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Massage therapy for people living with MSK pain [INFOGRAPHIC]
By Richard Lebert
By Richard Lebert

Chronic MSK pain is associated with significant social and economic costs. Conventional treatment options such opioid-based analgesics, corticosteroid injections, and surgical interventions are associated with small improvements versus placebo and an increased risk of harm, prompting stakeholders to re-evaluate how treatment is provided for people living with chronic MSK pain.
Musculoskeletal pain is a complex and multifactorial phenomenon and treatment requires an individualized multidisciplinary approach that addresses biopsychosocial influences and empowers people with shared decision-making. Increasingly, evidence-based non-pharmacological treatments options are being integrated with standard care as part of a person-centered approach.
The paradigm shift to an evidence-based multidisciplinary approach presents an opportunity for RMTs to collaborate with other healthcare professionals to improve a patient’s health and treatment outcome. With respect to the multidisciplinary treatment of pain, massage therapy has a desirable safety profile and it is a health care option that has been shown to be effective for many persistent pain syndromes. What is often not appreciated is that a number of clinical practice guidelines and systematic reviews support the use of massage therapy for patients suffering from a whole host of conditions, including but not limited to: back pain, tension-type headaches, TMJ disorder, carpal tunnel syndrome, and plantar heel pain. For example, the endorsement from the American College of Physicians who now recognizes massage therapy as a treatment option for patients with acute and chronic low back pain. The Canadian Guideline for Opioid and Chronic Non-Cancer Pain now recommends a trial of massage therapy rather than a trial of opioids for a number of conditions including: back and neck pain, osteoarthritis of the knee and headaches.
References
- Busse, J. W. et al.(2017) Guideline for opioid therapy and chronic noncancer pain. Canadian Medical Association journal, 189(18), E659–E666. doi:10.1503/cmaj.170363
- Chou, R. et al.(2017) Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline. Annals of internal medicine, 166(7), 493–505. doi:10.7326/M16-2459
- Chou, R. et al. (2020) Opioid Treatments for Chronic Pain. Agency for Healthcare Research and Quality (US).DOI:https://doi.org/10.23970/AHRQEPCCER229.
- Côté, P. et al. (2019) Non-pharmacological management of persistent headaches associated with neck pain: A clinical practice guideline from the Ontario protocol for traffic injury management (OPTIMa) collaboration. European journal of pain (London, England), 23(6), 1051–1070. doi:10.1002/ejp.1374
- Fraser, J. J. et al. (2018). Does manual therapy improve pain and function in patients with plantar fasciitis? A systematic review. The Journal of manual & manipulative therapy, 26(2), 55–65. doi:10.1080/10669817.2017.1322736
- Huisstede, B. M. et al. (2018) Effectiveness of Surgical and Postsurgical Interventions for Carpal Tunnel Syndrome-A Systematic Review. Archives of physical medicine and rehabilitation, 99(8), 1660–1680.e21. doi:10.1016/j.apmr.2017.04.024
- Lin, I. et al.(2020) What does best practice care for musculoskeletal pain look like? Eleven consistent recommendations from high-quality clinical practice guidelines: systematic review. British journal of sports medicine, 54(2), 79–86. doi:10.1136/bjsports-2018-099878
- Qaseem, A. et al. (2017) Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Annals of internal medicine, 166(7), 514–530. doi:10.7326/M16-2367
- Randhawa, K., Bohay, R., Côté, P., van der Velde, G., Sutton, D., Wong, J. J., … Taylor-Vaisey, A. (2016). The Effectiveness of Noninvasive Interventions for Temporomandibular Disorders: A Systematic Review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. The Clinical journal of pain, 32(3), 260–278. doi:10.1097/AJP.0000000000000247
- Skelly, A.C., et al. (2020) Noninvasive Nonpharmacological Treatment for Chronic Pain: A Systematic Review Update. Rockville (MD): Agency for Healthcare Research and Quality (US). DOI: https://doi.org/10.23970/ AHRQEPCCER227
Richard Lebert works in Petrolia Ontario and is associate faculty at Lambton College. Richard runs an online resource (RMTedu.com) exploring long-term solutions that promote growth and development of the profession. When he is not in the clinic his favorite activities are hiking, camping and kayaking with family and friends.