Massage Effectiveness for Primary Care Patients with Chronic Low Back Pain and Below Normal SF-36v2 Mental Health Scores: Secondary Analysis

Abstract

Purpose: The challenging condition of chronic low back pain (CLBP) is often complicated by negative mental health factors. Non-pharmacological approaches to address CLBP alone and in combination with mental health issues are needed. A recently completed NIH funded study examined the effectiveness of clinical massage therapy (CMT) on functional health outcomes for CLBP patients referred to CMT by their PCP regardless of mental health status save psychosis. CMT was found to have significant and clinically meaningful effectiveness for patients (N=85) in the primary outcomes: Oswestry Disability Index, SF-36v2 mental and physical components and pain domain (in review). The purpose this study's secondary analysis is to determine the extent to which participants that began the study below normal in the SF-36v2 mental health component had clinically meaningful change.

Methods: CLBP patients referred by their PCP were assigned to community massage practitioners (CMPs) to receive up to ten, 1-hour CMT sessions over 12-weeks. Individual treatment plans were formulated by study CMPs. Secondary data analyses were conducted examining a subpopulation (n=41) of those beginning the study at below normal (<45) for the SF-36v2 mental health component score.

Results: Mean change for those <norMHC was 8.4 (±7.6) vs. −1.9 (±6.6) for the SF-36v2 mental health component score (p<0.0001). 70% (vs. 19%) achieved clinically meaningful improvement (≥4.6 change) in the SF-36v2 mental health component score (p<0.0001). Furthermore, 48% of <norMHC, transitioned from below to at or above normal post-intervention. The relationship of mental health scores with other outcomes will be discussed.

Conclusion: While primary study results indicate significant and clinically meaningful outcome for CMT, these secondary analyses suggest striking CMT effectiveness for CLBP patients with below normal mental health component assessments, particularly in regards to their mental health. Stakeholders should consider/utilize CMT as an effective intervention for CLBP patients, particularly those with below normal mental health assessments.