OBJECTIVES: To investigate the effects of Swedish massage with aromatic ginger oil (SMGO) on chronic low back pain and disability in older adults compared with traditional Thai massage (TTM). DESIGN: Randomized controlled trial. SETTING: Massage clinic in Ratchaburi province, Thailand. PARTICIPANTS: 164 patients were screened; 140 were eligible, and randomized to either SMGO (n=70) or TTM (n=70). INTERVENTION: Trained staff provided participants with a 30-min SMGO or TTM twice a week for five weeks. MEASUREMENT: The Visual Analogue Scale (VAS) assessed immediate effect (after each massage) and the short form McGill Pain Questionnaire (MPQ) assessed effectiveness of massage in short-term (six weeks) and long-term (15 weeks). Disability improvement was measured by the Owestry Disability Questionnaire (ODQ) at baseline, short- and long-term. RESULTS: Both SMGO and TTM led to significant improvements in pain intensity (p<0.05) and disability (p<0.05) across the period of assessments, indicating immediate, short- and long-term effectiveness. SMGO was more effective than TTM in reducing pain (p=0.04) and improving disability at short- and long-term assessments (p=0.04). CONCLUSIONS: These findings suggest that the integration of either SMGO or TTM therapy as additional options to provide holistic care to older people with chronic low back pain could be considered by health professionals. Further research into the use of ginger as an adjunct to massage therapy, particularly TTM, is recommended.