Massage Beats Meds for Lower Back Pain, Study Says (HealthDay)

By Maureen Salamon
HealthDay Reporter by Maureen Salamon
healthday Reporter – Tue?Jul?5, 11:50?pm?ET

TUESDAY, July 5 (HealthDay News) -- Massage therapy may be better than medication or exercise for easing low back pain in the short term, a new government-funded study suggests.

Seattle researchers recruited 401 patients, mostly middle-aged, female and white, all of whom had chronic low back pain.

Those who received a series of either relaxation massage or structural massage were better able to work and be active for up to a year than those getting "usual medical care," which included painkillers, anti-inflammatory drugs, muscle relaxants or physical therapy, the researchers found.

Lead study author Daniel Cherkin, director of Group Health Research Institute, said he had expected structural massage, which manipulates specific pain-related back muscles and ligaments, would prove superior to relaxation or so-called Swedish massage, which aims to promote a feeling of body-wide relaxation.

Structural massage, which focuses on soft-tissue abnormalities, requires more training and may be more likely to be paid for by health insurance plans, which may equate it with physical therapy, said Cherkin.

"I thought structural massage would have been at least a little better, and that's not the case," Cherkin said. "If you're having continuing problems with back pain even after trying usual medical care, massage may be a good thing to do. I think the results are pretty strong."

The study, funded by the National Center for Complementary and Alternative Medicine, part of the U.S. National Institutes of Health, is published in the July 5 issue of Annals of Internal Medicine.

Participants were randomly assigned to one of the three groups: structural massage, relaxation massage or usual care. Those in the massage groups were given hour-long massage treatments weekly for 10 weeks.

At 10 weeks, more than one-third of those who received either type of massage said their back pain was much better or gone, compared to only one in 25 patients who received usual care, the study said. Those in the massage groups were also twice as likely in that period to have spent fewer days in bed, used less anti-inflammatory medication and engaged in more activity than the standard care group.

Six months out, both types of massage were still linked to improved function, Cherkin said, but after one year, pain and function was almost equal in all three groups.

Noting that most Americans will experience low back pain during their lifetime, Cherkin said another benefit of massage is its relative safety.

"Maybe one of 10 patients felt pain during or after massage, but most of those thought it was a 'good pain,'" he said. "A good massage therapist will be in tune with the patient and will ask what hurts."

One of the study's weaknesses was that those who were assigned to usual care knew that others were receiving massage therapy and may have been disappointed to be excluded, tainting their reported improvement, said Dr. Robert Duarte, director of the Pain and Headache Treatment Center at North Shore-LIJ Health System in Manhasset, N.Y.

"I think massage therapy can be useful for patients with back pain, but more as a . . . supplemental therapy," Duarte added.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more on low back pain.

Massage Beats Meds for Lower Back Pain, Study Says (HealthDay)

TUESDAY, July 5 (HealthDay News) -- Massage therapy may be better than medication or exercise for easing low back pain in the short term, a new government-funded study suggests.

Seattle researchers recruited 401 patients, mostly middle-aged, female and white, all of whom had chronic low back pain.

Those who received a series of either relaxation massage or structural massage were better able to work and be active for up to a year than those getting "usual medical care," which included painkillers, anti-inflammatory drugs, muscle relaxants or physical therapy, the researchers found.

Lead study author Daniel Cherkin, director of Group Health Research Institute, said he had expected structural massage, which manipulates specific pain-related back muscles and ligaments, would prove superior to relaxation or so-called Swedish massage, which aims to promote a feeling of body-wide relaxation.

Structural massage, which focuses on soft-tissue abnormalities, requires more training and may be more likely to be paid for by health insurance plans, which may equate it with physical therapy, said Cherkin.

"I thought structural massage would have been at least a little better, and that's not the case," Cherkin said. "If you're having continuing problems with back pain even after trying usual medical care, massage may be a good thing to do. I think the results are pretty strong."

The study, funded by the National Center for Complementary and Alternative Medicine, part of the U.S. National Institutes of Health, is published in the July 5 issue of Annals of Internal Medicine.

Participants were randomly assigned to one of the three groups: structural massage, relaxation massage or usual care. Those in the massage groups were given hour-long massage treatments weekly for 10 weeks.

At 10 weeks, more than one-third of those who received either type of massage said their back pain was much better or gone, compared to only one in 25 patients who received usual care, the study said. Those in the massage groups were also twice as likely in that period to have spent fewer days in bed, used less anti-inflammatory medication and engaged in more activity than the standard care group.

Six months out, both types of massage were still linked to improved function, Cherkin said, but after one year, pain and function was almost equal in all three groups.

Noting that most Americans will experience low back pain during their lifetime, Cherkin said another benefit of massage is its relative safety.

"Maybe one of 10 patients felt pain during or after massage, but most of those thought it was a 'good pain,'" he said. "A good massage therapist will be in tune with the patient and will ask what hurts."

One of the study's weaknesses was that those who were assigned to usual care knew that others were receiving massage therapy and may have been disappointed to be excluded, tainting their reported improvement, said Dr. Robert Duarte, director of the Pain and Headache Treatment Center at North Shore-LIJ Health System in Manhasset, N.Y.

"I think massage therapy can be useful for patients with back pain, but more as a . . . supplemental therapy," Duarte added.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more on low back pain.

