Investigating Medical Massage Therapy for Patients With Sub-Acute Lower Back Pain

Musculoskeletal injuries (MSKI) affect approximately 800,000 service members (SMs)annually and result in 25 million days of limited duty. These conditions account for 34%of medical evacuations from theatre, and are the primary reasons for medical separation.Low back pain (LBP) is the leading cause of MSKI amongst active‐duty service members(ADSMs) with a lifetime prevalence rate of up to 80%. The burden of disease for LBP isreaching $100 billion annually in the United States and new methods for prevention andtreatment are necessary.At the present time, there is no "gold standard" for LBP management and strong evidenceas to what is most beneficial is lacking. One of the most promising medical options forLBP is massage therapy (MT), given that no special equipment is needed, it can bedelivered anywhere, it is non‐habit forming, and the likelihood for serious harm is low.Massage therapy is unique in that it can naturally enhance local blood flow, therebyproviding vital oxygen and nutrients to areas damaged by MSKI to promote healing, offersrelaxation and normalization of soft tissue which reduces pain, lessens swelling, clearslocal pain mediators, improves cognitive/psychosocial complications (e.g., depression,anxiety, etc.), aids in sleep quality, and provides a positive hormone release. To date,however, there has not been a large randomized control trial (RCT) performed on patientswith subacute LBP to demonstrate healing and preventing patients from becomingchronically injured.To address this limitation, we will enroll a total of 200 patients to assess the efficacyof medical massage therapy (MMT) combined with standard of care (SoC) in ADSMs withsubacute LBP (intervention) as compared to SoC only (control). Five specific aims havebeen designed to understand if weekly MMT can reduce medically restricted duty days(MRDD) (Aim #1), decrease pain/disability and improve sleep quality (Aim #2), and lessenthe need for prescription medications (Aim #3). Data will be aggregated at the end of thestudy through survey tools and self‐reported information to understand the economicimpact of (Aim #4) and to understand which patient phenotypes are optimal for future care(Aim #5).