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Massage and Heat

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Massage and heat are used primarily to treat musculoskeletal pain. Their benefit is well known in a number of musculoskeletal pain disorders, although there are significant differences among therapists as to how treatment is delivered.

Table 5: Massage and Heat in Post-SCI Pain

It stands to reason that local heat and massage therapy would be most effective for musculoskeletal pain post-SCI.NorrbrinkBudh and Lundeberg (2004) in a survey of SCI patients 3 years post-injury found massage and heat were the best non-pharmacological treatments. In a prospective controlled trial, 30 individuals were divided into either a massage therapy or acupuncture group. Each group received treatment two times a week for 6 weeks and were followed up for 2 months. The study found that the massage therapy group was not effective in improving pain intensity compared to the acupuncture group. In a crossover RCT, Chase et al. (2013) found that patients that received light touch and then massage were more likely report reduction in pain intensity than those that received massage and then light touch. The study did not examine the effectiveness of either treatment compared to the alternative; hence, it is difficult to examine if one treatment itself is more effective than the other.

Conclusion

There is level 2 evidence (from one randomized controlled trial and one prospective controlled trial; Chase et al. 2012; Norrbrink & Lundeberg 2011) that massage therapy may not improve neuropathic and musculoskeletal pain intensity post SCI.

  • Massage may not be helpful for post-SCI neuropathic and musculoskeletal pain.