The National Institutes of Health’s (NIH) National Center for Complementary and Integrative Health (NCCIH) has released a report that references “Evidence-Based Evaluation of Complementary Health Approaches for Pain Management in the United States,” which was published Sept. 1 by Mayo Clinic Proceedings and which states that, based on an evaluation of randomized, controlled clinical trials, massage and other complementary therapies may be effective for various types of common pain conditions.
NCCIH is one of 27 centers and institutes under the umbrella of the U.S. National Institutes of Health (NIH), and is charged with funding research into complementary medicine.
Types of CAM
The review focused on trials conducted in the U.S. on these complementary approaches: acupuncture, glucosamine and chondroitin, massage therapy, methylsulfonylmethane, omega-3 fatty acids, osteopathic manipulative therapy, relaxation techniques, s-adenosylmethionine, spinal manipulation, tai chi and yoga.
Types of Pain Conditions
The report focused on the above-noted complementary therapies for one or more of five pain conditions: fibromyalgia, low-back pain, neck pain, osteoarthritis, and severe headaches and migraine.
Massage & Fibromyalgia
Regarding fibromyalgia, the authors wrote, “[a] small study (12 women) examined Swedish massage vs. myofascial release therapy for fibromyalgia symptoms.75 No difference was seen between groups on the [Fibromyalgia Impact Questionnaire].”
Massage & Low-Back Pain
Regarding low-back pain, the authors identified eight randomized, controlled clinical trials and determined, “for chronic [low-back] pain, [two] larger studies comparing massage with usual care reported modest improvements in pain and function at 10 weeks, but the benefit was not sustained at 52 weeks.”
The authors also noted that three smaller studies “compared massage to either usual outpatient rehabilitation or relaxation and did not observe significant between-group differences for pain and/or function.
“For acute or subacute [low-back pain], [two] smaller studies found significant, albeit modest, improvements in pain compared with no treatment,” they added.
Massage & Neck Pain
The authors looked at four randomized, controlled trials that examined massage’s ability to relieve symptoms associated with chronic neck pain.
One study, “Randomized trial of therapeutic massage for chronic neck pain,” conducted in 2009, “reported a dose-response relationship between the number and duration of massage sessions per week and improvement in the NDI score and neck pain intensity,” the authors noted.
“The findings indicated that 60 minutes of massage 2 to 3 times per week was significantly better than either 30 or 60 minutes of massage once per week after the 4 weeks of treatment,” they reported.
A follow-up to the study randomized participants to one additional massage therapy session per week for six more weeks.
“At the end of treatment, those randomized to the additional sessions had significantly improved pain and function vs those who did not receive the additional sessions; the difference between groups was no longer significant after 14 weeks of follow-up,” the authors stated.
Massage & Osteoarthritis
The authors found two randomized, controlled clinical trials that examined the efficacy of Swedish massage for symptoms related to osteoarthritis of the knee.
After completing eight weeks of massage, subjects in the first study’s massage group “had significant improvement vs those randomized to usual care in the [Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)] total score as well as in each of the WOMAC subscale scores (pain, function, and joint stiffness),” the authors wrote.
In the other study, subjects “were randomized to one of five groups for 8 weeks: (1) usual care, (2) 240 minutes of massage over [eight] weeks, (3) 360 minutes of massage, (4) 480 minutes of massage, and (5) 600 minutes of massage.
“Only individuals receiving at least 480 minutes of massage therapy (groups 4 and 5) had substantial improvement in the WOMAC total score and the WOMAC pain subscale score vs the usual care group,” the authors wrote. “Across the [two] trials, only one adverse event, discomfort at the knee in one participant, was noted.”
Massage & Severe Headache
“One small study that compared myofascial trigger point massage, a sham device, and wait list found that massage reduced headache frequency but did not significantly reduce the intensity or duration of headaches,” the authors wrote.