The effectiveness of massage therapy for the treatment of nonspecific low back pain: a systematic review of systematic reviews

Saravana Kumar, Kate Beaton, Tricia Hughes, Saravana Kumar, Kate Beaton, Tricia Hughes

Abstract

Introduction: The last decade has seen a growth in the utilization of complementary and alternative medicine therapies, and one of the most popular and sought-after complementary and alternative medicine therapies for nonspecific low back pain is massage. Massage may often be perceived as a safe therapeutic modality without any significant risks or side effects. However, despite its popularity, there continues to be ongoing debate on the effectiveness of massage in treating nonspecific low back pain. With a rapidly evolving research evidence base and access to innovative means of synthesizing evidence, it is time to reinvestigate this issue.

Methods: A systematic, step-by-step approach, underpinned by best practice in reviewing the literature, was utilized as part of the methodology of this umbrella review. A systematic search was conducted in the following databases: Embase, MEDLINE, AMED, ICONDA, Academic Search Premier, Australia/New Zealand Reference Centre, CINAHL, HealthSource, SPORTDiscus, PubMed, The Cochrane Library, Scopus, Web of Knowledge/Web of Science, PsycINFO, and ProQuest Nursing and Allied Health Source, investigating systematic reviews and meta-analyses from January 2000 to December 2012, and restricted to English-language documents. Methodological quality of included reviews was undertaken using the Centre for Evidence Based Medicine critical appraisal tool.

Results: Nine systematic reviews were found. The methodological quality of the systematic reviews varied (from poor to excellent) although, overall, the primary research informing these systematic reviews was generally considered to be weak quality. The findings indicate that massage may be an effective treatment option when compared to placebo and some active treatment options (such as relaxation), especially in the short term. There is conflicting and contradictory findings for the effectiveness of massage therapy for the treatment of nonspecific low back pain when compared against other manual therapies (such as mobilization), standard medical care, and acupuncture.

Conclusion: There is an emerging body of evidence, albeit small, that supports the effectiveness of massage therapy for the treatment of non-specific low back pain in the short term. Due to common methodological flaws in the primary research, which informed the systematic reviews, recommendations arising from this evidence base should be interpreted with caution.

Keywords: complementary and alternative medicine; evidence-based practice; massage therapy; systematic review.

Figures

Figure 1
Figure 1
Flowchart of study selection. Note: Flowchart is as per the PRISMA flowchart format.

References

    1. Kohn LT, Corrigan JM, Donaldson err is human: building a safer health system Institute of Medicine; 2000Available from: Accessed September 14, 2012
    1. Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn’t. BMJ. 1996;312:71–72.
    1. Furlan AD, Brosseau L, Imamura M, Irvin E. Massage for low-back pain: a systematic review within the framework of the Cochrane Collaboration Back Review Group. Spine (Phila PA 1976) 2002;27:1896–1910.
    1. Furlan AD, Yazdi F, Tsertsvadze A, et al. A systematic review and meta-analysis of efficacy, cost-effectiveness, and safety of selected complementary and alternative medicine for neck and low-back pain. Evid Based Complement Alternat Med. 2012;2012:953139.
    1. Furlan A, Imamura M, Dryden T, Irvin E. Massage for low back pain: an updated systematic review within the framework of the Cochrane Back Review Group. Spine (Phila Pa 1976) 2009;34(16):1669–1684.
    1. Andersson GB. Epidemiological features of chronic low-back pain. Lancet. 1999;354:581–585.
    1. Hestbaek L, Leboeuf-Yde C, Manniche C. Low back pain: what is the long-term course? A review of studies of general populations. Eur Spine J. 2003;12:149–165.
    1. Imamura M, Furlan AD, Dryden T, Irvin E. Evidence-informed management of chronic low back pain with massage. Spine J. 2008;8(1):121–133.
    1. MacLennan AH, Myers SP, Taylor AW. The continuing use of complementary and alternative medicine in South Australia: costs and beliefs in 2004. Med J Aust. 2006;184:27–31.
    1. Lewis M, Johnson MI. The clinical effectiveness of therapeutic massage for musculoskeletal pain: a systematic review. Physiotherapy. 2006;92:146–158.
    1. Merlin T, Weston A, Tooher R. Extending an evidence hierarchy to include topics other than treatment: revising the Australian ‘levels of evidence’. BMC Med Res Methodol. 2009;9(34)
    1. Moyer CA, Rounds J, Hannum JW. A meta-analysis of massage therapy research. Psychol Bull. 2004;130:3–18.
    1. Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009;339:b2700.
    1. Centre for Evidence Based Medicine Systematic Review Critical Appraisal Sheet Oxford: University of Oxford; 2005Available from: Accessed November 16, 2012
    1. Pengel HM, Maher CG, Refshauge KM. Systematic review of conservative interventions for subacute low back pain. Clin Rehabil. 2002;16:811–820.
    1. Bronfort G, Haas M, Evans RL, Bouter LM. Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synthesis. Spine J. 2004;4:335–356.
    1. Ernst E, Posadzki P, Lee MS. Reflexology: an update of a systematic review of randomised clinical trials. Maturitas. 2011;68:116–120.
    1. Kim YC, Lee MS, Park ES, Lew JH, Lee BJ. Acupressure for the treatment of musculoskeletal pain conditions: a systematic review. J Musculoskelet Pain. 2012;20:116–121.
    1. van Middelkoop M, Rubinstein SM, Kuijpers T, et al. A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain. Eur Spine J. 2011;20:19–39.
    1. Brosseau L, Wells GA, Poitras S, et al. Ottawa Panel evidence-based clinical practice guidelines on therapeutic massage for low back pain. J Bodyw Mov Ther. 2012;16:424–455.
    1. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds JM, Gavaghan DJ, McQuay HJ. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials. 1996;17:1–12.
    1. Khan KS, Ter Riet G, Glanville J, Sowden AJ, Kleijnen J, The NHS Centre for Reviews and Dissemination (CRD), editors. CRD’s guidance for carrying out or commissioning reviews. 2nd ed. York: NHS Centre for Reviews and Dissemination, University of York; 2000. Undertaking systematic reviews of research on effectiveness. CRD Report No. 4.
    1. Lin CW, Haas M, Maher CG, Machado LA, van Tulder MW. Cost-effectiveness of guideline-endorsed treatments for low back pain: a systematic review. Eur Spine J. 2011;20:1024–1038.
    1. Chou R, Qaseem A, Snow V, et al. Clinical Efficacy Assessment Subcommittee of the American College of Physicians. American College of Physicians. American Pain Society Low Back Pain Guidelines Panel Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007;147(7):478–491.
    1. Airaksinen O, Brox JI, Cedraschi C, et al. COST B13 Working Group on Guidelines for Chronic Low Back Pain Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J. 2006;15(Suppl 2):S192–S300.

Source: PubMed

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