Manual Therapies and Massages for Back Pain

Manuelle Therapie & Massagen bei Rückenschmerzen

Who doesn’t know this: The back hurts, the muscles feel tense and you feel the need for a short, soothing massage, even by a layman.

Professional massages and manual therapy are also very popular. In 2016, massages and manual therapies were responsible for almost a quarter of the more than 11 million prescribed physiotherapy services of the AOK, a major German health insurance. 1

It is not surprising that many people consider massage to be an effective treatment for back pain: In several studies, about half of the patients with back pain had already used massage for treatment – far more than other non-drug procedures studied. 2,3

Manual therapy (also known as chirotherapy) is a popular method of treating back pain. In manual therapy, functional disorders of the spine are diagnosed and treated by specially trained physiotherapists or doctors by means of suitable hand movements and mobilization techniques. 4

But how effective are massages and manual therapy really for the treatment of back pain? Do they help to overcome the pain or do they only make you feel good for a moment? And can I still do something myself to improve the effect of massages or manual therapy in case of back pain? Find the answer to these questions in the following article!

Massages for back pain: the feeling of well-being with questionable effect

As already described above: Massages are not only popular, they are also prescribed by doctors as a medical treatment – according to some examinations even in almost one in three patients. 1, 5

But what about the effectiveness of massages? Are they so popular because they are so effective?

A large survey has looked at the results of numerous studies on massage and back pain. Overall, the study results were very contradictory – regardless of whether back pain was short or long term. Although a massage seems to relieve some of the pain and the frequent limitation of movement for back pain, this only lasts for a short period after the massage. However, there were also few side effects except a frequent short-term worsening of pain. 6

The guidelines for the treatment of low back pain come to a similar conclusion. They also see a short-term effect against pain during massages, but it does not last long. In addition, it is criticised that massage contributes to pain patients behaving passively and that it doesn’t help those affected to intervene in the course of the disease themselves. 7

It looks similar for neck pain: Studies can at best demonstrate a short-term effect. 8 Current guidelines therefore do not recommend massage for the treatment of neck pain. 9

Manual therapy for back pain: Pain relief through adjusting?

With the trained manual therapy techniques, physicians or physiotherapists with additional training can not only diagnose functional disorders of the spine but also treat them immediately with suitable procedures without further equipment. 4, 10

But how effective are these actions to relieve pain and improve spine function?

Here too, the results of numerous studies have been summarized for acute back pain (i.e. pain that does not last longer than six weeks) – and a positive effect of manual therapy on pain and limited mobility has been found. 11 Even with prolonged pain, some, if not all, studies found a positive effect of manual therapy. 12 The guidelines therefore rate manual therapy for low back pain as more advisable than massages. 7

Manual therapy also appears to be an effective alternative to treatment for neck pain, although few studies are available. 13 Accordingly, the guidelines for the treatment of neck pain also evaluate manual therapy as part of the recommended treatment, regardless of the duration of the symptoms. 9

Due to the very rare but possible side effects of manual therapy, attention is repeatedly drawn to the proper execution by qualified specialists. 7, 14

What you can do to further alleviate the symptoms in addition to massage or manual therapy

Of course, manual therapy or massages can be combined with almost any other method of treatment.

However, both procedures are so-called passive therapies – i.e. the patient cannot carry them out himself and is dependent on other (usually trained specialist personnel).

Experts stress again and again: The most important step for the improvement of back or neck pain is the active handling of the complaints. Whether physiotherapy, another form of movement therapy or sport: Especially if the further treatment consists of passive methods (such as massage or manual therapy for back pain), it is important to act actively and with movement against back pain. 15

The Kaia-Health App can help you integrate exactly these movements into your everyday life and to supplement massages or manual therapy for back pain with an important component.