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Liu C, Chen X, Wu S. The effect of massage therapy on pain after surgery: A comprehensive meta-analysis. Complement Ther Med 2022; 71:102892. [PMID: 36309174 DOI: 10.1016/j.ctim.2022.102892] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 08/30/2022] [Accepted: 10/17/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Findings on the usefulness of massage therapy (MT) in postoperative pain management are often inconsistent among studies. OBJECTIVES This study's aim is to conduct a meta-analysis of randomized controlled trials (RCT) to clarify the effects of massage therapy in the treatment of postoperative pain. METHODS Three databases (PubMed, Embase, and Cochrane Central Register of Controlled Trials) were searched for RCTs published from database inception through January 26, 2021. The primary outcome was pain relief. The quality of RCTs was appraised with the Cochrane Collaboration risk of bias tool. The random-effect model was used to calculate the effect sizes and standardized mean difference (SMD) with 95 % confidential intervals (CIs) as a summary effect. The heterogeneity test was conducted through I2. Subgroup and sensitivity analyses were used to explore the source of heterogeneity. Possible publication bias was assessed using visual inspection of funnel plot asymmetry. RESULTS The analysis included 33 RCTs and showed that MT is effective in reducing postoperative pain (SMD, -1.32; 95 % CI, -2.01 to -0.63; p = 0.0002; I2 = 98.67 %). A similar significant effect was found for both short (immediate assessment) and long terms (assessment performed 4-6 weeks after the MT). Remarkably, we found neither the duration per session nor the dose had an impact on the effect of MT and there seemed to be no difference in the effects of different MT types. In addition, MT seemed to be more effective for adults. Furthermore, MT had better analgesic effects on cesarean section and heart surgery than orthopedic surgery. LIMITATIONS Publication bias is possible due to the inclusion of studies in English only. Additionally, the included studies were extremely heterogeneous. Double-blind research on MT is difficult to implement, and none of the included studies is double-blind. There was some heterogeneity and publication bias in the included studies. In addition, there is no uniform evaluation standard for the operation level of massage practitioners, which may lead to research implementation bias. CONCLUSIONS MT is effective in reducing postoperative pain in both short and long terms.
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Affiliation(s)
- Chunhua Liu
- Department of Cancer Rehabilitation, Lishui Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang University of Traditional Chinese Medicine, Lishui, Zhejiang, China.
| | - Xiang Chen
- The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
| | - Simin Wu
- Department of Cancer Rehabilitation, Lishui Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang University of Traditional Chinese Medicine, Lishui, Zhejiang, China.
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Efficacy of Manual Therapy and Transcutaneous Electrical Nerve Stimulation in Cervical Mobility and Endurance in Subacute and Chronic Neck Pain: A Randomized Clinical Trial. J Clin Med 2021; 10:jcm10153245. [PMID: 34362029 PMCID: PMC8347502 DOI: 10.3390/jcm10153245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/12/2021] [Accepted: 07/15/2021] [Indexed: 11/23/2022] Open
Abstract
Neck pain is a frequent health problem. Manual therapy (MT) and transcutaneous electrical nerve stimulation (TENS) are recommended techniques for treatment of mechanical neck disorders (MND) in Spanish Public Primary Care Physiotherapy Services. The aim of this study was to compare the efficacy of MT versus TENS in active mobility and endurance in cervical subacute or chronic neck pain. Ninety patients with MND were randomly allocated to receive ten 30-min sessions of either MT or TENS, in a multi-centered study through 12 Primary Care Physiotherapy Units in the Madrid community. Active cervical range of motion (CD-ROM) and endurance (Palmer and Epler test) were evaluated pre- and post-intervention and at 6-month follow-up. A generalized linear model of repeated measures was constructed for the analysis of differences. Post-intervention MT yielded a significant improvement in active mobility and endurance in patients with subacute or chronic MND, and at 6-month follow-up the differences were only significant in endurance and in sagittal plane active mobility. In the TENS group, no significant improvement was detected. With regard to other variables, MT improved mobility and endurance more effectively than TENS at post-intervention and at 6-month follow-up in the sagittal plane. Only MT generated significant improvements in cervical mobility and endurance in the three movement planes.
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Bhoi D, Jain D, Garg R, Iyengar KP, Hoda W, Vaishya R, Jain VK. Complementary and Alternative Modalities (CAM) for pain management in musculoskeletal diseases (MSDs). J Clin Orthop Trauma 2021; 18:171-180. [PMID: 34017678 PMCID: PMC8113975 DOI: 10.1016/j.jcot.2021.04.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/16/2021] [Accepted: 04/21/2021] [Indexed: 02/07/2023] Open
Abstract
Musculoskeletal diseases are a group of clinical conditions affecting the body's movement and remain a common source of pain affecting the quality of life. The aetio-pathological reasons for pain associated with musculoskeletal diseases can be varied and complex. Conventional medicine can treat or modify pain due to musculoskeletal diseases; however, these may be associated with some side effects and at times may not be able to relieve pain completely. These treatment modalities also have ceiling effects like doses of analgesics, the number of nerve blocks, etc. Complementary and Alternative Medicine (CAM) provides a supplementary, unconventional modality to alleviate discomfort and disability associated with these mostly chronic conditions to manage activities of daily living. These modalities have been variedly combined with conventional management for symptom control and thus improve day-to-day activities. We assess the role of commonly used CAM modalities in the management of pain arising from Musculoskeletal diseases.
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Affiliation(s)
- Debesh Bhoi
- Department of Anaesthesiology, Pain Medicine and Critical Care, AIIMS, New Delhi, 110029, India
| | - Dhruv Jain
- Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Rakesh Garg
- Department of Onco-Anaesthesiology and Palliative Medicine, Dr BRAIRCH, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Karthikeyan P. Iyengar
- Trauma and Orthopaedic Surgeon, Southport and Ormskirk NHS Trust, Southport, PR8 6PN, UK
| | - Wasimul Hoda
- Department of Superspeciality Anesthesia, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Raju Vaishya
- Department of Orthopaedics, Indraprastha Apollo Hospital, Sarita Vihar, Mathura Road, 110076, New Delhi, India
| | - Vijay Kumar Jain
- Department of Orthopaedics, Atal Bihari Vajpayee Institute of Medical Sciences, Dr Ram Manohar Lohia Hospital, New Delhi, 110001, India
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Islam MU, Nayab M, Ansari AN. Effect of dry cupping versus soft and prolonged massage in the management of knee osteoarthritis - a randomized controlled clinical trial. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2021; 18:797-804. [PMID: 33787191 DOI: 10.1515/jcim-2020-0350] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 10/20/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Osteoarthritis is one of the most common musculoskeletal diseases which leads to functional decline and loss of quality of life. Knee osteoarthritis is considered as highly burdensome disease as well as highest contributor to global disability. Ḥijāmah (Cupping Therapy) and Dalk (Massage) are claimed effective in the treatment of Waja'ul Mafāṣil (osteoarthritis). Present study was framed to compare the efficacy of Ḥijāmah bilā Sharṭ (Dry Cupping) and Dalk-i-Layyin Kathīr (soft and prolonged massage) with Roghan-i-Bābūna (chamomile oil) in the management of Waja' ur Rukbah (knee osteoarthritis). METHODS In present randomised controlled clinical trial, a total of 48 diagnosed patients of knee osteoarthritis were allocated randomly into group A (n=24) and group B (n=24). Group A was treated with soft and prolonged massage with Roghan-i-Bābūna while group B was managed with dry cupping on alternate day for 15 min. Visual Analog Scale (VAS) and Knee osteoarthritis outcome score (KOOS) were used for the assessment of efficacy. A total of 40 patients, group A (n=20) and group B (n=20), were completed the allocated duration of protocol therapy and were restricted to statistical analysis. RESULTS Statistically highly significant improvement was observed in objective parameters using both paired and unpaired t-tests. VAS and all KOOS subscales were found to be strongly significant at 20th day when compared with baseline (p<0.001). In intergroup comparison significant change (p>0.05) was not observed. Safety parameters were in their normal range after treatment. CONCLUSIONS Dalk-i-Layyin Kathīr with Roghan-i-Bābūna and Ḥijāmah bilā Sharṭ both were found safe and effective in the management of Waja'ur Rukbah. Hence, it may be concluded that both regimenal therapies are safe, effective and almost equal in their efficacy in the management of Knee Osteoarthritis.
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Affiliation(s)
- Mearaj Ul Islam
- Department of Ilaj bit Tadbeer, National Institute of Unani Medicine, Bengaluru, 560091, India
| | - Mohd Nayab
- Department of Ilaj bit Tadbeer, National Institute of Unani Medicine, Bengaluru, 560091, India
| | - Abdul Nasir Ansari
- Department of Ilaj bit Tadbeer, National Institute of Unani Medicine, Bengaluru, 560091, India
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Maissan F, Pool J, de Raaij E, Wittink H, Ostelo R. Treatment based classification systems for patients with non-specific neck pain. A systematic review. Musculoskelet Sci Pract 2020; 47:102133. [PMID: 32148328 DOI: 10.1016/j.msksp.2020.102133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 02/02/2020] [Accepted: 02/15/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE We aimed to identify published classification systems with a targeted treatment approach (treatment-based classification systems (TBCSs)) for patients with non-specific neck pain, and assess their quality and effectiveness. DESIGN Systematic review. DATA SOURCES MEDLINE, CINAHL, EMBASE, PEDro and the grey literature were systematically searched from inception to December 2019. STUDY APPRAISAL AND SYNTHESIS The main selection criterium was a TBCS for patients with non-specific neck pain with physiotherapeutic interventions. For data extraction of descriptive data and quality assessment we used the framework developed by Buchbinder et al. We considered as score of ≤3 as low quality, a score between 3 and 5 as moderate quality and a score ≥5 as good quality. To assess the risk of bias of studies concerning the effectiveness of TBCSs (only randomized clinical trials (RCTs) were included) we used the PEDro scale. We considered a score of ≥ six points on this scale as low risk of bias. RESULTS Out of 7664 initial references we included 13 studies. The overall quality of the TBCSs ranged from low to moderate. We found two RCTs, both with low risk of bias, evaluating the effectiveness of two TBCSs compared to alternative treatments. The results showed that both TBCSs were not superior to alternative treatments. CONCLUSION Existing TBCSs are, at best, of moderate quality. In addition, TBCSs were not shown to be more effective than alternatives. Therefore using these TBCSs in daily practice is not recommended.
