Tuesday 30th October 2018

Traditional home massage found to be far superior to anti-inflammatory drugs for chronic upper back pain

Summary

Although anti-inflammatory drugs are heavily advertised and routinely prescribed for pain syndromes a recent clinical trial found them to be far less effective than simple home massage for the relief of upper back pain. It not only produced a far superior at reduction in pain, it also produced significant improvements in ranges of motion and a reduction in muscular tightness and tenderness.


The pain reduction and functional improvements gained from the self massage indicate that myofascial issues are a significant part of such syndromes, and shows that self massage at home can be a useful part of their management. Musculoskeletal pain syndromes can be quite complex issues though, so we see the best use of self massage not as a substitute for popping a pill, but as part of a professional management that properly takes care of the underlying causes of pain syndromes and reduced function.

The trial details

Subjects

The 60 subjects (two groups of 30) were aged from 18-60 and had suffered from upper back pain for at least 12 weeks. The only other significant inclusion criteria was the presence of at least one myofascial trigger point. Studies have shown an extremely high prevalence of trigger points in such pain syndromes. One study even found trigger points in the shoulder muscles nearly 90% of asymptomatic people. Simply, practically all chronic upper back pain sufferers would have trigger points so it is reasonable to say that the groups were fairly representative of all upper back pain sufferers.

The treatments

The self massage

The subjects used a hooked cane called a Wilai stick to apply massage along the paraspinal muscles of the upper thoracic area. Using the stick, pressure was applied until mild pain was experienced, then released after five seconds. This was repeated five times for each point. The self massage was followed by a two minute stretching routine. The treatment was repeated each day for 5 days.

The anti-inflammatory drugs

Subjects took 400mg of ibuprofen three times daily for five days

The measurements

The following measurements were used

  • the level of pain using a visual analogue scale
  • the amount of pressure on muscles needed to elicit tenderness
  • cervical ranges of motion

The results

Over the five days the self massage group experienced a reduction in pain from 5.4 to 0.08 on the 1-10 scale, plus excellent clinical improvements in tissue hardness/tenderness and cervical ranges of motion. In contrast, the ibuprofen group experienced a smaller reduction in pain, and no improvement in any other aspects.

Clinical discussion

Apart from showing that pharmaceutical companies and the medical industry are making massive fortunes pushing drugs that kill people while safer, less expensive and more effective solutions are available, the trial results help guide us in what is needed to successfully treat these pain syndromes.

The involvement of myofascial issues

The self massage used emulates the professional massage technique ischemic compression or “pressure point therapy”. This targets myofascial issues, especially trigger points. The excellent results show that myofascial issues are a major cause of upper back/cervical pain and dysfunction.

The usefulness of self/home massage

The positive results support the use of home massage. However, as with home massage using our DrGraeme massagers we are not suggesting that it should be seen as an alternative to “popping pills”. Musculoskeletal pain and dysfunction can be a complex clinical entity, and should be addressed by a proper program determined by a professional after appropriate examination. Trigger points and other chronic myofascial issues can require extensive therapy repeated over a long period of time, so home massage is a very useful tool. However, a professional management plan may also include aspects such as joint function, the need for ergonomic and manual handling advice, the need for rehabilitation exercises, more complex myofascial issues that require professional intervention, and possibly many other aspects.

Reference


Wamontree, Phanida. et.al. THE EFFECTS OF TRADITIONAL THAL SELF-MASSAGE USING WILAI MASSAGE STICKTM IN PATIENTS ON UPPER TRAPEZIUS WITH MYOFASCIAL TRIGGER POINTS: A RANDOMIZED CONTROL TRIAL. J. Phys. Ther. Sci. 27: 3493-3497, 2015

Samples and practitioner orders

We happily supply sample massagers to degree qualified practitioners who deal with musculoskeletal complaints, on a one per clinic basis.  Please email us directly on graeme@drgraeme.com for samples or practitioner/wholesale supply.





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About Dr Graeme

Several years ago Dr Graeme, a Chiropractor practicing in Victoria, Australia was looking for a serious hand held massager his patients could use at home to get the extra quality massage they needed. The ones he found in the shops and on-line for home use looked nice but were not serious, and ... read more