Massage Therapy For Back Pain
Back pain is one of the leading cause of disability worldwide (Global Burden of Disease Study 2016).
The social and economical repercussions of this is enormousness. As a result the health care system is looking for options that cost-effective and easy to implement - In Steps Massage Therapy!
Massage Therapy Is A Non-Pharmacological Intervention Supported By Best Practice Guidelines
Recent recommendations from The American College of Physicians (Wenger et al. 2017) and the Canadian Medical Association (Traeger et al. 2017) represent a monumental shift in pain management. Physicians, now more than ever are recommending conservative treatment including massage, acupuncture and exercise as part of a multi-modal approach for patients suffering from low back pain, anxiety and stress.
Massage Therapy Should No Longer Be Considered A Luxury
Massage Therapy is a multi-modal approach that can involve a number of rehabilitation strategies based on patient-specific assessment findings including, but not limited to:
• Manual Therapy (nerve mobilization, soft tissue massage, triggerpoint, IASTM)
• Education on Psychosocial Factors (eg. BPS framework of pain, fear avoidance)
• Mindfulness-Based Stress Reduction
• Remedial Loading Programs (eg. static stretching and strengthening exercises)
Why Does Massage Therapy Work?
Massage therapy is a clinically-oriented multi-modal approach (manual therapy, remedial exercise and patient education) based on the three pillars of evidence based practice (best available evidence, clinical expertise and patient values).
The responses to massage therapy are multifactorial - physiological and psychological factors interplay in a complex manner. A biopsychosocial framework is a practical approach for investigating the complex interplay between massage therapy and the determinants of health, and pain.
Structures To Be Aware Of When Treating Back Pain
Structures to keep in mind while assessing and treating patients suffering from low back pain may include neurovascular structures and investing fascia of:
• Gluteal Muscle Group (Gluteus Maximus, Gluteus Medius and Gluteus Minimus)
• Thoracolumbar Fascia
• Quadratus Lumborum
• External Obliques, Internal Obliques, Transverse Abdominis
• Hip Flexors (Psoas Major & Iliacus)
• Erector Spinae (Iliocostalis, Longissimus, Spinalis)
More to Explore
Adelmanesh et al. (2016). The Diagnostic Accuracy of Gluteal Trigger Points to Differentiate Radicular From Nonradicular Low Back Pain. Clin J Pain.
Basson et al. (2017). The Effectiveness of Neural Mobilization for Neuro-Musculoskeletal Conditions: A Systematic Review and Meta-Analysis. J Orthop Sports Phys Ther.
Brinjikji et al. (2015). Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations. American Journal of Neuroradiology.
Busse et al. (2017). Guideline for opioid therapy and chronic noncancer pain. CMAJ.
Cherkin et al. (2011). A Comparison of the Effects of 2 Types of Massage and Usual Care on Chronic Low Back Pain. Annals of Internal Medicine.
Chou et al. (2017). Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline. Ann Intern Med.
Chou et al. (2018). The Global Spine Care Initiative: applying evidence-based guidelines on the non-invasive management of back and neck pain to low- and middle-income communities. Eur Spine J.
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Dewitte et al. (2018). Clinical classification criteria for nonspecific low back pain: A Delphi-survey of clinical experts. Musculoskelet Sci Pract.
Elder et al. (2017). Real-World Massage Therapy Produces Meaningful Effectiveness Signal for Primary Care Patients with Chronic Low Back Pain: Results of a Repeated Measures Cohort Study. Pain Med.
Foster et al. (2018). Prevention and treatment of low back pain: evidence, challenges, and promising directions. Lancet.
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