Chronic low back pain, 20 years follow up after back school and shiatsu massage in a controlled, blind, perspective, randomized trial

Abstract

Background:

Lot of studies have been made to demonstrate effectiveness of therapy in acute and sub acute l.b.p. Less are the trials about therapies in chronic l.b.p. Many people have experienced subjective effectiveness of massage, reflex therapy, but there are really few studies evaluating their objective effectiveness.

Aims:

Verify after 20 years follow up, the trend of the low back pain and the treatments used, in time, after the treatments carried out, in reducing pain and disability of people with chronic l.b.p. Materials and Methods: A preliminary trial including patients with l.b.p. since three month. All the subjects hadn’t sciatica, neurological signs, evident alteration on x-ray, they were randomised. An independent blind observatory evaluates the preliminary results on pain and disability with two item scales, Backill and Mcgill pain questionnaire. About 20 years after the end of treatment we made a recall with telephone interview about the trend of back pain in 20 years.

Results:

All the participants recalled answered the brief questionnaire proposed, all of them had recurrent back pain.

Conclusion:

Chronic low back pain it’s a difficult trial for every physician. The role of education and self-care seems to be one of the important factors for the management of c.l.b.p.

Background:

Low back pain (LBP) remains a problem at epidemic proportion, a burden for the patient, the family, and the economy. Despite the multiplicity of treatments available, a clear choice of effective treatment has not emerged. Massage therapy has a long history, and is associated with various effects that, in the symptomatic treatment, are potentially beneficial. Ernst in his systematic review analysed four trials comparing massage with other therapies. All of those trials are burdened with methodological flaws; however there is some evidence that massage is effective. Pope et al. compared spinal manipulation, with t.e.n.s., corset and massage in sub acute low back pain, but used massage like a placebo group and concluded that there are no significant differences between treatments. Also Gillan used in his trial, massage like a control group receiving non- specific back massage comparing to McKenzie protocol. Cherkin in his randomised trial, compared massage vs acupuncture and self-care in back pain persisting at least six weeks. He found that massage is clearly superior in back function and satisfaction, there were no significant differences in symptoms. Also acupuncture had better results in satisfaction. Before alternatives therapies such as massage and acupuncture, are incorporated into standard primary care practice, more scientifically rigorous studies are needed, to determine which treatments are consistently cost-effective for LBP.