Effect of Massage on Chronic Low Back Pain

描述（由申请人提供）：美国人越来越多地寻求按摩治疗师的护理，以缓解背痛。不幸的是，很少有人知道最容易获得的按摩形式的有效性，瑞典按摩放松。放松按摩旨在放松整个身体，而不是更多的治疗导向形式的按摩，涉及操纵肌肉，筋膜或韧带被认为是造成疼痛的原因。尽管放松按摩在几乎所有的按摩学校都有教授，并被大多数美国按摩治疗师使用，但其对背痛的有效性从未被评估过。本研究的主要目的是确定放松按摩是否是治疗慢性腰痛的有效方法。如果发现有效，放松按摩将代表一种广泛可用和安全的替代常用的肌肉松弛药物，可能有副作用和习惯的风险。这项研究还将使我们能够确定放松按摩是否比治疗性按摩更有效或更不有效，以减少由于背痛引起的短期和长期疼痛和功能障碍。399名患有持续至少3个月的非特异性腰痛的健康计划成员（每组133名）将被随机分配到放松按摩，治疗按摩或对照组，对照组除常规护理外不接受任何治疗。按摩治疗师将在10周内提供10次治疗。将在基线和随机化后4、10、26和52周由对治疗设盲的访视者评估主要结局（功能和腰痛的困扰）。这项研究还将探讨慢性下背部患者的身体，心理和临床基线特征的能力，以预测哪些患者将从每种类型的按摩中受益最多。这项研究的结果将阐明最常见的按摩形式对治疗发达国家最常见，最具挑战性和最昂贵的健康问题之一的价值。这些发现将帮助医生做出明智和自信的推荐，消费者和保险公司做出安全和具有成本效益的选择，按摩学校做出负责任的课程决定。

DESCRIPTION (provided by applicant): Americans are increasingly seeking care from massage therapists for relief of back pain. Unfortunately, little is known about the effectiveness of the most readily available form of massage, Swedish massage for relaxation. Relaxation massage is intended to relax the whole body, in contrast to more therapeutically-oriented forms of massage that involve manipulation of the muscles, fascia or ligaments believed responsible for the pain. Although relaxation massage is taught in almost all massage schools and used by most US massage therapists, its effectiveness for back pain has never been evaluated. The primary aim of this study is to determine if relaxation massage is an effective treatment for chronic low back pain. If found effective, relaxation massage would represent a widely available and safe alternative to commonly prescribed muscle relaxant medications that can have side effects and a risk of habituation. The study will also allow us to determine if relaxation massage is more or less effective than therapeutic massage in reducing short-term and long-term pain and dysfunction due to back pain. 399 health plan members (133 per group) with non-specific low back pain lasting at least 3 months will be randomized to relaxation massage, therapeutic massage, or a control group that receives no treatment beyond their usual care. Massage therapists will provide 10 treatments over 10-weeks. The primary outcomes, function and bothersomeness of low back pain, will be assessed at baseline and 4, 10, 26, and 52 weeks after randomization by interviewers masked to treatment. This study will also explore the ability of physical, psychosocial, and clinical baseline characteristics of patients with chronic low back to predict which patients will benefit most from each type of massage. The results of this study will clarify the value of the most common form of massage for treating one of the most common, challenging, and expensive health problems plaguing developed countries. The findings will help physicians make informed and confident referrals, consumers and insurers make safe and cost-effective choices, and massage schools make responsible curriculum decisions.