Summary
Although anti-inflammatory drugs are heavily advertised and routinely prescribed for pain syndromes a recent clinical trial found them to be far less effective than simple home massage for the relief of upper back pain. The simple home massage not only proved a far superior at reduction in pain, it also produced significant improvements in ranges of motion and a reduction in muscular tightness and tenderness. Musculoskeletal pain syndromes can be quite complex issues though, so we see the best use of self massage not as a substitute for popping a pill, but as part of a professional management that properly takes care of the underlying causes of pain syndromes and reduced function.
The trial details
Subjects
The 60 subjects (two groups of 30) were aged from 18-60 and had suffered from upper back pain for at least 12 weeks.
The treatments
The self massage
The subjects used a hooked cane called a Wilai stick to apply massage along the paraspinal muscles of the upper thoracic area. Using the stick, pressure was applied until mild pain was experienced, then released after five seconds. This was repeated five times for each point. The self massage was followed by a two minute stretching routine. The treatment was repeated each day for 5 days.
The anti-inflammatory drugs
Subjects took 400mg of ibuprofen three times daily for five days
The measurements
The following measurements were used
- the level of pain using a visual analogue scale
- the amount of pressure on muscles needed to elicit tenderness
- cervical ranges of motion
The results
Over the five days the self massage group experienced a reduction in pain from 5.4 to 0.08 on the 1-10 scale, plus excellent clinical improvements in tissue hardness/tenderness and cervical ranges of motion. In contrast, the ibuprofen group experienced a smaller reduction in pain, and no improvement in any other aspects.
Clinical discussion
Apart from showing that pharmaceutical companies and the medical industry are making massive fortunes pushing drugs that kill people while safer, less expensive and more effective solutions are available, the trial results help guide us in what is needed to successfully treat these pain syndromes.
The involvement of myofascial issues
The self massage used emulates the professional massage technique ischemic compression or “pressure point therapy”. This targets myofascial issues, especially trigger points. The excellent results show that myofascial issues are a major cause of upper back/cervical pain and dysfunction.
The usefulness of self/home massage
The positive results support the use of home massage. However, as with home massage using our DrGraeme massagers we are not suggesting that it should be seen as an alternative to “popping pills”. Musculoskeletal pain and dysfunction can be a complex clinical entity, and should be addressed by a proper program determined by a professional after appropriate examination. Trigger points and other chronic myofascial issues can require extensive therapy repeated over a long period of time, so home massage is a very useful tool. However, a professional management plan may also include aspects such as joint function, the need for ergonomic and manual handling advice, the need for rehabilitation exercises, more complex myofascial issues that require professional intervention, and possibly many other aspects.
Reference
Wamontree, Phanida. et.al. THE EFFECTS OF TRADITIONAL THAL SELF-MASSAGE USING WILAI MASSAGE STICKTM IN PATIENTS ON UPPER TRAPEZIUS WITH MYOFASCIAL TRIGGER POINTS: A RANDOMIZED CONTROL TRIAL. J. Phys. Ther. Sci. 27: 3493-3497, 2015