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Affiliation(s)
- Francois Maissan
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, the Netherlands; Department of Health Sciences, VU University, Amsterdam, the Netherlands; Department of Epidemiology and Biostatistics, Amsterdam UMC, Amsterdam, Amsterdam Movement Sciences, the Netherlands.
| | - Jan Pool
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, the Netherlands
| | - Edwin de Raaij
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, the Netherlands; Department of Health Sciences, VU University, Amsterdam, the Netherlands; Department of Epidemiology and Biostatistics, Amsterdam UMC, Amsterdam, Amsterdam Movement Sciences, the Netherlands
| | - Harriet Wittink
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, the Netherlands
| | - Raymond Ostelo
- Department of Health Sciences, VU University, Amsterdam, the Netherlands; Department of Epidemiology and Biostatistics, Amsterdam UMC, Amsterdam, Amsterdam Movement Sciences, the Netherlands
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Miake-Lye IM, Mak S, Lee J, Luger T, Taylor SL, Shanman R, Beroes-Severin JM, Shekelle PG. Massage for Pain: An Evidence Map. J Altern Complement Med 2019; 25:475-502. [PMID: 30892910 PMCID: PMC6533778 DOI: 10.1089/acm.2018.0282] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Objectives: Massage therapy has been proposed for painful conditions, but it can be difficult to understand the breadth and depth of evidence, as various painful conditions may respond differently to massage. The authors conducted an evidence mapping process and generated an "evidence map" to visually depict the distribution of evidence available for massage and various pain indications to identify gaps in evidence and to inform future research priorities. Design: The authors searched PubMed, Embase, and Cochrane for systematic reviews reporting pain outcomes for massage therapy. The authors assessed the quality of each review using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) criteria. The authors used a bubble plot to depict the number of included articles, pain indication, effect of massage for pain, and strength of findings for each included systematic review. Results: The authors identified 49 systematic reviews, of which 32 were considered high quality. Types of pain frequently included in systematic reviews were cancer pain, low back pain, and neck pain. High quality reviews concluded that there was low strength of evidence of potential benefits of massage for labor, shoulder, neck, low back, cancer, arthritis, postoperative, delayed onset muscle soreness, and musculoskeletal pain. Reported attributes of massage interventions include style of massage, provider, co-interventions, duration, and comparators, with 14 high-quality reviews reporting all these attributes in their review. Conclusion: Prior reviews have conclusions of low strength of evidence because few primary studies of large samples with rigorous methods had been conducted, leaving evidence gaps about specific massage type for specific pain. Primary studies often do not provide adequate details of massage therapy provided, limiting the extent to which reviews are able to draw conclusions about characteristics such as provider type.
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Affiliation(s)
- Isomi M Miake-Lye
- 1 West Los Angeles Veterans Affairs Medical Center, Los Angeles, CA.,2 Fielding School of Public Health, Department of Health Policy and Management, University of California, Los Angeles, Los Angeles, CA
| | - Selene Mak
- 1 West Los Angeles Veterans Affairs Medical Center, Los Angeles, CA.,2 Fielding School of Public Health, Department of Health Policy and Management, University of California, Los Angeles, Los Angeles, CA
| | | | - Tana Luger
- 2 Fielding School of Public Health, Department of Health Policy and Management, University of California, Los Angeles, Los Angeles, CA
| | - Stephanie L Taylor
- 1 West Los Angeles Veterans Affairs Medical Center, Los Angeles, CA.,2 Fielding School of Public Health, Department of Health Policy and Management, University of California, Los Angeles, Los Angeles, CA
| | - Roberta Shanman
- 4 Southern California Evidence-Based Practice Center, RAND Corporation, Santa Monica, CA
| | | | - Paul G Shekelle
- 1 West Los Angeles Veterans Affairs Medical Center, Los Angeles, CA
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Varaei S, Shirbeygi L, Farahani L, Eslami Hasan Abadi Z, Shamsizadeh M. Comparison the Effects of Massage with Olive Oil and Sweet Almonds Oil on Prevention of Pressure Ulcer in Hospitalized Patients in ICU. ACTA ACUST UNITED AC 2019. [DOI: 10.30699/ajnmc.27.5.353] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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8
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The Effects of Massage Therapy on Pain and Anxiety after Surgery: A Systematic Review and Meta-Analysis. Pain Manag Nurs 2018; 18:378-390. [PMID: 29173797 DOI: 10.1016/j.pmn.2017.09.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 08/16/2017] [Accepted: 09/09/2017] [Indexed: 11/22/2022]
Abstract
Pain management is critical for patients after surgery, but current pain management methods are not always adequate. Massage therapy may be a therapeutic complementary therapy for pain. Many researchers have investigated the effects of massage therapy on post-operative pain, but there have been no systematic reviews and meta-analysis of its efficacy for post-operative patients. Our objective was to assess the effects of massage therapy on pain management among post-operative patients by conducting a systematic review and meta-analysis. The databases searched included MEDLINE, CINAHL, and the Cochrane Library's CENTRAL. To assess the effects of massage therapy on post-operative pain and anxiety, we performed a meta-analysis and calculated standardized mean difference with 95% CIs (Confidential Intervals) as a summary effect. Ten randomized controlled trials were selected (total sample size = 1,157). Meta-analysis was conducted using subgroup analysis. The effect of single dosage massage therapy on post-operative pain showed significant improvement (-0.49; 95% confidence intervals -0.64, -0.34; p < .00001) and low heterogeneity (p = .39, I2 = 4%), sternal incisions showed significant improvement in pain (-0.68; -0.91, -0.46; p< .00001) and low heterogeneity (p = .76, I2 = 0%). The anxiety subgroups showed substantial heterogeneity. The findings of this study revealed that massage therapy may alleviate post-operative pain, although there are limits on generalization of these findings due to low methodological quality in the reviewed studies.
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Yang Y, Yan X, Deng H, Zeng D, Huang J, Fu W, Xu N, Liu J. The efficacy of traditional acupuncture on patients with chronic neck pain: study protocol of a randomized controlled trial. Trials 2017; 18:312. [PMID: 28693563 PMCID: PMC5504675 DOI: 10.1186/s13063-017-2009-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 05/22/2017] [Indexed: 01/19/2023] Open
Abstract
Background A large number of randomized trials on the use of acupuncture to treat chronic pain have been conducted. However, there is considerable controversy regarding the effectiveness of acupuncture. We designed a randomized trial involving patients with chronic neck pain (CNP) to investigate whether acupuncture is more effective than a placebo in treating CNP. Methods/design A five-arm, parallel, single-blinded, randomized, sham-controlled trial was designed. Patients with CNP of more than 3 months’ duration are being recruited from Guangdong Provincial Hospital of Chinese Medicine (China). Following examination, 175 patients will be randomized into one of five groups (35 patients in each group) as follows: a traditional acupuncture group (group A), a shallow-puncture group (group B), a non-acupoint acupuncture group (group C), a non-acupoint shallow-puncture group (group D) and a sham-puncture group (group E). The interventions will last for 20 min and will be carried out twice a week for 5 weeks. The primary outcome will be evaluated by changes in the Northwick Park Neck Pain Questionnaire (NPQ). Secondary outcomes will be measured by the pain threshold, the Short Form McGill Pain Questionnaire-2 (SF-MPQ-2), the 36-Item Short-Form Health Survey (SF-36) and diary entries. Analysis of the data will be performed at baseline, at the end of the intervention and at 3 months’ follow-up. The safety of acupuncture will be evaluated at each treatment period. Discussion The purpose of this trial is to determine whether traditional acupuncture is more effective for chronic pain relief than sham acupuncture in adults with CNP, and to determine which type of sham acupuncture is the optimal control for clinical trials. Trial registration Chinese Clinical Trial Registry: ChiCTR-IOR-15006886. Registered on 2 July 2015. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-2009-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yiling Yang
- Guangzhou University of Traditional Chinese Medicine, 12 Jichang Road, Guangzhou, 510006, People's Republic of China
| | - Xiaoxia Yan
- Guangzhou University of Traditional Chinese Medicine, 12 Jichang Road, Guangzhou, 510006, People's Republic of China
| | - Hongmei Deng
- Guangzhou University of Traditional Chinese Medicine, 12 Jichang Road, Guangzhou, 510006, People's Republic of China
| | - Dian Zeng
- Guangzhou University of Traditional Chinese Medicine, 12 Jichang Road, Guangzhou, 510006, People's Republic of China
| | - Jianpeng Huang
- The Secondary Medical College, Guangzhou University of Traditional Chinese Medicine, 111 Dade Road, Guangzhou, 510120, People's Republic of China
| | - Wenbin Fu
- Guangzhou University of Traditional Chinese Medicine, 12 Jichang Road, Guangzhou, 510006, People's Republic of China.,The Secondary Medical College, Guangzhou University of Traditional Chinese Medicine, 111 Dade Road, Guangzhou, 510120, People's Republic of China
| | - Nenggui Xu
- Guangzhou University of Traditional Chinese Medicine, 12 Jichang Road, Guangzhou, 510006, People's Republic of China.
| | - Jianhua Liu
- Guangzhou University of Traditional Chinese Medicine, 12 Jichang Road, Guangzhou, 510006, People's Republic of China. .,The Secondary Medical College, Guangzhou University of Traditional Chinese Medicine, 111 Dade Road, Guangzhou, 510120, People's Republic of China.
