Furlan A D, Brosseau L, Welch V, Wong J
Research, Institute for Work & Health, 250 Bloor St, East. Suite 702, Toronto, ON, Canada, M4W 1E6.
Cochrane Database Syst Rev. 2000(4):CD001929. doi: 10.1002/14651858.CD001929.
Low back pain is one of the most common and costly musculoskeletal problems in modern societies. Proponents of massage therapy claim it can minimize pain and disability, and speed return to normal function.
To assess the effects of massage therapy for non-specific low back pain.
We searched Medline, Embase, Cochrane Controlled Trials Register, Healthstar, CINAHL and Dissertation abstracts from 1966 to 1999 with no language restrictions. References in the included studies and in reviews of the literature were also screened. Contact with content experts and massage associations were also made.
This review included randomized, quasi-randomized or controlled clinical trials that investigated the use of any type of massage (using the hands or a mechanical device) as a treatment for nonspecific low back pain.
One reviewer applied the selection criteria and extracted the data. Two reviewers (one blinded to authors, institutions and journals) independently assessed the quality of each trial. A qualitative analysis (best-evidence synthesis) was performed due to clinical heterogeneity among the included trials and insufficient data reported.
Four randomized controlled trials met the inclusion criteria. Two trials were of high and two of low methodological quality. None evaluated massage as the main intervention. Rather, it was the control intervention in studies evaluating manipulation, electrical stimulation, and a lumbar corset. There is limited evidence showing that massage is less effective than manipulation immediately after the first session and moderate evidence showing it is less effective than TENS during the course of sessions in relieving pain and improving activity. At the completion of treatment and at 3 weeks after discharge there is no difference among massage and manipulation, electrical stimulation or corsets, but this evidence is limited.
REVIEWER'S CONCLUSIONS: Based on the studies reviewed, there is insufficient evidence to recommend massage as a stand-alone treatment for non-specific low back pain. There is a need for high quality controlled trials to further evaluate the effects of massage for this condition.
下腰痛是现代社会中最常见且花费高昂的肌肉骨骼问题之一。按摩疗法的支持者宣称其可将疼痛和残疾程度降至最低，并加速恢复正常功能。
评估按摩疗法对非特异性下腰痛的疗效。
我们检索了1966年至1999年的Medline、Embase、Cochrane对照试验注册库、Healthstar、CINAHL及学位论文摘要，无语言限制。对纳入研究及文献综述中的参考文献也进行了筛选。还与内容专家及按摩协会进行了联系。
本综述纳入了随机、半随机或对照临床试验，这些试验研究了使用任何类型的按摩（用手或机械设备）作为非特异性下腰痛的治疗方法。
一名审阅者应用选择标准并提取数据。两名审阅者（其中一名对作者、机构和期刊不知情）独立评估每个试验的质量。由于纳入试验之间存在临床异质性且报告的数据不足，因此进行了定性分析（最佳证据综合）。
四项随机对照试验符合纳入标准。两项试验方法学质量高，两项质量低。没有试验将按摩作为主要干预措施进行评估。相反，在评估手法治疗、电刺激和腰椎护具的研究中，按摩是对照干预措施。有限的证据表明，在第一次治疗后立即进行比较，按摩的效果不如手法治疗；中等证据表明，在治疗过程中，按摩在缓解疼痛和改善活动方面的效果不如经皮电刺激神经疗法（TENS）。在治疗结束时及出院后3周，按摩与手法治疗、电刺激或护具之间没有差异，但这方面的证据有限。
基于所综述的研究，没有足够的证据推荐将按摩作为非特异性下腰痛的单一治疗方法。需要高质量的对照试验来进一步评估按摩对这种疾病的疗效。
