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For back pain, massage rubs you the right way

There are 20 million people in this country who are wise enough to do something most of us don't, and Dan Cherkin is one of them.

"I get regular massages," Cherkin said. "Not for any therapeutic reasons, simply for relaxation. They're great."

Anyone who has received massage therapy knows the feeling. But Cherkin can do you one better. He is lead author on a study published in the Archives of Internal Medicine earlier this year that showed massage therapy was superior for treating chronic lower-back pain compared with acupuncture or self-care education.

It is the first major U.S. finding that links massage therapy to relieving a most common and nagging health problem.

Massage as it relates to back pain "has not been studied much at all until just the last couple of years," said Cherkin, acting director of the research arm of Group Health Cooperative. "It hasn't been on the radar screen for medical researchers."

Bottom line:

The finding: Massage therapy is significantly superior for treating chronic lower-back pain compared to acupuncture or giving people reading material about how to properly care for their backs.

The significance: This is the first major U.S. finding that links massage therapy to relieving this common health problem.

Credentials please?
Before heading for the massage table nearest you, it is always a good idea to ask a massage therapist about credentials. A new survey by the national certification board shows only 50 percent of consumers ask where a therapist trained or if he or she is certified.

Resources
The Evanston-based American Massage Therapy Association (888-843-2682 or www.amtamassage.org) is a good resource organization, and the National Certification Board for Therapeutic Massage and Bodywork (www.ncbtmb.com) can provide referrals to one of its 45,000 certified members.

Cherkin said the surging popularity of massage therapy among patients and the willingness among some insurance plans to cover it prompted him to secure federal money to carry out his study, which included physician-collaborators from Harvard Medical School's Center for Alternative Medicine Research and the University of Washington.

About 15 years into a research career dedicated to lower-back pain, he learned a lot about massage therapy.

"It was widely used by doctors (in the early 1900s)," Cherkin said. "They even did some of the massages themselves. Then massage therapy was sort of relegated to physical therapists, who dropped it as a regular practice by the time of World War II. It has been part of health care in other cultures the whole time."

In his past research efforts, Cherkin found therapies such as physical therapy or chiropractic "not all that much better" for treating back pain than educating patients about how to properly care for their backs. The success of massage therapy in the recent study surprised him.

What the study showed

The experiment involved 262 patients, ages 20 to 70, who had all visited the doctor for persistent back pain within the previous six weeks.

The participants were randomly assigned to receive therapeutic massage, traditional Chinese medicine acupuncture or self-care educational materials. Ten massage or acupuncture appointments were allowed during a 10-week period.

At the 10-week mark, the patients were interviewed regarding symptoms and ability to function. Massage was found to be significantly better than acupuncture and self-care for improving symptoms and daily function.

Acupuncture did not fare any better than self-care. After one year, the massage group also used the least medications and had the lowest costs for additional back care.

"We don't know the reasons why massage therapy works," Cherkin said. "It could be the massage itself, moving the tissue. Or it could be just the experience of receiving the massage. It is very relaxing and provides an hour of peace once or twice a week."

Needless misery

Cherkin plans to seek a grant to better understand why massage is effective for lower-back pain. Meanwhile, he continues studies about whether chronic back pain is relieved by the ancient martial art of tai chi or mindfulness meditation (developed by University of Massachusetts researcher and best-selling author Jon Kabat-Zinn).

All this from a guy who hasn't suffered a single day from backaches.

"I got into medical research to discover how we can help people with common problems that are generally neglected," Cherkin said.

"Most doctors recognize we don't know much about why or how to treat chronic back pain. People with back pain are probably a lot more miserable than they need to be."

Those folks would be smart to overcome any misconceptions they might still hold about massage, such as thinking it is strictly for pampering yourself. A luxurious slowdown in today's fast-forward world? Yes. Frivolous? No.