Intended for healthcare professionals


Massage treatment for back pain

BMJ 2003; 326 doi: (Published 15 March 2003) Cite this as: BMJ 2003;326:562

Evidence for symptomatic relief is encouraging but not compelling

  1. E Ernst, director, complementary medicine (
  1. Peninsula Medical School, Complementary Medicine, Universities of Plymouth and Exeter, Exeter EX2 4NT

    Throughout history different forms of massage treatment have been used in all medical cultures to alleviate a wide range of symptoms. This article focuses on the most common form, classic muscular (Swedish) massage, as a symptomatic treatment for back pain.1 It will define the therapeutic modality, review the evidence for or against effectiveness and safety, and discuss possible mechanisms of action as well as the problems of conducting research in this area.

    Swedish massage is a touch therapy that uses a range of techniques to manipulate the soft tissues of the body: effleurage (slow rhythmic stroking), kneading (circular compression), petrissage (forceful skin rolling), friction (penetrating pressure from the fingertips with circular or transverse movement), tapotement (percussive movements), vibration (trembling movement of both hands).2 In most English speaking countries, massage is seen as an alternative or complementary treatment,3 whereas on the European continent it is considered a conventional treatment, particularly for back pain. In …

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