Massage Therapy for Lower Back Pain
"Oh, my back still hurts," Jim groaned as he sat on the bed and bent over to pick up his shoe.
"Why don't you try a massage?" His wife asked. "My friend Carol swears massage is the only thing that can help her back pain."
Jim sighed as he tied his shoe. "I suppose I have tried everything else. The chiropractor says my back is fine, just the muscles are tight. My doctor gave me muscle relaxants which I don't like to take, and our insurance only covered four physical therapy visits. Massage can't hurt my back any more than it already does, I guess."
Jim is typical of most Americans trying massage for the first time. Many feel that it can't hurt to try. But what does massage do? What kind of massage should you try? How do you find a massage therapist?
Research on Massage Therapy
A July 2001 survey conducted by the American Massage Therapy Association found that the number of adults receiving massages from a massage therapist more than doubled since 1997.
Most healthcare providers are recognizing massage therapy as a legitimate aid for lower back pain and an effective adjunct to lower back treatments. Fifty-four percent of healthcare providers say they will encourage their patients to pursue massage therapy in addition to medical treatment.
A study on massage and back pain conducted at the Touch Research Institute at the University of Miami in 2001 found that: "Massage lessened lower back pain, depression and anxiety, and improved sleep. The massage therapy group also showed improved range of motion and their serotonin and dopamine levels were higher." (International Journal of Neuroscience, 106, 131-145.)
Benefits of Massage Therapy
According to the American Massage Therapy Association, research shows that massage therapy provides several important health benefits, including:
- Massage improves blood circulation, which aids in recovery of muscle soreness from physical activity.
- Massage relaxes muscles for an improved range of motion. The muscle relaxation also helps with insomnia.
- Massage leads to increased endorphin levels. The increase of endorphin levels is actually one of the greatest benefits of massage therapy. Endorphins are the chemicals the body produces that make you feel good, which is very effective in managing chronic pain.
Neuromuscular Massage Therapy
The most effective type of massage therapy for lower back pain is neuromuscular therapy. Neuromuscular therapy is also called trigger point myotherapy. The American Academy of Pain Management recognizes this form of massage therapy as an effective treatment for back pain caused by soft tissue injury (such as a muscle strain).
Neuromuscular Massage Therapy Technique
Neuromuscular therapy consists of alternating levels of concentrated pressure on the areas of muscle spasm. The massage therapy pressure is usually applied with the fingers, knuckles, or elbow. Once applied to a muscle spasm, the pressure should not vary for ten to thirty seconds.
Muscles that are in spasm will be painful to the touch. The pain is caused by ischemic muscle tissue. Ischemia means the muscle is lacking proper blood flow, usually due to the muscle spasm. This in turn creates the following undesirable process:
- Because the muscle is not receiving enough blood, the muscle is also not receiving enough oxygen
- The lack of oxygen causes the muscle to produce lactic acid
- The lactic acid makes the muscle feel sore following physical activity.
After the muscle is relaxed through massage therapy, the lactic acid will be released from the muscle, and the muscle should start receiving enough blood and oxygen.
Neuromuscular therapy will feel painful at first, but the pressure of the massage should alleviate the muscle spasm. At this point, it is extremely important to communicate with the massage therapist regarding the pressure - whether the pressure is too much, too little, getting better, getting worse. The therapist should listen and respond accordingly. The massage therapy pressure should never be overly painful. In fact, most people describe the pressure as “good pain”.
What to Expect After Massage Therapy
Following a neuromuscular therapy massage, any soreness that presents itself should fade after twenty-four to thirty-six hours. The muscles that were tight should remain noticeably more relaxed for four to fourteen days, depending on stress.
Massage Therapy Considerations for Lower Back Pain
The muscle spasm should relax in response to the pressure applied by the massage therapist. If the muscle does not relax in response to the pressure, there is usually inflammation present. Massage is not the best treatment option for inflamed muscles, and patients should consult their doctor for treatment for the inflammation.
Most muscle spasms require four massage treatments, usually over the course of six weeks, to achieve the best effect. If muscle spasms do not begin to respond to neuromuscular therapy within two massages, neuromuscular massage therapy may not be the best treatment option.
If you have severe lower back pain, it is advisable to be checked by medical personnel before beginning massage therapy.
Combining Massage Therapy with Other Treatments
Massage therapy will produce the best results when combined with medical treatments such as physical therapy, chiropractic, or physician care. Many massage therapy professionals will work as part of an interdisciplinary health care team in overall patient evaluation and treatment.