Is massage better than anti-inflammatory drugs (NSAIDS)

The trial where massage and NSAIDS were directly compared

In this trial a traditional Thai self massage was compared with the NSAID Ibuprofen (2). The details are as follows.

The patients

60 people with long standing upper back pain were given 5 days of either:

The treatments

• 400mg of the NSAID Iboprufen three times daily, or
• daily self application of self massage using a tool called a Wilai Stick. We cover this in the section of self massage options below.

What they measured

The researchers measured pain, plus functional things such as muscle tightness and head/neck movement.

What the trial found

Those receiving the massages had a good reduction in pain, and improvement in the the functional things such as head/neck movement. On the other hand those receiving the Iboprufen only had a slight improvement in pain and no improvement in the functional things

Summary of clinical trial results and safety for massage

Summary of the clinical trial results and safety for NSAIDS

While massage has been shown to very safe and moderately effective the clinical trial results and other scientific evidence shows that at best NSAIDS only give a small amount to short term relief, while being responsible for hundreds of thousands of deaths and hospitalisations. Details follow:

Clinical trial results

According to the reviews of the clinical trials of the use of NSAIDS for back pain the results range from very small and not clinically significant, to small to moderate short term relief (1,6,7).

Safety of NSAIDS

As well as there being practically no evidence of being effective NSAIDS have a horrendous record of causing serious medical side effects and death. Let’s look at look at what NSAIDS do.

• NSAIDS are responsible for 100,000 hospitisations a year. The medical cost of treating NSAID side effects is $4 billion per year. 16,500 people die each year from these side effects. (8)⁠
• According to the USA FDA, 2-4% of those taking NSAIDS for a year will develop a symptomatic ulcer which may be life threatening. (9)⁠
• 1-2% of NSAIDS users will become hospitalised, and the annual death rate is 0.08-0.22% (9)⁠
• 50% of those taking NSAIDS will develop mucosal lesions which cause bleeding, ulcers and perforations. Patients can eventually die from these complications. (10)⁠
• the newer “safer” NSAIDS are killing people too (11)⁠

Why ulcers caused by NSAIDS are so dangerous

NSAIDS cause bleeding ulcers in your digestive tract. The big problem is that while if you have a bleeding ulcer in your skin you can see the blood, but if a gastro intestinal ulcer bleeds the blood stays inside you and is digested, so you do not see it. Often the first sign is that you are either dead or being rushed to the emergency room.

Several of the reviews of NSAIDS recommend that to improve safety doctors be diligent in assessing patients receiving NSAIDS (12,13). However, a doctor will only realise if you have bleeding ulcers if they do invasive scopes or notice you are becoming anaemic. Despite the encouragement for doctors to be vigilant the facts speak for themselves.

Your self massage options

As you have seen massage is totally superior to taking NSAIDS for back pain, but using professionals for ongoing regular massages can be expensive. The good news is that there are excellent self massage options that are effective and very safe. Let us look at your options.

• Balls and rollers: (popular, but not very effective)
• Thai self massage:( (easy and effective)
• Chairs and cushions: (easy and some benefits)
• Vibrating massagers: (easy and the most effective, but you need a proper machine- not a massage gun )

Self massage allows for regular massages

Most therapies are more effective with regular applications over time rather than a once off application. Therefore, and long as they providing some reasonable benefits regular self massages can be as effective or even more so than an occasional professional therapy.

Vibration massagers (recommended)

These are devices that have a pad that sits on the surface and send therapeutic vibrations deep into your muscles. They are very effective, easy to use and extremely safe. For more information about vibration massagers and how to use vibration massage please see:

• The scientifically proven effects of vibration massage- with clinical applications
• Vibration massage usage guide

Appendix: how clinical trials can mislead

In this section I'll show you how drug companies use clincal trials to produce "evidence" that their drugs are worthwhile. The drug companies then use these trial results to "educate" doctors so the push them onto the public.

References

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