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Arslan M, Gökgöz N, Dane Ş. The effect of traditional wet cupping on shoulder pain and neck pain: A pilot study. Complement Ther Clin Pract 2016; 23:30-3. [PMID: 27157955 DOI: 10.1016/j.ctcp.2016.02.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 02/14/2016] [Accepted: 02/24/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Wet cupping therapy (WCT) is a traditional complementary method recommended to decrease the symptoms of a lot of diseases and used in the treatment of pain syndromes. In this pilot study, the possible effects of wet cupping therapy on nonspecific neck and upper shoulder pain were investigated. METHODS Sixty one eligible volunteer participants with nonspecific neck and upper shoulder pain for at least 3 months were allocated. The Numeric Rating Scale (NRS) was used to assess pain scores. Pain scores were recorded before and after wet cupping therapy. RESULTS The mean scores of neck pain in study group were 7.02 (SD = 1.8) before and 3.70 (SD = 2.2) after cupping therapy. The decrease of pain scores between pre- and post-test was statistically significant (p < 0.05). DISCUSSION It can be stated that WCT has potential therapeutic effect in nonspecific neck and upper shoulder pain. Future full-scale randomized controlled trials will be needed to provide firm evidence of the effectiveness of this intervention.
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Affiliation(s)
- Müzeyyen Arslan
- Turgut Ozal University, School of Nursing, Yunus Emre Mahallesi, Takdir Caddesi No:5 Yenimahalle, Etlik, Ankara, Turkey.
| | - Nurcan Gökgöz
- Turgut Ozal University, School of Nursing, Yunus Emre Mahallesi, Takdir Caddesi No:5 Yenimahalle, Etlik, Ankara, Turkey.
| | - Şenol Dane
- Turgut Özal University, Medical Faculty, Department of Physiology, Yunus Emre Mahallesi, Takdir Caddesi No:5 Yenimahalle, Etlik, Ankara, Turkey.
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Thai massage, and Thai herbal compress versus oral ibuprofen in symptomatic treatment of osteoarthritis of the knee: a randomized controlled trial. BIOMED RESEARCH INTERNATIONAL 2014; 2014:490512. [PMID: 25254207 PMCID: PMC4165631 DOI: 10.1155/2014/490512] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 07/28/2014] [Accepted: 08/11/2014] [Indexed: 01/07/2023]
Abstract
The aim of this study was to verify the clinical responses to Thai massage (TM) and Thai herbal compression (THC) for treating osteoarthritis (OA) of the knee in comparison to oral ibuprofen. This study was a randomized, evaluator-blind, controlled trial. Sixty patients with OA of the knee were randomly assigned to receive either a one-hour session of TM or THC (three times weekly) or oral ibuprofen (three times daily). The duration of treatment was three weeks. The clinical assessments included visual analog scale assessing pain and stiffness, Lequesne's functional index, time for climbing up ten steps, and physician's and patient's overall opinions on improvement. In a within-group comparison, each treatment modality caused a significant improvement of all variables determined for outcome assessments. In an among group comparison, all modalities provided nearly comparable clinical efficacy after a three-week symptomatic treatment of OA of the knee, in which a trend toward greatest improvement was likely to be found in THC group. In conclusion, TM and THC generally provided comparable clinical efficacy to oral ibuprofen after three weeks of treatment and could be considered as complementary and alternative treatments for OA of the knee.
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Cheville AL, Basford JR. Role of rehabilitation medicine and physical agents in the treatment of cancer-associated pain. J Clin Oncol 2014; 32:1691-702. [PMID: 24799472 PMCID: PMC5569680 DOI: 10.1200/jco.2013.53.6680] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
PURPOSE To provide an overview of rehabilitation medicine- and physical modality-based approaches to cancer pain management, and to highlight the fact that these approaches are generally used in conjunction and that a majority are focused on minimizing pain during periods of mobility and the performance of activities of daily living. METHODS We performed a nonsystematic literature review and provide a description of the current standard of care. RESULTS Rehabilitative and physical modalities used to manage pain can be grouped into four categories: those that modulate nociception, stabilize or unload painful structures, influence physiological processes that indirectly influence nociception, or alleviate pain arising from the overloading of muscles and connective tissues that often occurs after surgery or with sarcopenia in late-stage cancer. Most modalities have been pragmatically refined over the years, and many have an evidence base, although few have been explicitly validated in the oncologic setting. With few exceptions, they are patient controlled and free of adverse effects. CONCLUSION Physical modalities and rehabilitation medicine offer a range of pain management approaches that may serve as beneficial adjuncts to the conventional systemic and interventional analgesic strategies used to control cancer-related pain. These approaches may be particularly beneficial to patients with movement-associated pain and those who are ambivalent regarding pharmacoanalgesia.
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Bryans R, Decina P, Descarreaux M, Duranleau M, Marcoux H, Potter B, Ruegg RP, Shaw L, Watkin R, White E. Evidence-Based Guidelines for the Chiropractic Treatment of Adults With Neck Pain. J Manipulative Physiol Ther 2014; 37:42-63. [DOI: 10.1016/j.jmpt.2013.08.010] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2013] [Revised: 07/25/2013] [Accepted: 08/01/2013] [Indexed: 01/29/2023]
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Affiliation(s)
| | - Soni Srikantaiah
- M S Ramaiah Medical College; Department of Physiotherapy; MSRIT Post Bangalore Karnataka India 560054
| | - Ramakrishnan Mani
- School of Physiotherapy, University of Otago; Centre for Health, Activity and Rehabilitation Research; 325 Great King Street North Dunedin Dunedin Otago New Zealand 9016
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Massage therapy for neck and shoulder pain: a systematic review and meta-analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:613279. [PMID: 23533504 PMCID: PMC3600270 DOI: 10.1155/2013/613279] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Accepted: 01/14/2013] [Indexed: 11/18/2022]
Abstract
Objective. To evaluate the effectiveness of massage therapy (MT) for neck and shoulder pain. Methods. Seven English and Chinese databases were searched until December 2011 for randomized controlled trials (RCTs) of MT for neck and shoulder pain. The methodological quality of RCTs was assessed based on PEDro scale. The meta-analyses of MT for neck and shoulder pain were performed. Results. Twelve high-quality studies were included. In immediate effects, the meta-analyses showed significant effects of MT for neck pain (standardised mean difference, SMD, 1.79; 95% confidence intervals, CI, 1.01 to 2.57; P < 0.00001) and shoulder pain (SMD, 1.50; 95% CI, 0.55 to 2.45; P = 0.002) versus inactive therapies. And MT showed short-term effects for shoulder pain (SMD, 1.51; 95% CI, 0.53 to 2.49; P = 0.003). But MT did not show better effects for neck pain (SMD, 0.13; 95% CI, −0.38 to 0.63; P = 0.63) or shoulder pain (SMD, 0.88; 95% CI, −0.74 to 2.51; P = 0.29) than active therapies. In addition, functional status of the shoulder was not significantly affected by MT. Conclusion. MT may provide immediate effects for neck and shoulder pain. However, MT does not show better effects on pain than other active therapies. No evidence suggests that MT is effective in functional status.
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Gay CW, Alappattu MJ, Coronado RA, Horn ME, Bishop MD. Effect of a single session of muscle-biased therapy on pain sensitivity: a systematic review and meta-analysis of randomized controlled trials. J Pain Res 2013; 6:7-22. [PMID: 23403507 PMCID: PMC3569047 DOI: 10.2147/jpr.s37272] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Muscle-biased therapies (MBT) are commonly used to treat pain, yet several reviews suggest evidence for the clinical effectiveness of these therapies is lacking. Inadequate treatment parameters have been suggested to account for inconsistent effects across studies. Pain sensitivity may serve as an intermediate physiologic endpoint helping to establish optimal MBT treatment parameters. The purpose of this review was to summarize the current literature investigating the short-term effect of a single dose of MBT on pain sensitivity in both healthy and clinical populations, with particular attention to specific MBT parameters of intensity and duration. METHODS A systematic search for articles meeting our prespecified criteria was conducted using Cumulative Index to Nursing and Allied Health Literature (CINAHL) and MEDLINE from the inception of each database until July 2012, in accordance with guidelines from the Preferred Reporting Items for Systematic reviews and Meta-Analysis. Relevant characteristics from studies included type, intensity, and duration of MBT and whether short-term changes in pain sensitivity and clinical pain were noted with MBT application. Study results were pooled using a random-effects model to estimate the overall effect size of a single dose of MBT on pain sensitivity as well as the effect of MBT, dependent on comparison group and population type. RESULTS Reports from 24 randomized controlled trials (23 articles) were included, representing 36 MBT treatment arms and 29 comparative groups, where 10 groups received active agents, 11 received sham/inert treatments, and eight received no treatment. MBT demonstrated a favorable and consistent ability to modulate pain sensitivity. Short-term modulation of pain sensitivity was associated with short-term beneficial effects on clinical pain. Intensity of MBT, but not duration, was linked with change in pain sensitivity. A meta-analysis was conducted on 17 studies that assessed the effect of MBT on pressure pain thresholds. The results suggest that MBT had a favorable effect on pressure pain thresholds when compared with no-treatment and sham/inert groups, and effects comparable with those of other active treatments. CONCLUSION The evidence supports the use of pain sensitivity measures by future research to help elucidate optimal therapeutic parameters for MBT as an intermediate physiologic marker.
