Abstract
Chronic unspecific back pain (cBP) is often associated with depressive symptoms, negative body perception, and abnormal interoception. Given the general failure of surgery in cBP, treatment guidelines focus on conservative therapies. Neurophysiological evidence indicates that C-tactile fibers associated with the oxytonergic system can be activated by slow superficial stroking of the skin in the back, shoulder, neck, and dorsal limb areas. We hypothesize that, through recruitment of C-tactile fibers, psycho-regulatory massage therapy (PRMT) can reduce pain in patients with cBP. In our study, 66 patients were randomized to PRMT or CMT (classical massage therapy) over a 12-week period and tested by questionnaires regarding pain (HSAL= Hamburger Schmerz Adjektiv Liste; Hamburg Pain adjective list), depression (BDI-II = Beck depression inventory), and disability (ODI = Oswestry Disability Index). In all outcome measures, patients receiving PRMT improved significantly more than did those receiving CMT. The mean values of the HSAL sensory subscale decreased by −51.5% in the PRMT group compared to −6.7% in the CMT group. Depressive symptoms were reduced by −55.69% (PRMT) and −3.1% (CMT), respectively. The results suggest that the superiority of PRMT over CMT may rely on its ability to activate the C-tactile fibers of superficial skin layers, recruiting the oxytonergic system.
Highlights
Chronic back pain has a leading position worldwide in disease-related disability and loss of quality of life [1]
HSAL total, affective, and sensory scores for pain: The total scores and the affective and sensory subscores of HSAL were significantly smaller in the T2 and T3 sessions in the psycho-regulatory massage therapy (PRMT) group compared to the classical massage therapy (CMT) group
All HSAL parameters were statistically significant for the effect of treatment session in PRMT (p < 0.001)
Summary
Chronic back pain (cBP) has a leading position worldwide in disease-related disability and loss of quality of life [1]. It represents a common health problem, especially among women. 2009/2010, one in four women reported suffering cBP (lasting >3 months) within the last 12 months [2]. Modern recommendations by national and international health organizations focus on non-drug therapy options in the treatment of chronic (non-specific) back pain. Additional treatment with pain-relieving medication is recommended. Surgery is not recommended because there is little evidence of its effectiveness [5,8,9]
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