Effect of Massage on Chronic Low Back Pain

描述(申请人提供)：越来越多的美国人寻求按摩治疗师的护理来缓解背部疼痛。不幸的是，人们对最容易获得的按摩形式--瑞典式放松按摩的有效性知之甚少。放松按摩的目的是放松全身，而不是更注重治疗的按摩形式，后者涉及到操纵肌肉、筋膜或韧带，据信这些肌肉、筋膜或韧带被认为是导致疼痛的原因。尽管几乎所有的按摩学校都教授放松按摩，大多数美国按摩治疗师都使用放松按摩，但它对背部疼痛的有效性从未被评估过。这项研究的主要目的是确定放松按摩是否是治疗慢性下腰痛的有效方法。如果发现有效，放松按摩将是一种广泛可用的安全替代通常开出的肌肉放松药物，这些药物可能会有副作用和习惯化的风险。这项研究还将使我们能够确定放松按摩在减少由于背部疼痛引起的短期和长期疼痛和功能障碍方面是否比治疗性按摩更有效。399名健康计划成员(每组133名)持续至少3个月的非特异性下腰痛将被随机分为放松按摩、治疗性按摩或对照组，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。随机化后4、10、26和52周，将由蒙面接受治疗的面试者在基线和4、10、26和52周后评估下腰痛的主要结果、功能和烦扰程度。这项研究还将探索慢性腰背患者的生理、心理社会和临床基线特征预测哪些患者将从每种类型的按摩中受益最大的能力。这项研究的结果将阐明最常见的按摩形式对于治疗困扰发达国家的最常见、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知情和自信的转介，消费者和保险公司做出安全和经济高效的选择，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.