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Affiliation(s)
- Charles W Gay
- Rehabilitation Science Doctoral Program, College of Public Health and Health Professions, Gainesville, FL
| | - Meryl J Alappattu
- Rehabilitation Science Doctoral Program, College of Public Health and Health Professions, Gainesville, FL
| | - Rogelio A Coronado
- Rehabilitation Science Doctoral Program, College of Public Health and Health Professions, Gainesville, FL
| | - Maggie E Horn
- Rehabilitation Science Doctoral Program, College of Public Health and Health Professions, Gainesville, FL
| | - Mark D Bishop
- Department of Physical Therapy, University of Florida, Gainesville, FL
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Ruhe A, Fejer R, Walker B. Does postural sway change in association with manual therapeutic interventions? A review of the literature. Chiropr Man Therap 2013; 21:9. [PMID: 23374610 PMCID: PMC3575324 DOI: 10.1186/2045-709x-21-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2012] [Accepted: 01/31/2013] [Indexed: 02/09/2023] Open
Abstract
UNLABELLED STUDY DESIGN Literature Review OBJECTIVES The objective of this literature review was to determine if postural sway changes in association with manual therapeutic interventions and to investigate whether any changes occur in healthy individuals or in association with pain intensity. SUMMARY OF BACKGROUND DATA Improving postural stability has been proposed as a goal of manual therapeutic interventions. So far, no literature review has addressed whether there is supportive evidence for this and if so, what factors may be associated or causative for observed sway alterations. SEARCH METHODS Seven online databases (PubMed, MEDLINE, EMBASE, CINAHL, Web of Science, ScienceDirect and the Cochrane library) were systematically searched followed by a manual search of the retrieved papers. SELECTION CRITERIA Studies comparing postural sway derived from bipedal force plate measurements in association with a manual therapeutic intervention, ideally compared to a control group. DATA COLLECTION AND ANALYSIS Two reviewers independently screened titles and abstracts for relevance, conducted the data extraction and the risk of bias assessment which was conducted using the RTI item bank. A descriptive analysis was conducted as the heterogeneous study designs prevented pooling of data. RESULTS Nine studies of varying methodological quality met the inclusion criteria. No direct comparison of data across the studies was possible. There was no evidence that manual interventions lead to a change in postural sway in healthy individuals regardless of the body regions addressed by the intervention. There was some indication that postural sway may change at follow-up measurements in pain sufferers; however, this may be due to variations in pain intensity rather than resulting from the intervention itself. CONCLUSIONS There is no conclusive scientific evidence that manual therapeutic interventions may exhibit any immediate or long-term effect on COP excursions. Any changes in sway may be attributable to decreases in pain intensity.
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Affiliation(s)
- Alexander Ruhe
- School of Health Professions, Murdoch University, Murdoch, Western Australia, Australia.
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Lin JH, Shen T, Chung RCK, Chiu TTW. The effectiveness of Long's manipulation on patients with chronic mechanical neck pain: a randomized controlled trial. ACTA ACUST UNITED AC 2013; 18:308-15. [PMID: 23352180 DOI: 10.1016/j.math.2012.11.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Revised: 10/24/2012] [Accepted: 11/19/2012] [Indexed: 12/27/2022]
Abstract
Long's manipulation (LM) is a representative Chinese manipulation approach incorporating both spinal manipulation and traditional Chinese massage (TCM) techniques. This randomized controlled trial (RCT) aimed to compare the immediate and short-term relative effectiveness of LM to TCM on patients with chronic neck pain. Patients were randomly assigned to either LM group or TCM group. LM group was treated with Long's manipulation, while the TCM group received TCM therapy. Patients attended 8 sessions of treatment (one session every three days). Outcome measures included neck disability (Northwick Park Neck Pain Questionnaire; NPQ), pain intensity (Numeric Pain Rating Scale; NPRS), patient perceived satisfaction of care (PPS) (11-point scale), craniovertebral angle (CV angle) and cervical range of motion (ROM). A blinded assessor performed assessment at baseline, immediate after treatment and 3 months post treatment. LM group achieved significantly greater improvement than TCM group in pain intensity (p < 0.001), neck disability (p = 0.049) and satisfaction (p < 0.001) up to 3-month follow-up. There was no significant difference in improvements in CV angle and most of cervical ROM between groups (p = 0.169 ∼ 0.888) with an exception of flexion at 3-month follow-up (p = 0.005). This study shows that LM could produce better effects than TCM in relieving pain and improving disability in the management of patients with chronic mechanical neck pain.
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Affiliation(s)
- Jian Hua Lin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
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19
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Ali A, Kahn J, Rosenberger L, Perlman AI. Development of a manualized protocol of massage therapy for clinical trials in osteoarthritis. Trials 2012; 13:185. [PMID: 23035641 PMCID: PMC3519579 DOI: 10.1186/1745-6215-13-185] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Accepted: 09/27/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Clinical trial design of manual therapies may be especially challenging as techniques are often individualized and practitioner-dependent. This paper describes our methods in creating a standardized Swedish massage protocol tailored to subjects with osteoarthritis of the knee while respectful of the individualized nature of massage therapy, as well as implementation of this protocol in two randomized clinical trials. METHODS The manualization process involved a collaborative process between methodologic and clinical experts, with the explicit goals of creating a reproducible semi-structured protocol for massage therapy, while allowing some latitude for therapists' clinical judgment and maintaining consistency with a prior pilot study. RESULTS The manualized protocol addressed identical specified body regions with distinct 30- and 60-min protocols, using standard Swedish strokes. Each protocol specifies the time allocated to each body region. The manualized 30- and 60-min protocols were implemented in a dual-site 24-week randomized dose-finding trial in patients with osteoarthritis of the knee, and is currently being implemented in a three-site 52-week efficacy trial of manualized Swedish massage therapy. In the dose-finding study, therapists adhered to the protocols and significant treatment effects were demonstrated. CONCLUSIONS The massage protocol was manualized, using standard techniques, and made flexible for individual practitioner and subject needs. The protocol has been applied in two randomized clinical trials. This manualized Swedish massage protocol has real-world utility and can be readily utilized both in the research and clinical settings. TRIAL REGISTRATION Clinicaltrials.gov NCT00970008 (18 August 2009).
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Affiliation(s)
- Ather Ali
- Department of Pediatrics, Yale University School of Medicine, 2 Church Street South, New Haven, CT 06519, USA.
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Abstract
BACKGROUND AND PURPOSE Chronic neck pain is prevalent in the workplace. Research suggests that psychosocial stress may contribute to the development of neck pain by causing excessive or prolonged muscle activity in some individuals. The purpose of this case report is to describe the rationale, development, and implementation of stress management as an adjunct to standard physical therapist management of chronic neck pain in a female office worker who responded to psychosocial stress with elevated muscle activity prior to treatment. CASE DESCRIPTION A 44-year-old female office employee with an 8-year history of chronic neck pain participated in this case report. The patient was selected from a group of research participants who demonstrated elevated electromyographic (EMG) activity of the trapezius muscle in response to simulated occupational stressors. The multidisciplinary intervention consisted of 8 physical therapy sessions, supplemented by 8 stress management sessions that included EMG biofeedback and psychotherapy to facilitate muscle relaxation. OUTCOMES Neck disability decreased by 50%, trait anxiety decreased by 21%, and the duration of trapezius muscle rest in the workplace increased by 56% immediately after the 8-week intervention. These improvements were maintained 6 months after treatment, and the patient reported a complete absence of neck disability at the 2-year follow-up assessment. DISCUSSION A sustained reduction in neck disability was observed for a patient with chronic neck pain after participating in a multidisciplinary intervention that combined physical therapy and stress management approaches to facilitate muscle relaxation in the workplace. Future clinical trials are needed to assess whether stress management is a useful adjunct therapy for patients with chronic neck pain who show elevated muscle activity in response to psychosocial stress.
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21
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Patel KC, Gross A, Graham N, Goldsmith CH, Ezzo J, Morien A, Peloso PMJ. Massage for mechanical neck disorders. Cochrane Database Syst Rev 2012:CD004871. [PMID: 22972078 DOI: 10.1002/14651858.cd004871.pub4] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND The prevalence of mechanical neck disorders (MND) is known to be both a hindrance to individuals and costly to society. As such, massage is widely used as a form of treatment for MND. OBJECTIVES To assess the effects of massage on pain, function, patient satisfaction, global perceived effect, adverse effects and cost of care in adults with neck pain versus any comparison at immediate post-treatment to long-term follow-up. SEARCH METHODS We searched The Cochrane Library (CENTRAL), MEDLINE, EMBASE, MANTIS, CINAHL, and ICL databases from date of inception to 4 Feburary 2012. SELECTION CRITERIA Studies using random assignment were included. DATA COLLECTION AND ANALYSIS Two review authors independently conducted citation identification, study selection, data abstraction and methodological quality assessment. Using a random-effects model, we calculated the risk ratio and standardised mean difference. MAIN RESULTS Fifteen trials met the inclusion criteria. The overall methodology of all the trials assessed was either low or very low GRADE level. None of the trials were of strong to moderate GRADE level. The results showed very low level evidence that certain massage techniques (traditional Chinese massage, classical and modified strain/counter strain technique) may have been more effective than control or placebo treatment in improving function and tenderness. There was very low level evidence that massage may have been more beneficial than education in the short term for pain bothersomeness. Along with that, there was low level evidence that ischaemic compression and passive stretch may have been more effective in combination rather than individually for pain reduction. The clinical applicability assessment showed that only 4/15 trials adequately described the massage technique. The majority of the trials assessed outcomes at immediate post-treatment, which is not an adequate time to assess clinical change. Due to the limitations in the quality of existing studies, we were unable to make any firm statement to guide clinical practice. We noted that only four of the 15 studies reported side effects. All four studies reported post-treatment pain as a side effect and one study (Irnich 2001) showed that 22% of the participants experienced low blood pressure following treatment. AUTHORS' CONCLUSIONS No recommendations for practice can be made at this time because the effectiveness of massage for neck pain remains uncertain.As a stand-alone treatment, massage for MND was found to provide an immediate or short-term effectiveness or both in pain and tenderness. Additionally, future research is needed in order to assess the long-term effects of treatment and treatments provided on more than one occasion.
