Back Pain and Massage

Marina Alyea, a certified massage therapist in San Francisco, is familiar with the ravages of back pain. She has worked on people’s backs, she said, that were so tight and inflexible they felt armored. “Often people don’t realize how much tension they feel until they’re touched,” she says.

The most typical problem areas are the upper back, neck and shoulders, followed by the lower back — aches that are generally brought on as a result of job-related stress and a sedentary lifestyle, explains Alyea. In the effort to be more active, her clients often become weekend sports fanatics “and injure themselves because they’re so tight from work,” she says.

Emotions can also take their toll on a person’s back. “I had one client who was talking about the possibility of going to war, and while I was massaging her, she came out with her great worry that her son might be drafted,” Alyea says. After confiding her fears, Alyea says, the client breathed more deeply and her shoulders finally relaxed.

What’s gratifying, she says, is seeing someone’s body loosen up. “Clients start having more color in the body,” Alyea says. “The tone of the tissue itself changes because massage increases circulation.”

Could massage help my aching back?

Scientists have recently done studies suggesting that it might. A study in the Archives of Internal Medicine showed that massage substantially relieved lower back pain over the long term for people who suffered moderately severe chronic pain. After an hour of massage once a week for 10 weeks, participants in the study found their pain levels had dropped dramatically — by nearly 50 percent. With the reduction of pain, participants also improved their ability to carry out daily tasks by about 50 percent. A 2008 review of 13 studies found that massage may be beneficial for low back pain, especially when combined with exercises and education.

How could massage help relieve back pain?

There are many theories as to how massage works. The use of therapeutic massage dates back thousands of years to ancient cultures in China, India, and Japan when practitioners used forms of massage to promote well-being. However, it’s only recently that Western scientists have done research suggesting that massage can ease lower back pain. According to one study, massage induces mental and physical relaxation and increases the level of pain you can tolerate by releasing endorphins, the body’s natural painkillers.

What kinds of massage should I consider?

Most massage therapists practice different types of massage, including Swedish and shiatsu. In Swedish massage, the therapist kneads or rubs your body, often using broad sweeping strokes to relax muscles and promote circulation. In shiatsu, practitioners apply pressure to certain “trigger points” in the body to relieve pain.

Before getting massage therapy, ask your doctor if there’s any reason you should not have a massage. As with any bodywork, don’t be reluctant to tell your therapist if she’s exerting too much or too little pressure, if the pressure feels too painful, or if there are any areas she should avoid. Also, discuss any conditions you have with your massage therapist, who can recommend the best types of massage for you.

“As far as I’m concerned, massage therapy is going to be fine no matter what the situation is. The chance of doing any harm is negligible,” says Dr. Frank Eismont, professor and chair of the Department of Orthopedics at the University of Miami.

What should I expect if I see a massage therapist?

It really depends on the level of skill and experience of the therapist, explains Alyea, who encourages people to ask about training. Let the therapist know what you’d like to get out of the session, and how long you’d like it to last. Massages generally last from 30 to 90 minutes, and the rate should be established in advance. Make sure you tell the therapist about any condition you might have that she should be aware of, and let her know which areas need the most attention.

Will one session be enough?

It all depends on the individual. Severe back pain could require several sessions. Nagging back pain from bad posture is among the easiest to remedy, according to massage therapists. “I try to help clients readjust how they sit and help them relax their muscles, and they often feel a lot better,” Alyea says. “Other people I advise to get up from their desk and move around [during the day].”

How much of an impact will the massage have on my pain?

Again, it depends on how much pain you’re in and what’s causing it. For people who suffer from chronic lower back pain, the beneficial effects may last longer than you might think. The Archives of Internal Medicine study reported that a year after the 78 people suffering from lower back pain received 10 weeks of massage, they still felt much better than they did before their initial massage. A year after they finished their last session, in fact, the intensity of their symptoms and degree of disability was still about 50 percent less than before they ever had a massage, according to the study.

Further Resources

To find a massage therapist, start by making sure that the person is certified. Also organizations of massage therapists can help with a referral:

National Certification Board for Therapeutic Massage and Bodywork

Associated Bodywork and Massage Professionals (This group keeps an updated list of members who are certified).

American Massage Therapy Association


Furlan, AD, Imamura, M, Dryden, T, Irvin, E. Massage for low-back pain. Cochrane Database Systematic Review; 8; 4.

Andersson, Gunnar BJ, “Epidemiological features of chronic low-back pain,” Lancet, 354 (9178): 581-585

Furlan, AD, Brosseau L, et al, “Massage for Low Back Pain,” (Cochrane Review). The Cochrane Library, Issue 4. Oxford: Update Software.

Cherkin, Daniel C, Eisenberg, David, et al, “Randomized Trial Comparing Traditional Chinese Medical Acupuncture, Therapeutic Massage, and Self-care Education for Chronic Low Back Pain,” Arch Intern Med;161:1081-1088.

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