topic>Insurance medicine</topic><topic>Intervention</topic><topic>Low Back Pain</topic><topic>Low Back Pain - therapy</topic><topic>Manipulation, Spinal</topic><topic>Manual therapy</topic><topic>Massage</topic><topic>Massage - adverse effects</topic><topic>Massage - methods</topic><topic>Medicine General & Introductory Medical Sciences</topic><topic>Mixed duration</topic><topic>Musculoskeletal conditions</topic><topic>Non‐specific low back pain</topic><topic>Orthopaedics & trauma</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Return to Work</topic><topic>Review Type</topic><topic>Rheumatology</topic><topic>Sick Leave</topic><topic>Target condition</topic><topic>Treatment</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Furlan, Andrea D</creatorcontrib><creatorcontrib>Giraldo, Mario</creatorcontrib><creatorcontrib>Baskwill, Amanda</creatorcontrib><creatorcontrib>Irvin, Emma</creatorcontrib><creatorcontrib>Imamura, Marta</creatorcontrib><creatorcontrib>Furlan, Andrea D</creatorcontrib><collection>Wiley-Blackwell Cochrane Library</collection><collection>Cochrane Library</collection><collection>Cochrane Library (Open Aceess)</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cochrane database of systematic reviews</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Furlan, Andrea D</au><au>Giraldo, Mario</au><au>Baskwill, Amanda</au><au>Irvin, Emma</au><au>Imamura, Marta</au><au>Furlan, Andrea D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Massage for low‐back pain</atitle><jtitle>Cochrane database of systematic reviews</jtitle><addtitle>Cochrane Database Syst Rev</addtitle><date>2015-09-01</date><risdate>2015</risdate><volume>2015</volume><issue>9</issue><spage>CD001929</spage><pages>CD001929-</pages><issn>1465-1858</issn><issn>1469-493X</issn><eissn>1465-1858</eissn><eissn>1469-493X</eissn><abstract>Background
Low‐back pain (LBP) is one of the most common and costly musculoskeletal problems in modern society. It is experienced by 70% to 80% of adults at some time in their lives. Massage therapy has the potential to minimize pain and speed return to normal function.
Objectives
To assess the effects of massage therapy for people with non‐specific LBP.
Search methods
We searched PubMed to August 2014, and the following databases to July 2014: MEDLINE, EMBASE, CENTRAL, CINAHL, LILACS, Index to Chiropractic Literature, and Proquest Dissertation s. We also checked reference lists. There were no language restrictions used.
Selection criteria
We included only randomized controlled trials of adults with non‐specific LBP classified as acute, sub‐acute or chronic. Massage was defined as soft‐tissue manipulation using the hands or a mechanical device. We grouped the comparison groups into two types: inactive controls (sham therapy, waiting list, or no treatment), and active controls (manipulation, mobilization, TENS, acupuncture, traction, relaxation, physical therapy, exercises or self‐care education).
Data collection and analysis
We used standard Cochrane methodological procedures and followed CBN guidelines. Two independent authors performed article selection, data extraction and critical appraisal.
Main results
In total we included 25 trials (3096 participants) in this review update. The majority was funded by not‐for‐profit organizations. One trial included participants with acute LBP, and the remaining trials included people with sub‐acute or chronic LBP (CLBP). In three trials massage was done with a mechanical device, and the remaining trials used only the hands. The most common type of bias in these studies was performance and measurement bias because it is difficult to blind participants, massage therapists and the measuring outcomes. We judged the quality of the evidence to be "low" to "very low", and the main reasons for downgrading the evidence were risk of bias and imprecision. There was no suggestion of publication bias. For acute LBP, massage was found to be better than inactive controls for pain ((SMD ‐1.24, 95% CI ‐1.85 to ‐0.64; participants = 51; studies = 1)) in the short‐term, but not for function ((SMD ‐0.50, 95% CI ‐1.06 to 0.06; participants = 51; studies = 1)). For sub‐acute and chronic LBP, massage was better than inactive controls for pain ((SMD ‐0.75, 95% CI ‐0.90 to ‐0.60; participants = 761; studies = 7)) and function (SMD ‐0.72, 95% CI ‐1.05 to ‐0.39; 725 participants; 6 studies; ) in the short‐term, but not in the long‐term; however, when compared to active controls, massage was better for pain, both in the short ((SMD ‐0.37, 95% CI ‐0.62 to ‐0.13; participants = 964; studies = 12)) and long‐term follow‐up ((SMD ‐0.40, 95% CI ‐0.80 to ‐0.01; participants = 757; studies = 5)), but no differences were found for function (both in the short and long‐term). There were no reports of serious adverse events in any of these trials. Increased pain intensity was the most common adverse event reported in 1.5% to 25% of the participants.
Authors' conclusions
We have very little confidence that massage is an effective treatment for LBP. Acute, sub‐acute and chronic LBP had improvements in pain outcomes with massage only in the short‐term follow‐up. Functional improvement was observed in participants with sub‐acute and chronic LBP when compared with inactive controls, but only for the short‐term follow‐up. There were only minor adverse effects with massage.</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>26329399</pmid><doi>10.1002/14651858.CD001929.pub3</doi><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection; Cochrane Library |
| subjects | Acute Pain Acute Pain - therapy Adult Back disorders Bias Chronic Pain Chronic Pain - therapy Complementary & alternative medicine Humans Insurance medicine Intervention Low Back Pain Low Back Pain - therapy Manipulation, Spinal Manual therapy Massage Massage - adverse effects Massage - methods Medicine General & Introductory Medical Sciences Mixed duration Musculoskeletal conditions Non‐specific low back pain Orthopaedics & trauma Randomized Controlled Trials as Topic Return to Work Review Type Rheumatology Sick Leave Target condition Treatment |
| title | Massage for low‐back pain |
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