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Affiliation(s)
- Kinjal C Patel
- Advantage Health Castleridge, 2210-4818B Westwinds Drive NE, Calgary, Alberta, Canada
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Brosseau L, Wells GA, Tugwell P, Casimiro L, Novikov M, Loew L, Sredic D, Clément S, Gravelle A, Hua K, Kresic D, Lakic A, Ménard G, Côté P, Leblanc G, Sonier M, Cloutier A, McEwan J, Poitras S, Furlan A, Gross A, Dryden T, Muckenheim R, Côté R, Paré V, Rouhani A, Léonard G, Finestone HM, Laferrière L, Dagenais S, De Angelis G, Cohoon C. Ottawa Panel evidence-based clinical practice guidelines on therapeutic massage for neck pain. J Bodyw Mov Ther 2012; 16:300-325. [PMID: 22703740 DOI: 10.1016/j.jbmt.2012.04.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Revised: 03/30/2012] [Accepted: 04/05/2012] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To update evidence-based clinical practice guideline (EBCPG) on the use of massage compared to a control or other treatments for adults (>18 years) suffering from sub-acute and chronic neck pain. METHODS A literature search was performed from January 1, 1948 to December 31, 2010 for relevant articles. The Ottawa Panel created inclusion criteria focusing on high methodological quality and grading methods. Recommendations were assigned a grade (A, B, C, C+, D, D+, D-) based on strength of evidence. RESULTS A total of 45 recommendations from ten articles were developed including 8 positive recommendations (6 grade A and 2 grade C+) and 23 neutral recommendations (12 grade C and 11 grade D). DISCUSSION Therapeutic massage can decrease pain, tenderness, and improve range of motion for sub-acute and chronic neck pain. CONCLUSION The Ottawa Panel was able to demonstrate that the massage interventions are effective for relieving immediate post-treatment neck pain symptoms, but data is insufficient for long-term effects.
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Affiliation(s)
- Lucie Brosseau
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada; Montfort Hospital Research Institute, Ottawa, Ontario, Canada.
| | - George A Wells
- Clinical Epidemiology Unit, Ottawa Hospital Research Institute, Ottawa Hospital, Civic Campus, Ottawa, Ontario, Canada; Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Peter Tugwell
- Clinical Epidemiology Unit, Ottawa Hospital Research Institute, Ottawa Hospital, Civic Campus, Ottawa, Ontario, Canada; Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada; Centre for Global Health, Institute of Population Health, Ottawa, Ontario, Canada
| | - Lynn Casimiro
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada; Montfort Hospital Research Institute, Ottawa, Ontario, Canada
| | - Michael Novikov
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Laurianne Loew
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Danijel Sredic
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Sarah Clément
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Amélie Gravelle
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Kevin Hua
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Daniel Kresic
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Ana Lakic
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Gabrielle Ménard
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Pascale Côté
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Ghislain Leblanc
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Mathieu Sonier
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Alexandre Cloutier
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Jessica McEwan
- University of Ottawa Health Sciences Library, Ottawa, Ontario, Canada
| | - Stéphane Poitras
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Andrea Furlan
- Institute for Work and Health, Toronto, Ontario, Canada
| | - Anita Gross
- School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Trish Dryden
- Research and Corporate Planning Centennial College, Toronto, Ontario, Canada
| | | | - Raynald Côté
- Academy of Massage and Orthotherapy, Gatineau, Quebec, Canada
| | - Véronique Paré
- Academy of Massage and Orthotherapy, Gatineau, Quebec, Canada
| | - Alexandre Rouhani
- Centre de Massothérapie et Soins Corporels l'Orchidée, Gatineau, Québec, Canada
| | | | - Hillel M Finestone
- SCO Health Services, Elisabeth Bruyère Health Centre, Ottawa, Ontario, Canada
| | - Lucie Laferrière
- Directorate Force Health Protection, Canadian Forces Health Services Group Headquarters, National Defense, Ottawa, Ontario, Canada
| | | | - Gino De Angelis
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Courtney Cohoon
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
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Lin JH, Chiu TTW, Hu J. Chinese manipulation for mechanical neck pain: a systematic review. Clin Rehabil 2012; 26:963-73. [PMID: 22473303 DOI: 10.1177/0269215512441485] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To assess whether Chinese manipulation improves pain, function/disability and global perceived effect in adults with acute/subacute/chronic neck pain. DATA SOURCES CAJ Full-text Database (Chinese), Wanfang Database (Chinese), Cochrane Database (English) and Medline (English). REVIEW METHODS Literature searching was performed with the following keywords and their combination: 'manual therapy/bone setting/Chinese manipulation', 'neck/cervical pain', 'cervical vertebrae', 'cervical spondylosis/radiculopathy' and 'randomized controlled trial/review.' Two independent reviewers selected studies, extracted data and assessed risk of bias for each included study. Randomized controlled trials or quasi-randomized controlled trials on the effect of Chinese manipulation in treating adult patients with neck pain were selected. Mean differences with 95% confidence intervals (CI) were calculated. Quality of the evidence was assessed by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. RESULTS Four studies (610 participants) were included in this review. There was very low-quality evidence suggesting that, compared to cervical traction in sitting, Chinese manipulation produced more immediate post-intervention pain relief (mean difference: -1.06; 95% CI: -1.37~ -0.75; P < 0.001) and improvement of global signs and symptoms (mean difference: -3.81; 95% CI: -4.71 ~ -2.91; P < 0.001). Very low-quality evidence showed that Chinese manipulation alone was superior to Chinese traditional massage in immediate post-intervention pain relief (mean difference: -2.02; 95% CI: -2.78~ -1.26; P < 0.001). CONCLUSIONS There was limited evidence showing Chinese manipulation could produce short-term improvement for neck pain.
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Affiliation(s)
- Jian Hua Lin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
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24
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Perlman AI, Ali A, Njike VY, Hom D, Davidi A, Gould-Fogerite S, Milak C, Katz DL. Massage therapy for osteoarthritis of the knee: a randomized dose-finding trial. PLoS One 2012; 7:e30248. [PMID: 22347369 PMCID: PMC3275589 DOI: 10.1371/journal.pone.0030248] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Accepted: 12/14/2011] [Indexed: 11/20/2022] Open
Abstract
Background In a previous trial of massage for osteoarthritis (OA) of the knee, we demonstrated feasibility, safety and possible efficacy, with benefits that persisted at least 8 weeks beyond treatment termination. Methods We performed a RCT to identify the optimal dose of massage within an 8-week treatment regimen and to further examine durability of response. Participants were 125 adults with OA of the knee, randomized to one of four 8-week regimens of a standardized Swedish massage regimen (30 or 60 min weekly or biweekly) or to a Usual Care control. Outcomes included the Western Ontario and McMaster Universities Arthritis Index (WOMAC), visual analog pain scale, range of motion, and time to walk 50 feet, assessed at baseline, 8-, 16-, and 24-weeks. Results WOMAC Global scores improved significantly (24.0 points, 95% CI ranged from 15.3–32.7) in the 60-minute massage groups compared to Usual Care (6.3 points, 95% CI 0.1–12.8) at the primary endpoint of 8-weeks. WOMAC subscales of pain and functionality, as well as the visual analog pain scale also demonstrated significant improvements in the 60-minute doses compared to usual care. No significant differences were seen in range of motion at 8-weeks, and no significant effects were seen in any outcome measure at 24-weeks compared to usual care. A dose-response curve based on WOMAC Global scores shows increasing effect with greater total time of massage, but with a plateau at the 60-minute/week dose. Conclusion Given the superior convenience of a once-weekly protocol, cost savings, and consistency with a typical real-world massage protocol, the 60-minute once weekly dose was determined to be optimal, establishing a standard for future trials. Trial Registration ClinicalTrials.gov NCT00970008
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Affiliation(s)
- Adam I Perlman
- Duke Integrative Medicine, Duke University School of Medicine, Durham, North Carolina, United States of America.
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Eton DT, Bauer BA, Sood A, Yost KJ, Sloan JA. Patient-reported outcomes in studies of complementary and alternative medicine: problems, solutions, and future directions. Explore (NY) 2012; 7:314-9. [PMID: 21907154 DOI: 10.1016/j.explore.2011.06.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2010] [Indexed: 11/18/2022]
Abstract
Patient-reported outcome (PRO) measures are frequently used to assess therapeutic efficacy and effectiveness of complementary and alternative medicine (CAM). Although CAM investigators are increasingly making use of valid, self-report instruments to assess patient-relevant outcomes, the sheer number of available instruments poses challenges. Two of the more pressing issues are discussed: the lack of guidance for selecting measures and the limited attention paid to the clinical meaningfulness of PRO results. Solutions are offered that may support selection and standardization of outcome measures for future CAM studies. This includes testing of tools from the National Institutes of Health's Patient-Reported Outcomes Measurement Information System (PROMIS). Increased standardization of outcome measurement in CAM studies will allow for more cross-study comparisons and facilitate the statistical pooling of results, ultimately leading to a more informative evidence base.
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Affiliation(s)
- David T Eton
- Division of Health Care Policy & Research, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota 55905, USA.
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26
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Serrano-Aguilar P, Kovacs FM, Cabrera-Hernández JM, Ramos-Goñi JM, García-Pérez L. Avoidable costs of physical treatments for chronic back, neck and shoulder pain within the Spanish National Health Service: a cross-sectional study. BMC Musculoskelet Disord 2011; 12:287. [PMID: 22188790 PMCID: PMC3297536 DOI: 10.1186/1471-2474-12-287] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2011] [Accepted: 12/21/2011] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Back, neck and shoulder pain are the most common causes of occupational disability. They reduce health-related quality of life and have a significant economic impact. Many different forms of physical treatment are routinely used. The objective of this study was to estimate the cost of physical treatments which, despite the absence of evidence supporting their effectiveness, were used between 2004 and 2007 for chronic and non-specific neck pain (NP), back pain (BP) and shoulder pain (SP), within the Spanish National Health Service in the Canary Islands (SNHSCI). METHODS Chronic patients referred from the SNHSCI to private physical therapy centres for NP, BP or SP, between 2004 and 2007, were identified. The cost of providing physical therapies to these patients was estimated. Systematic reviews (SRs) and clinical practice guidelines (CPGs) for NP, BP and SP available in the same period were searched for and rated according to the Oxman and AGREE criteria, respectively. Those rated positively for ≥70% of the criteria, were used to categorise physical therapies as Effective; Ineffective; Inconclusive; and Insufficiently Assessed. The main outcome was the cost of physical therapies included in each of these categories. RESULTS 8,308 chronic cases of NP, 4,693 of BP and 5,035 of SP, were included in this study. Among prescribed treatments, 39.88% were considered Effective (physical exercise and manual therapy with mobilization); 23.06% Ineffective; 13.38% Inconclusive, and 23.66% Insufficiently Assessed. The total cost of treatments was € 5,107,720. Effective therapies accounted for € 2,069,932. CONCLUSIONS Sixty percent of the resources allocated by the SNHSCI to fund physical treatment for NP, BP and SP in private practices are spent on forms of treatment proven to be ineffective, or for which there is no evidence of effectiveness.
