Back pain is one of the most common reasons people seek medical treatment, often the reason for missed work days, and it is also usually difficult to treat. Generally medications, injections, or surgeries are suggested as well as physical therapy. People have benefited from one or more of these interventions, however, most often the pain relief is short-term, doesn’t address the source of the issue (namely muscle tension), and people usually want to try less invasive options before something as dramatic as surgery. While physical therapy can be helpful, physical therapists often do not have the time to manually work on muscle tension the way massage therapists do, which is why physical therapists often refer their patients to massage therapists to help speed along the efficacy of their work.Research has found that massage can be a profound option for healing back pain. This is because massage inherently helps the muscles and body with:
- Decreased inflammation, which is highly associated with pain
- increased “feel good” endorphins, which lowers the experience of pain
- Decreased muscle tension
- Increased circulation
Conditions treated by massage
Low back conditions or diagnoses that massage can help with include, but are not limited to
- Herniated or Bulging Disc
- Degenerative Disc Disorder
- Spinal Stenosis
- SI joint dysfunction
- Spinal fusions
- Arthritis of the spine
- muscle spasm
- muscle strain
Best type of massage for lower back pain
Typically massage for lower back pain is goal-oriented, which means therapeutic massage is best. Therapeutic massage, frequently interchangeable with “Deep Tissue” massage, can include Trigger point, Myofascial release, positional release, neuromuscular and body mobilization techniques. A sample treatment for low back pain could follow this progression:
After an intake discussion, Sovereign Body Massage practitioners typically begin with assessment techniques which are commonly Swedish or Myofascial in origin. Once muscles that need to be treated are identified, the approach generally shifts to techniques that are more therapeutic in origin. These can include, but are not limited to Trigger point, positional release, neuromuscular, and deeper myofascial release techniques.
However, as with any massage, it is how your body best responds to different approaches as well as your intention (i.e.relaxation? pain relief? a little of both?) that will drive what kind of massage is best for you. Some people’s nervous system allows for intense work (read Deep tissue) with minimal relaxation component (read Swedish, lymphatic); however for others, this approach can be counterproductive. Regarding this, it is important to have a discussion with your massage therapist, to understand it can be an exploration process of finding the right approach, and also that many different types of massage can be combined to customize the treatment. As with any exploration, honest feedback between therapist and client about what does and doesn’t work is key.
Additionally, with goal-oriented massage, a treatment plan will be developed and assessed for efficacy per session by you and your practitioner, and self-care exercises may be suggested. It is best to schedule out at least three appointments for massage, each about 2-3 weeks apart to see if massage is useful to the goal. At the end of three appointments, results will be assessed in order to determine the next course of action.
It is important to note that acute issues are frequently easier and quicker to address; however if the pain has been chronic, it may take longer for lasting change to occur. In certain cases, the underlying cause of muscle tension and pain is a structural issue, such as a joint replacement or irregular bone length, in which case, massage becomes part of the client’s maintenance program to manage the pain rather than “cure” it.
Where to massage for lower back pain
A common massage therapy treatment plan often includes assessment and attention to the following muscles:
- Quadrates Lumborum (QL), which attaches between the ribs and pelvis
- Erector Spinae muscle groups which attach to and run the length of the spine on each side
- Gluteal muscles, especially Gluteus medius; which is frequently the cause of low back pain
- Hamstrings- the large muscles on the back of your thigh; if they are too short this can decrease mobility of the back
- Hip flexors- these are located on the front side of your hips and oppose your glut muscles
- Abdomen- less common, but possibly related as it is the opposing muscle group of your back
To keep massage safe for you
It is extremely important to be able to answer the following questions your massage therapist may ask so she can create the safest treatment for you:
- has there been a diagnosis? Please be ready to explain.
- Have any tests or imaging been done? If so, what were the results?
- Have any limitations on movement or daily activity been given to you by your doctor?
- Have any medications been prescribed? If so, what are the side effects?
Self massage for lower back pain
Massage will always only be part of your overall treatment plan because it enhances your capability for change; however if this capacity is not reinforced in daily life, real change can be hindered. With this in mind, it is important to do self care. Self-care can include:
- Thermal therapies such as heat and/or ice application
- Taking Epsom salt baths
- Daily stretching; looking to yoga and exercise professionals can be helpful for this. Massage therapists can really only suggest what muscle groups should be targeted
- Weekly strengthening program of exercise, preferably designed by an exercise professional
- At home therapeutic exercises as demonstrated in the following videos
- Complimentary therapies such as Craniosacral therapy for low back pain
At-home therapeutic exercise examples:
These videos demonstrate how you can self- massage your back with the use of tennis balls and an appropriate surface to lay on such as a yoga mat. The first video gives a better view of ball placement, while the second one offers a more detailed explanation and walk-through of the exercise itself. As always, STOP if there is pain. Do not push or force anything. Make sure you are breathing and also make sure the exercise is safe for your particular situation before doing it.
Helps for better idea of placement:
DO NOT put ball on spine- put it on the muscles/pain spots on either side of spine:
Other resources for managing low back pain
I love Katy Bowman’s approach to healing the body, which includes a pretty revolutionary way of thinking about our body movement on any given day within a myriad of regular activities. You can peruse her many articles about low back pain, but here is one to start with: https://www.