Randomized clinical trial assessing whether additional massage treatments for chronic neck pain improve 12- and 26-week outcomes.
Study Goal
The researchers aimed to determine the optimal dose of massage for treating chronic nonspecific neck pain and evaluate the benefits of a "booster" dose.
Results Summary
The study found no significant differences among primary treatment groups, but participants receiving booster doses showed short-term improvements in dysfunction and pain at 12 weeks, though these effects were not sustained at 26 weeks. The booster dose was only effective among those initially receiving 60-minute massages.
Population
179 participants with chronic nonspecific neck pain from Group Health and the general population of Seattle, WA, USA.
Effective Dosage
Primary groups received 30 minutes 2x or 3x/week or 60 minutes 1x, 2x, or 3x/week for 4 weeks; booster groups received an additional six 60-minute massages 1x/week.
Duration
4 weeks for primary treatment, with follow-up at 12 and 26 weeks.
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
massage (30 minutes 2x/wk) | no change | neck-related dysfunction and pain | persons with chronic nonspecific neck pain | - | no observed differences | #1 |
massage (30 minutes 3x/wk) | no change | neck-related dysfunction and pain | persons with chronic nonspecific neck pain | - | no observed differences | #2 |
massage (60 minutes 1x/wk) | no change | neck-related dysfunction and pain | persons with chronic nonspecific neck pain | - | no observed differences | #3 |
massage (60 minutes 2x/wk) | no change | neck-related dysfunction and pain | persons with chronic nonspecific neck pain | - | no observed differences | #4 |
massage (60 minutes 3x/wk) | no change | neck-related dysfunction and pain | persons with chronic nonspecific neck pain | - | no observed differences | #5 |
booster dose (additional six massages, 60 minutes 1x/wk) | decrease | dysfunction | persons with chronic nonspecific neck pain | relative risk [RR]=1.56 [1.08-2.25], p=.018 | had improvements | #6 |
booster dose (additional six massages, 60 minutes 1x/wk) | decrease | pain | persons with chronic nonspecific neck pain | RR=1.25 [0.98-1.61], p=.077 | had improvements | #7 |
booster dose (additional six massages, 60 minutes 1x/wk) | no change | dysfunction | persons with chronic nonspecific neck pain | RR=1.22 [0.85-1.74] | were nonsignificant | #8 |
booster dose (additional six massages, 60 minutes 1x/wk) | no change | pain | persons with chronic nonspecific neck pain | RR=1.09 [0.82-1.43] | were nonsignificant | #9 |
booster dose (additional six massages, 60 minutes 1x/wk) | decrease | dysfunction and pain | persons with chronic nonspecific neck pain initially randomized to one of the 60-minute massage groups | - | only effective | #10 |
BACKGROUND CONTEXT: This is the first study to systematically evaluate the value of a longer treatment period for massage. We provide a framework of how to conceptualize an optimal dose in this challenging setting of nonpharmacologic treatments. PURPOSE: The aim was to determine the optimal dose of massage for neck pain. STUDY DESIGN/SETTING: Two-phase randomized trial for persons with chronic nonspecific neck pain. Primary randomization to one of five groups receiving 4 weeks of massage (30 minutes 2x/or 3x/wk or 60 minutes 1x, 2x, or 3x/wk). Booster randomization of participants to receive an additional six massages, 60 minutes 1x/wk, or no additional massage. PATIENT SAMPLE: A total of 179 participants from Group Health and the general population of Seattle, WA, USA recruited between June 2010 and August 2011 were included. OUTCOME MEASURES: Primary outcomes self-reported neck-related dysfunction (Neck Disability Index) and pain (0-10 scale) were assessed at baseline, 12, and 26 weeks. Clinically meaningful improvement was defined as greater than or equal to 5-point decrease in dysfunction and greater than or equal to 30% decrease in pain from baseline. METHODS: Clinically meaningful improvement for each primary outcome with both follow-up times was analyzed using adjusted modified Poisson generalized estimating equations (GEEs). Secondary analyses for the continuous outcomes used linear GEEs. RESULTS: There were no observed differences by primary treatment group at 12 or 26 weeks. Those receiving booster dose had improvements in both dysfunction and pain at 12 weeks (dysfunction: relative risk [RR]=1.56 [1.08-2.25], p=.018; pain: RR=1.25 [0.98-1.61], p=.077), but those were nonsignificant at 26 weeks (dysfunction: RR=1.22 [0.85-1.74]; pain: RR=1.09 [0.82-1.43]). Subgroup analysis by primary and booster treatments found the booster dose only effective among those initially randomized to one of the 60-minute massage groups. CONCLUSIONS: "Booster" doses for those initially receiving 60 minutes of massage should be incorporated into future trials of massage for chronic neck pain.