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Affiliation(s)
- Pedro Serrano-Aguilar
- Health Technology Assessment Unit, Canary Islands Health Service, Government of the Canary Islands, Santa Cruz de Tenerife, Spain.
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The effect of traditional cupping on pain and mechanical thresholds in patients with chronic nonspecific neck pain: a randomised controlled pilot study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2011; 2012:429718. [PMID: 22203873 PMCID: PMC3235710 DOI: 10.1155/2012/429718] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2011] [Revised: 09/07/2011] [Accepted: 09/13/2011] [Indexed: 02/01/2023]
Abstract
Introduction. Cupping has been used since antiquity in the treatment of pain conditions. In this pilot study, we investigated the effect of traditional cupping therapy on chronic nonspecific neck pain (CNP) and mechanical sensory thresholds. Methods. Fifty CNP patients were randomly assigned to treatment (TG, n = 25) or waiting list control group (WL, n = 25). TG received a single cupping treatment. Pain at rest (PR), pain related to movement (PM), quality of life (SF-36), Neck Disability Index (NDI), mechanical detection (MDT), vibration detection (MDT), and pressure pain thresholds (PPT) were measured before and three days after a single cupping treatment. Patients also kept a pain and medication diary (PaDi, MeDi) during the study. Results. Baseline characteristics were similar in the two groups. After cupping TG reported significantly less pain (PR: −17.9 mm VAS, 95%CI −29.2 to −6.6; PM: −19.7, 95%CI −32.2 to −7.2; PaDi: −1.5 points on NRS, 95%CI −2.5 to −0.4; all P < 0.05) and higher quality of life than WL (SF-36, Physical Functioning: 7.5, 95%CI 1.4 to 13.5; Bodily Pain: 14.9, 95%CI 4.4 to 25.4; Physical Component Score: 5.0, 95%CI 1.4 to 8.5; all P < 0.05). No significant effect was found for NDI, MDT, or VDT, but TG showed significantly higher PPT at pain-areas than WL (in lg(kPa); pain-maximum: 0.088, 95%CI 0.029 to 0.148, pain-adjacent: 0.118, 95%CI 0.038 to 0.199; both P < 0.01). Conclusion. A single application of traditional cupping might be an effective treatment for improving pain, quality of life, and hyperalgesia in CNP.
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Cramer H, Lauche R, Hohmann C, Choi KE, Rampp T, Musial F, Langhorst J, Dobos G. Randomized controlled trial of pulsating cupping (pneumatic pulsation therapy) for chronic neck pain. ACTA ACUST UNITED AC 2011; 18:327-34. [PMID: 22189364 DOI: 10.1159/000335294] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Pneumatic pulsation therapy may combine the effects of cupping therapy and massage. This study investigated the effect of pneumatic pulsation therapy on chronic neck pain compared to standard medical care. METHODS 50 patients (79.15% female; 46.17 ± 12.21 years) with chronic nonspecific neck pain were randomized to treatment group (TG; n = 25) or control group (CG; n = 25). The TG received 5 pneumatic pulsation treatments over a period of 2 weeks utilizing a mechanical device. Treatment was applied as a combination of moving and stationary pulsating cupping. Main outcome measure was pain intensity in pain diaries (numerical rating scale). Secondary outcome measures included functional disability (NDI), quality of life (SF-36), and pain at motion. Sensory thresholds, including pressure pain threshold, were measured at pain-related sites. RESULTS After the intervention, significant group differences occurred regarding pain intensity (baseline: 4.12 ± 1.45 in TG and 4.20 ± 1.57 in CG; post-intervention: 2.72 ± 1.62 in TG and 4.44 ± 1.96 in CG; analysis of covariance: p = 0.001), NDI (baseline: 25.92 ± 8.23 and 29.83; post-intervention: 20.44 ± 10.17 and 28.83; p = 0.025), and physical quality of life (baseline: 43.85 ± 7.65 and 41.66 ± 7.09; post-intervention: 47.60 ± 7.93 and 40.49 ± 8.03; p = 0.002). Further significant group differences were found for pain at motion (p = 0.004) and pressure pain threshold (p = 0.002). No serious adverse events were reported. CONCLUSION Pneumatic pulsation therapy appears to be a safe and effective method to relieve pain and to improve function and quality of life in patients with chronic neck pain.
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Affiliation(s)
- Holger Cramer
- Chair of Complementary and Integrative Medicine, University of Duisburg-Essen, Germany.
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What does the evidence tell us about design of future treatment trials for whiplash-associated disorders? Spine (Phila Pa 1976) 2011; 36:S292-302. [PMID: 22020597 DOI: 10.1097/brs.0b013e3182388259] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Reflective critique and recommendation development. OBJECTIVE To reflect on limitations in past trials and propose recommendations on innovative trial designs and methodologies for whiplash-associated disorders (WAD). SUMMARY OF BACKGROUND DATA The cost of doing clinical research and risk of retaining an evidence void is an overarching threat to lessening the transition of WAD to chronicity. METHODS Review trial limitations on neck pain and propose recommendations to amend these. RESULTS Three innovative trial designs, 20 methodological recommendations, and two knowledge translation (KT) research strategies are proposed. Many of the gaps in our current understanding of neck disorders can be linked to an inadequate research design and implementation. Increased utilization of three design options for evaluating therapies could lead to a more accurate and efficient understanding of the merits of various therapies singly and multimodal. Increased utilization of mixed methods or biological subcomponents may advance our understanding of neck disorders and the resulting disability. There is a need for harmonization and standardization across participant disorder classification; identification and tracking of prognostic factors and adverse events; adequate intervention description and dosing; and outcome selection comparable across studies and across International Classification Framework domains. Reasons for discordant conclusions including subjective elements need to be explored in future trials using qualitative methods. KT research that defines the barriers to implementation of existing knowledge and strategies to reduce the evidence to practice gap is urgently needed. CONCLUSION Our recommendations suggest an overarching need for adherence to CONSORT guidelines, a consensus taxonomy illuminating neck pain characterization, prognostic indicators, and diagnostic criteria as well as a core set of trial outcomes. Innovative trial design could lead to a more accurate and efficient understanding of the merits of various therapies. As the evidence emerges, studies of KT can inform us how it will impact clinical actions.
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A systematic review and meta-analysis of efficacy, cost-effectiveness, and safety of selected complementary and alternative medicine for neck and low-back pain. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2011; 2012:953139. [PMID: 22203884 PMCID: PMC3236015 DOI: 10.1155/2012/953139] [Citation(s) in RCA: 144] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2011] [Accepted: 05/14/2011] [Indexed: 01/31/2023]
Abstract
Background. Back pain is a common problem and a major cause of disability and health care utilization. Purpose. To evaluate the efficacy, harms, and costs of the most common CAM treatments (acupuncture, massage, spinal manipulation, and mobilization) for neck/low-back pain. Data Sources. Records without language restriction from various databases up to February 2010. Data Extraction. The efficacy outcomes of interest were pain intensity and disability. Data Synthesis. Reports of 147 randomized trials and 5 nonrandomized studies were included. CAM treatments were more effective in reducing pain and disability compared to no treatment, physical therapy (exercise and/or electrotherapy) or usual care immediately or at short-term follow-up. Trials that applied sham-acupuncture tended towards statistically nonsignificant results. In several studies, acupuncture caused bleeding on the site of application, and manipulation and massage caused pain episodes of mild and transient nature. Conclusions. CAM treatments were significantly more efficacious than no treatment, placebo, physical therapy, or usual care in reducing pain immediately or at short-term after treatment. CAM therapies did not significantly reduce disability compared to sham. None of the CAM treatments was shown systematically as superior to one another. More efforts are needed to improve the conduct and reporting of studies of CAM treatments.
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Sefton JM, Yarar C, Carpenter DM, Berry JW. Physiological and clinical changes after therapeutic massage of the neck and shoulders. ACTA ACUST UNITED AC 2011; 16:487-94. [PMID: 21570335 DOI: 10.1016/j.math.2011.04.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2010] [Revised: 04/04/2011] [Accepted: 04/12/2011] [Indexed: 11/19/2022]
Affiliation(s)
- Joellen M Sefton
- Neuromechanics Research Laboratory, Department of Kinesiology, Auburn University, Auburn, AL 36849-5323, USA.
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Lauche R, Cramer H, Choi KE, Rampp T, Saha FJ, Dobos GJ, Musial F. The influence of a series of five dry cupping treatments on pain and mechanical thresholds in patients with chronic non-specific neck pain--a randomised controlled pilot study. Altern Ther Health Med 2011; 11:63. [PMID: 21843336 PMCID: PMC3224248 DOI: 10.1186/1472-6882-11-63] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Accepted: 08/15/2011] [Indexed: 11/17/2022]
Abstract
Background In this preliminary trial we investigated the effects of dry cupping, an ancient method for treating pain syndromes, on patients with chronic non-specific neck pain. Sensory mechanical thresholds and the participants' self-reported outcome measures of pain and quality of life were evaluated. Methods Fifty patients (50.5 ± 11.9 years) were randomised to a treatment group (TG) or a waiting-list control group (WL). Patients in the TG received a series of 5 cupping treatments over a period of 2 weeks; the control group did not. Self-reported outcome measures before and after the cupping series included the following: Pain at rest (PR) and maximal pain related to movement (PM) on a 100-mm visual analogue scale (VAS), pain diary (PD) data on a 0-10 numeric rating scale (NRS), Neck Disability Index (NDI), and health-related quality of life (SF-36). In addition, the mechanical-detection thresholds (MDT), vibration-detection thresholds (VDT), and pressure-pain thresholds (PPT) were determined at pain-related and control areas. Results Patients of the TG had significantly less pain after cupping therapy than patients of the WL group (PR: Δ-22.5 mm, p = 0.00002; PM: Δ-17.8 mm, p = 0.01). Pain diaries (PD) revealed that neck pain decreased gradually in the TG patients and that pain reported by the two groups differed significantly after the fifth cupping session (Δ-1.1, p = 0.001). There were also significant differences in the SF-36 subscales for bodily pain (Δ13.8, p = 0.006) and vitality (Δ10.2, p = 0.006). Group differences in PPT were significant at pain-related and control areas (all p < 0.05), but were not significant for MDT or VDT. Conclusions A series of five dry cupping treatments appeared to be effective in relieving chronic non-specific neck pain. Not only subjective measures improved, but also mechanical pain sensitivity differed significantly between the two groups, suggesting that cupping has an influence on functional pain processing. Trial registration The trial was registered at clinicaltrials.gov (NCT01289964).
