skip navigation

June 2, 2003

Massage works well for back pain, Group Health researchers report

Seattle—Massage appears to be an effective way to treat back pain according to a new, in-depth review of evidence from dozens of studies of alternative treatments. Led by researchers from Group Health Center for Health Studies (CHS), the authors reported their findings in the June 3 issue of the Annals of Internal Medicine.

Their article concludes:

• Massage was found to be effective for relieving symptoms and increasing function among people with persistent back pain.
• Spinal manipulation (commonly done by chiropractors and osteopaths) has small clinical benefits for back pain—about the same as conventional medical treatments such as over-the-counter pain relievers and various types of physical therapy.
• The effectiveness of acupuncture for back pain remains unclear.
• Massage may reduce the costs of care after an initial course of therapy for back pain, but acupuncture or spinal manipulation may not.
• All three treatments were found to be relatively safe for treating back pain.

"Many Americans are using alternative treatments for back pain and paying a fair amount of money for them—either out-of-pocket or through insurance," says Daniel C. Cherkin, PhD, senior investigator at CHS and the lead author of the article. "So it’s important to know whether these treatments are effective and whether they should be made more widely available."

More than half of all Americans experience back pain each year, according to the report. Americans spend more that $25 billion annually on medical care services for back pain; another $50 billion is spent on lost productivity and disability payments each year.

Patients often find that conventional medical treatment for back pain doesn’t work, so they turn to alternative treatment for relief, Cherkin explains. Studies show that back pain accounts for 40 percent of visits to chiropractors, 20 percent of visits to massage therapists, and 14 percent of visits to acupuncturists.

Despite the popularity of these treatments, evidence supporting their use has been lacking, Cherkin adds. Many studies of alternative treatments have been conducted in recent years, but their "poor quality, inconsistent conclusions, and biases" have led to confusion and conflicting perceptions among lay people and health professionals, he says.

Cherkin and his colleagues analyzed scientific data from the most recent systematic reviews of randomized controlled trials evaluating acupuncture, massage therapy, and spinal manipulation for back pain, as well as trials that were conducted since the reviews were published.

Cherkin believes the public may be most surprised to learn that the medical community still doesn’t have good evidence about the effectiveness of acupuncture, despite the therapy’s visibility in the popular press. But a large new study begun in May at Group Health will lead to better answers. Funded by a $4.4 million grant from the National Institute of Health’s National Center for Complementary and Alternative Medicine, Cherkin and his team are conducting multi-site randomized controlled trial of acupuncture for chronic back pain. The study will take five years.

The review project published in Annals was funded by grants from the Agency for Healthcare Research and Quality, and the National Institutes of Health.

Other authors who contributed to the review are Karen Sherman, PhD, associate investigator at Group Health Center for Health Studies; Richard A. Deyo, professor, University of Washington Departments of Medicine and Health Services; and Paul G. Shekelle, MD, PHD, director, RAND’s Southern California Evidence-Based Practice Center and associate professor at UCLA’s Department of Medicine.

About Group Health Center for Health Studies

Group Health Center for Health Studies conducts epidemiologic, health-services, and clinical research related to prevention, diagnosis, and treatment of major health problems. Funded primarily through government and private research grants, the Center is located in Seattle, Washington.

Founded in 1947, Group Health is a consumer-governed, nonprofit health care system that coordinates care and coverage. Based in Seattle, Group Health and Group Health Options serve nearly 600,000 members in Washington and Idaho.

Top