Frey Law Laura A, Evans Stephanie, Knudtson Jill, Nus Steven, Scholl Kerri, Sluka Kathleen A
Program in Physical Therapy and Rehabilitation Science, The University of Iowa, Iowa City, Iowa 52242, USA. USA.
J Pain. 2008 Aug;9(8):714-21. doi: 10.1016/j.jpain.2008.03.009. Epub 2008 May 2.
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.
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.
按摩是一种常用于治疗肌痛的保守干预方法。尽管主观报告支持按摩可减轻疼痛这一前提,但很少有研究系统地调查按摩相对于对照组的剂量反应特征。本研究的目的是进行一项双盲、随机对照试验,以评估按摩对机械性痛觉过敏(压痛阈值,PPT)和使用延迟性肌肉酸痛(DOMS)作为肌痛内源性模型的感知疼痛的影响。参与者被随机分配到不治疗对照组、浅触摸组或深层组织按摩组。在第1次就诊时进行离心性腕伸展运动,以在48小时后的第2次就诊时诱发DOMS。使用视觉模拟量表(VAS)评估疼痛,并在基线、运动后、治疗前和治疗后测量PPT。深层按摩在肌肉拉伸期间减轻了疼痛(DOMS逆转48.4%)。相对于对照组(痛觉过敏增加38.4%),深层按摩组和浅触摸组在治疗后机械性痛觉过敏均有所降低(逆转27.5%)。静息痛在各治疗组之间没有差异。
这项随机对照试验表明,按摩能够将肌痛症状减轻约25%至50%,具体程度因评估技术而异。因此,潜在的镇痛效果可能取决于所使用的疼痛评估方法。这些信息可能有助于临床医生为肌痛患者确定保守治疗方案。