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Abstract
INTRODUCTION Multimodal approaches in behavioral treatment have gained recent interest, with proven efficacy for migraine. The utility of the Internet has been demonstrated for behavioral treatment of headache disorders, but not specifically for migraine. The aim of the study was to develop and evaluate an Internet-based multimodal behavior treatment (MBT) program for migraine and to test hand massage treatment as an adjunct. METHODS Eighty-three adults, 58 women and 25 men, with at least two migraine attacks a month were recruited via advertisements. An MBT program aiming at improvements in life-style and stress coping was developed for this study and, together with a diary, adapted for use over the Internet. Participants were randomized to MBT with and without hand massage and to a control group, and were followed for 11 months. Questionnaires addressing issues of quality of life (PQ23) and depressive symptoms (MADRS-S) were used. RESULTS A 50%, or greater, reduction in migraine frequency was found in 40% and 42% of participants of the two groups receiving MBT (with and without hand massage, respectively), who statistically were significantly more improved than participants in the control group. No effect of hand massage was detected, and gender did not show any independent contribution to the effect in a multivariate analysis. CONCLUSIONS MBT administered over the Internet appears feasible and effective in the treatment of migraine, but no effect of hand massage was found. For increased knowledge on long-term effects and the modes of action of the present MBT program, further studies are needed.
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Affiliation(s)
- Kerstin Hedborg
- Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, University of Gävle, Sweden.
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Hogg-Johnson S, Cole DC, Lee H, Beaton DE, Kennedy C, Subrata P. Changes in Physiotherapy Utilization in One Workforce: Implications for Accessibility among Canadian Working-Age Adults. Healthc Policy 2011; 6:e93-e108. [PMID: 22294994 PMCID: PMC3082390 DOI: 10.12927/hcpol.2011.22180] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
In debates over access to essential medical care, comparatively little attention has been paid to the provision of outpatient physiotherapy services. We examined physiotherapy utilization for musculoskeletal disorders (MSDs) among approximately 2,000 employees of a large, unionized, Ontario workplace. We obtained MSD-related physiotherapy claims and service data from the public Workplace Safety and Insurance Board, two private medical insurance carriers, a workplace special fund starting in 1995 and a workplace-contracted, on-site physiotherapy clinic starting in 1999. We observed substantial increases in overall physiotherapy utilization for MSDs: a median of 234 services per quarter for 1992-1994 to 1,281 for 1999-2002. With inclusive workplace provision policies, most physiotherapy utilization occurred on-site by 1999-2002 (70%). With a user-pay orientation to outpatient physiotherapy services increasing among working-age adults in Ontario, there is substantial potential for unequal access among those not privately insured or in workplaces with direct service provision.
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Affiliation(s)
- Sheilah Hogg-Johnson
- Senior Scientist, Institute for Work & Health, Dalla Lana School of Public Health, Toronto, ON
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Escortell-Mayor E, Riesgo-Fuertes R, Garrido-Elustondo S, Asúnsolo-Del Barco A, Díaz-Pulido B, Blanco-Díaz M, Bejerano-Álvarez E. Primary care randomized clinical trial: manual therapy effectiveness in comparison with TENS in patients with neck pain. ACTA ACUST UNITED AC 2010; 16:66-73. [PMID: 20691631 DOI: 10.1016/j.math.2010.07.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2009] [Revised: 06/26/2010] [Accepted: 07/06/2010] [Indexed: 11/19/2022]
Abstract
This study investigated effectiveness of manual therapy (MT) with transcutaneous electrical nerve stimulation (TENS) to reduce pain intensity in patients with mechanical neck disorder (MND). A randomized multi-centered controlled clinical trial was performed in 12 Primary Care Physiotherapy Units in Madrid Region. Ninety patients were included with diagnoses of subacute or chronic MND without neurological damage, 47 patients received MT and 43 TENS. The primary outcome was pain intensity measured in millimeters using the Visual Analogue Scale (VAS). Also disability, quality of life, adverse effects and sociodemographic and prognosis variables were measured. Three evaluations were performed (before, when the procedure finished and six months after). Seventy-one patients (79%) completed the follow-up measurement at six months. In more than half of the treated patients the procedure had a clinically relevant "short term" result after having ended the intervention, when either MT or TENS was used. The success rate decreased to one-third of the patients 6 months after the intervention. No differences can be found in the reduction of pain, in the decrease of disability nor in the quality of life between both therapies. Both analyzed physiotherapy techniques produce a short-term pain reduction that is clinically relevant.
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Affiliation(s)
- E Escortell-Mayor
- Servicio Madrileño de Salud - Primary Care, Atención Primaria, Área 3, C/ Ntra. Sra del Pilar s/n 28803, Alcalá de Henares, Madrid, Spain.
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Sefton JM, Yarar C, Berry JW, Pascoe DD. Therapeutic Massage of the Neck and Shoulders Produces Changes in Peripheral Blood Flow When Assessed with Dynamic Infrared Thermography. J Altern Complement Med 2010; 16:723-32. [PMID: 20590481 DOI: 10.1089/acm.2009.0441] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- JoEllen M. Sefton
- Neuromechanics Research Laboratory, Department of Kinesiology, Auburn University, Auburn, AL
| | - Ceren Yarar
- Neuromechanics Research Laboratory, Department of Kinesiology, Auburn University, Auburn, AL
| | - Jack W. Berry
- Department of Psychology, Samford University, Birmingham, AL
- UAB Injury Control Research Center, University of Alabama at Birmingham, Birmingham, AL
| | - David D. Pascoe
- Thermal Research Laboratory, Department of Kinesiology, Auburn University, Auburn, AL
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Manual therapy with or without physical medicine modalities for neck pain: a systematic review. ACTA ACUST UNITED AC 2010; 15:415-33. [PMID: 20538501 DOI: 10.1016/j.math.2010.04.003] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2010] [Revised: 04/20/2010] [Accepted: 04/27/2010] [Indexed: 11/22/2022]
Abstract
Manual therapy interventions are often used with or without physical medicine modalities to treat neck pain. This review assessed the effect of 1) manipulation and mobilisation, 2) manipulation, mobilisation and soft tissue work, and 3) manual therapy with physical medicine modalities on pain, function, patient satisfaction, quality of life (QoL), and global perceived effect (GPE) in adults with neck pain. A computerised search for randomised trials was performed up to July 2009. Two or more authors independently selected studies, abstracted data, and assessed methodological quality. Pooled relative risk (RR) and standardised mean differences (SMD) were calculated when possible. We included 19 trials, 37% of which had a low risk of bias. Moderate quality evidence (1 trial, 221 participants) suggested mobilisation, manipulation and soft tissue techniques decrease pain and improved satisfaction when compared to short wave diathermy, and that this treatment combination paired with advice and exercise produces greater improvements in GPE and satisfaction than advice and exercise alone for acute neck pain. Low quality evidence suggests a clinically important benefit favouring mobilisation and manipulation in pain relief [1 meta-analysis, 112 participants: SMD -0.34(95% CI: -0.71, 0.03), improved function and GPE (1 trial, 94 participants) for participants with chronic cervicogenic headache when compared to a control at intermediate and long term follow-up; but no difference when used with various physical medicine modalities.
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Bronfort G, Haas M, Evans R, Leininger B, Triano J. Effectiveness of manual therapies: the UK evidence report. CHIROPRACTIC & OSTEOPATHY 2010; 18:3. [PMID: 20184717 PMCID: PMC2841070 DOI: 10.1186/1746-1340-18-3] [Citation(s) in RCA: 274] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2009] [Accepted: 02/25/2010] [Indexed: 12/14/2022]
Abstract
BACKGROUND The purpose of this report is to provide a succinct but comprehensive summary of the scientific evidence regarding the effectiveness of manual treatment for the management of a variety of musculoskeletal and non-musculoskeletal conditions. METHODS The conclusions are based on the results of systematic reviews of randomized clinical trials (RCTs), widely accepted and primarily UK and United States evidence-based clinical guidelines, plus the results of all RCTs not yet included in the first three categories. The strength/quality of the evidence regarding effectiveness was based on an adapted version of the grading system developed by the US Preventive Services Task Force and a study risk of bias assessment tool for the recent RCTs. RESULTS By September 2009, 26 categories of conditions were located containing RCT evidence for the use of manual therapy: 13 musculoskeletal conditions, four types of chronic headache and nine non-musculoskeletal conditions. We identified 49 recent relevant systematic reviews and 16 evidence-based clinical guidelines plus an additional 46 RCTs not yet included in systematic reviews and guidelines.Additionally, brief references are made to other effective non-pharmacological, non-invasive physical treatments. CONCLUSIONS Spinal manipulation/mobilization is effective in adults for: acute, subacute, and chronic low back pain; migraine and cervicogenic headache; cervicogenic dizziness; manipulation/mobilization is effective for several extremity joint conditions; and thoracic manipulation/mobilization is effective for acute/subacute neck pain. The evidence is inconclusive for cervical manipulation/mobilization alone for neck pain of any duration, and for manipulation/mobilization for mid back pain, sciatica, tension-type headache, coccydynia, temporomandibular joint disorders, fibromyalgia, premenstrual syndrome, and pneumonia in older adults. Spinal manipulation is not effective for asthma and dysmenorrhea when compared to sham manipulation, or for Stage 1 hypertension when added to an antihypertensive diet. In children, the evidence is inconclusive regarding the effectiveness for otitis media and enuresis, and it is not effective for infantile colic and asthma when compared to sham manipulation.Massage is effective in adults for chronic low back pain and chronic neck pain. The evidence is inconclusive for knee osteoarthritis, fibromyalgia, myofascial pain syndrome, migraine headache, and premenstrual syndrome. In children, the evidence is inconclusive for asthma and infantile colic.