New Blood Thinner Beats Plavix When Paired With Low-Dose Aspirin (HealthDay)

MONDAY, June 27 (HealthDay News) -- Brilinta, an experimental anti-clotting medication currently awaiting U.S. Food and Drug Administration approval, performed better than the industry standard, Plavix, when used in tandem with low-dose aspirin, a new study finds.

Heart patients who took Brilinta (ticagrelor) with low-dose aspirin (less than 300 milligrams) had fewer cardiovascular complications than those taking Plavix (clopidogrel) plus low-dose aspirin, researchers found.

However, patients who took Brilinta with higher doses of aspirin (more than 300 milligrams) had worse outcomes than those who took Plavix plus high-dose aspirin, the investigators reported.

Antiplatelet drugs are used to prevent potentially dangerous blood clots from forming in patients with acute coronary syndrome, including those who have had a heart attack.

Brilinta has already been approved for use in many other countries. In July 2010, an FDA panel voted 7-to-1 to approve the use of Brilinta for U.S. patients undergoing angioplasty or stenting to open blocked arteries, but the approval process is still ongoing.

The panel's recommendation was based in part on prior findings from this study, called the Platelet Inhibition and Patient Outcomes (PLATO) trial.

In this latest analysis of PLATO findings, researchers found that patients who took Brilinta with low-dose aspirin were 16 percent less likely than those who took Plavix with low-dose aspirin to have a heart attack or stroke, or to die within a year.

The findings were reported Monday in an American Heart Association online conference.

One expert said the new information is valuable.

"The study highlights that if one chooses to use ticagrelor in subjects with acute coronary syndromes, it would be logical to use aspirin 81 milligrams per day (and not 325 mg daily)," said Dr. Jeffrey S. Berger, assistant professor of medicine and director of cardiovascular thrombosis at NYU Langone Medical Center in New York City. "Of note, there is little reason to ever use aspirin 325 mg except in the acute setting of a heart attack or stroke," he added. "A higher aspirin dose (325 mg versus 81 mg) increases the risk of bleeding without increasing the efficacy of the drug."

A study author agreed that for most patients, using the drug with a lower dose of aspirin is usually warranted.

"Patients with acute coronary syndrome have options to prevent recurrent events," study lead author Dr. Kenneth W. Mahaffey, co-director of cardiovascular research at the Duke Clinical Research Institute, and associate professor of medicine at Duke University Medical Center, said in an AHA news release. "Physicians choosing to use ticagrelor in countries where it is approved and available should consider using a low-dose of maintenance aspirin with the drug."

The data and conclusions of the research should be viewed as preliminary until published in a peer-reviewed journal.

More information

The American Academy of Family Physicians outlines medicines used to treat patients with acute coronary syndrome.

New Blood Thinner Beats Plavix When Paired With Low-Dose Aspirin (HealthDay)

MONDAY, June 27 (HealthDay News) -- Brilinta, an experimental anti-clotting medication currently awaiting U.S. Food and Drug Administration approval, performed better than the industry standard, Plavix, when used in tandem with low-dose aspirin, a new study finds.

Heart patients who took Brilinta (ticagrelor) with low-dose aspirin (less than 300 milligrams) had fewer cardiovascular complications than those taking Plavix (clopidogrel) plus low-dose aspirin, researchers found.

However, patients who took Brilinta with higher doses of aspirin (more than 300 milligrams) had worse outcomes than those who took Plavix plus high-dose aspirin, the investigators reported.

Antiplatelet drugs are used to prevent potentially dangerous blood clots from forming in patients with acute coronary syndrome, including those who have had a heart attack.

Brilinta has already been approved for use in many other countries. In July 2010, an FDA panel voted 7-to-1 to approve the use of Brilinta for U.S. patients undergoing angioplasty or stenting to open blocked arteries, but the approval process is still ongoing.

The panel's recommendation was based in part on prior findings from this study, called the Platelet Inhibition and Patient Outcomes (PLATO) trial.

In this latest analysis of PLATO findings, researchers found that patients who took Brilinta with low-dose aspirin were 16 percent less likely than those who took Plavix with low-dose aspirin to have a heart attack or stroke, or to die within a year.

The findings were reported Monday in an American Heart Association online conference.

One expert said the new information is valuable.

"The study highlights that if one chooses to use ticagrelor in subjects with acute coronary syndromes, it would be logical to use aspirin 81 milligrams per day (and not 325 mg daily)," said Dr. Jeffrey S. Berger, assistant professor of medicine and director of cardiovascular thrombosis at NYU Langone Medical Center in New York City. "Of note, there is little reason to ever use aspirin 325 mg except in the acute setting of a heart attack or stroke," he added. "A higher aspirin dose (325 mg versus 81 mg) increases the risk of bleeding without increasing the efficacy of the drug."

A study author agreed that for most patients, using the drug with a lower dose of aspirin is usually warranted.

"Patients with acute coronary syndrome have options to prevent recurrent events," study lead author Dr. Kenneth W. Mahaffey, co-director of cardiovascular research at the Duke Clinical Research Institute, and associate professor of medicine at Duke University Medical Center, said in an AHA news release. "Physicians choosing to use ticagrelor in countries where it is approved and available should consider using a low-dose of maintenance aspirin with the drug."

The data and conclusions of the research should be viewed as preliminary until published in a peer-reviewed journal.

More information

The American Academy of Family Physicians outlines medicines used to treat patients with acute coronary syndrome.