Research: KUMAR and COLLEAGUES,

Listed in Issue 256

Abstract

KUMAR and COLLEAGUES, 1. Department of Integrative Medicine, University Hospital Essen , Essen, Germany; 2. Institute of Social Medicine, Epidemiology and Health Economics, Charité-University Medical Centre and Immanuel Hospital Berlin , Berlin, Germany; 3. Department of Internal and Complementary Medicine, Immanuel Hospital Berlin, Berlin, Germany; 4. Karl and Veronica Carstens Foundation , Essen, Germany conducted a randomized clinical trial in order to evaluate the effectiveness of Ayurvedic massage in nonspecific chronic low back pain.

Background

Ayurveda is one of the oldest comprehensive healthcare systems worldwide. Ayurvedic massage and physical therapy are frequently used to treat patients with chronic pain syndromes and disorders of the musculoskeletal system. This study aimed to evaluate the effectiveness of Ayurvedic massage in nonspecific chronic low back pain by means of a randomized clinical trial.

Methodology

Design: Sixty-four patients (mean age, 54.8 years; 49 women and 15 men) with chronic low back pain who scored >40 mm on a 100-mm visual analogue scale (VAS) were randomly assigned to a 2-week massage group with 6 hours of Ayurvedic massage and external treatment (n = 32) or to a 2-week local thermal therapy group (n = 32). The study observation period was 4 weeks, consisting of a 2-week intervention phase followed by a 2-week follow-up phase. Outcome Measures: Primary outcome measure was the change of mean pain (VAS) from baseline to week 4. Secondary outcomes included pain-related bothersomeness, the Roland Disability Questionnaire, quality of life (Medical Outcomes Study 36-Item Short Form), the Hanover Functional Ability Questionnaire for measuring back pain-related disability, and psychological outcomes. Outcomes were assessed at baseline and after 2 and 4 weeks.

Results

Mean back pain (primary outcome) at week 2 was significantly reduced from 53.4 ± 18.5 to 21.6 ± 18.2 in the massage group and from 55.3 ± 12.9 to 41.8 ± 19.8 in the standard thermal therapy group (mean group difference, -18.7; 95% confidence interval, -28.7 to -8.7; p < 0.001). While beneficial effects on pain-related bothersomeness and psychological well-being were also apparent, the Ayurvedic intervention did not improve function or disability in the short-term observation period. Both programs were safe and well tolerated.

Conclusion

Ayurvedic external treatment is effective for pain-relief in chronic low back pain in the short term. Further studies with longer observation periods are needed to evaluate the long-term effects of the Ayurvedic external treatment approach on function and disability.

References

Kumar S1, Rampp T1, Kessler C2,3, Jeitler M2,3, Dobos GJ1, Lüdtke R4, Meier L2,3, Michalsen A2,3. Effectiveness of Ayurvedic Massage (Sahacharadi Taila) in Patients with Chronic Low Back Pain: A Randomized Controlled Trial. J Altern Complement Med. 23(2): 109-115. doi: 10.1089/acm.2015.0272. Epub Oct 5 2016. Feb 2017.

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