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Affiliation(s)
- Gert Bronfort
- Northwestern Health Sciences University, Bloomington, MN, USA.
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Bearne LM, Hurley MV. Physical therapies. Rheumatology (Oxford) 2010. [DOI: 10.1016/b978-0-443-06934-5.00008-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Eine halbsteife Nackenorthese vermindert die Symptomatik radikulärer Armschmerzen. MANUELLE MEDIZIN 2009. [DOI: 10.1007/s00337-009-0722-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Physical Therapy as Conservative Management for Cervical Pain and Headaches in an Adolescent with Neurofibromatosis Type 1: A Case Study. J Neurol Phys Ther 2009; 33:212-23. [DOI: 10.1097/npt.0b013e3181c1fac3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Spinal Accessory Neuropathy Associated With Deep Tissue Massage: A Case Report. Arch Phys Med Rehabil 2009; 90:1969-72. [DOI: 10.1016/j.apmr.2009.06.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2009] [Revised: 06/11/2009] [Accepted: 06/16/2009] [Indexed: 11/22/2022]
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Chan DKC, Johnson MI, Sun KO, Doble SJ, Jenkins S. Electrical acustimulation of the wrist for chronic neck pain: a randomized, sham-controlled trial using a wrist-ankle acustimulation device. Clin J Pain 2009; 25:320-6. [PMID: 19590481 DOI: 10.1097/ajp.0b013e318192ce39] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Chronic neck pain is a common problem and is treated using a variety of conservative treatments. This single-blind, randomized, sham-controlled trial investigated the value of adding electrical stimulation of acupuncture points on the wrist to a standardized program of neck exercises for chronic neck pain. METHODS At initial recruitment 60 patients were randomly assigned to receive either active or sham electrical stimulation of acupuncture points on the wrist in addition to standardized neck exercise. Active or sham wrist acustimulation was given for 30 minutes 2 times/wk over a period of 4 weeks. A 30 minutes program of standardized neck exercises was also performed simultaneously. RESULTS Forty-nine patients completed the study (22 active, 27 sham). Statistically significant improvements were found for acustimulation when compared with sham at immediate posttreatment and 1-month posttreatment for Numerical Rating Scale, Northwick Park Neck Pain Questionnaire and Pain Self-Efficacy Questionnaire. In active and sham electrical stimulation group 38.9% and 8.3% of patients reported a reduction of Numerical Rating Scale > 50% at 1-month posttreatment follow-up, respectively. All patients tolerated acustimulation and no adverse effects were reported. DISCUSSION Electrical acustimulation of the wrist administered as two, 30 minutes sessions /wk added value to standardized neck exercise for chronic neck pain. A 4-week course of treatment produced effects lasting 1-month posttreatment.
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Affiliation(s)
- Danny K C Chan
- Hong Kong Acupuncture and Physiotherapy Pain Center, Hong Kong SAR, Hong Kong Special Administrative Region, China.
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Abstract
SYNOPSIS For clinicians, systematic reviews can enhance incorporation into practice of the large volumes of information emerging from research on effectiveness and risks. But we believe that these reviews are most useful with simplified tools to facilitate translation of this knowledge into practice. We provide a "Neck Care Tool Kit" that gives a diagrammatic approach to prioritizing intervention. The evidence from a series of 11 systematic reviews by the Cervical Overview Group is depicted in decision flow-charts and tables to enhance clinical interpretation of the overview findings. On simple visual inspection of symbols in a table, the reader can establish where there is evidence of benefit or no benefit, the strength of the recommendation, and if these data represent short- or long-term findings. Where possible, we guide clinicians to dosage of specific treatment methods. There is no consensus as to which outcome measures to prioritize among the large number in use. This clinical commentary guides clinicians to view the evidence in enough detail to integrate it into their clinical practice environment. We conclude by delineating research gaps and proposing future research directions. LEVEL OF EVIDENCE Therapy, level 5.
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Kania A, Verhoef MJ, Dryden T, Ware MA. IN-CAM Outcomes Database: Its Relevance and Application in Massage Therapy Research and Practice. Int J Ther Massage Bodywork 2009; 2:8-16. [PMID: 21589721 PMCID: PMC3091455 DOI: 10.3822/ijtmb.v2i1.37] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
One of the most commonly used complementary and alternative medicine (CAM) modalities in North America is massage therapy (MT). Research to date indicates many potential health benefits of MT, suggesting that ongoing research efforts to further elucidate and substantiate preliminary findings within the massage profession should be given high priority. Central to the development of a sound evidence base for MT are the use of valid, reliable, and relevant outcome measures in research, and practice in assessing the effectiveness of MT. The purpose of the present article is to introduce MT researchers and massage therapists interested in using outcome measures in research and clinical practice to the IN-CAM Outcomes Database website by describing the Outcomes Database and identifying its utility in MT research and practice. The IN-CAM Outcomes Database is a centralized location where information on outcome measures is collected and made accessible to users. Outcome measures are organized in the database within the Framework of Outcome Domains. The Framework includes health domains relevant to conventional medicine and CAM alike, and health domains that have been identified as important to CAM interventions. Users of the website may search for information on a specific outcome measure, plan research projects, and engage in discussions related to outcomes assessment in the CAM field with other users and with members of the CAM research community. As the MT profession continues to evolve and move toward evidence-informed practice, the IN-CAM Outcomes Database website can be a valuable resource for MT researchers and massage therapists.
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Affiliation(s)
- Ania Kania
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
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Sherman KJ, Cherkin DC, Hawkes RJ, Miglioretti DL, Deyo RA. Randomized trial of therapeutic massage for chronic neck pain. Clin J Pain 2009; 25:233-8. [PMID: 19333174 PMCID: PMC2664516 DOI: 10.1097/ajp.0b013e31818b7912] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Little is known about the effectiveness of therapeutic massage, one of the most popular complementary medical treatments for neck pain. A randomized controlled trial was conducted to evaluate whether therapeutic massage is more beneficial than a self-care book for patients with chronic neck pain. METHODS Sixty-four such patients were randomized to receive up to 10 massages over 10 weeks or a self-care book. Follow-up telephone interviews after 4, 10, and 26 weeks assessed outcomes including dysfunction and symptoms. Log-binomial regression was used to assess whether there were differences in the percentages of participants with clinically meaningful improvements in dysfunction and symptoms (ie, >5-point improvement on the Neck Disability Index; >30% improvement from baseline on the symptom bothersomeness scale) at each time point. RESULTS At 10 weeks, more participants randomized to massage experienced clinically significant improvement on the Neck Disability Index [39% vs. 14% of book group; relative risk (RR)=2.7; 95% confidence interval (CI), 0.99-7.5] and on the symptom bothersomeness scale (55% vs. 25% of book group; RR=2.2; 95% CI, 1.04-4.2). After 26 weeks, massage group members tended to be more likely to report improved function (RR=1.8; 95% CI, 0.97-3.5), but not symptom bothersomeness (RR=1.1; 95% CI, 0.6-2.0). Mean differences between groups were strongest at 4 weeks and not evident by 26 weeks. No serious adverse experiences were reported. CONCLUSIONS This study suggests that massage is safe and may have clinical benefits for treating chronic neck pain at least in the short term. A larger trial is warranted to confirm these results.
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Affiliation(s)
- Karen J Sherman
- Group Health Center for Health Studies, Seattle, WA 98101, USA.
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Hurwitz EL, Carragee EJ, van der Velde G, Carroll LJ, Nordin M, Guzman J, Peloso PM, Holm LW, Côté P, Hogg-Johnson S, Cassidy JD, Haldeman S. Treatment of Neck Pain: Noninvasive Interventions. J Manipulative Physiol Ther 2009; 32:S141-75. [DOI: 10.1016/j.jmpt.2008.11.017] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Frey Law LA, Evans S, Knudtson J, Nus S, Scholl K, Sluka KA. Massage reduces pain perception and hyperalgesia in experimental muscle pain: a randomized, controlled trial. THE JOURNAL OF PAIN 2008; 9:714-21. [PMID: 18455480 DOI: 10.1016/j.jpain.2008.03.009] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2007] [Revised: 01/30/2008] [Accepted: 03/10/2008] [Indexed: 11/26/2022]
Abstract
UNLABELLED Massage is a common conservative intervention used to treat myalgia. Although subjective reports have supported the premise that massage decreases pain, few studies have systematically investigated the dose response characteristics of massage relative to a control group. The purpose of this study was to perform a double-blinded, randomized controlled trial of the effects of massage on mechanical hyperalgesia (pressure pain thresholds, PPT) and perceived pain using delayed onset muscle soreness (DOMS) as an endogenous model of myalgia. Participants were randomly assigned to a no-treatment control, superficial touch, or deep-tissue massage group. Eccentric wrist extension exercises were performed at visit 1 to induce DOMS 48 hours later at visit 2. Pain, assessed using visual analog scales (VAS), and PPTs were measured at baseline, after exercise, before treatment, and after treatment. Deep massage decreased pain (48.4% DOMS reversal) during muscle stretch. Mechanical hyperalgesia was reduced (27.5% reversal) after both the deep massage and superficial touch groups relative to control (increased hyperalgesia by 38.4%). Resting pain did not vary between treatment groups. PERSPECTIVE This randomized, controlled trial suggests that massage is capable of reducing myalgia symptoms by approximately 25% to 50%, varying with assessment technique. Thus, potential analgesia may depend on the pain assessment used. This information may assist clinicians in determining conservative treatment options for patients with myalgia.
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Affiliation(s)
- Laura A Frey Law
- Program in Physical Therapy and Rehabilitation Science, The University of Iowa, Iowa City, Iowa 52242, USA. USA.
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Treatment of Neck Pain: Noninvasive Interventions. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2008. [DOI: 10.1007/s00586-008-0631-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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