A Cochrane review [Abstract] 1 included 15 studies with a total of 810 subjects. Studies were not pooled due to substantial heterogeneity in the massage treatment and different control groups. Massage was compared with no treatment, hot packs, active range-of-movement exercises, acupuncture, exercises, sham laser, manual traction, mobilization, and education. Only 4/15 trials adequately described the massage technique. The majority of the trials assessed outcomes at immediate post-treatment, which is not an adequate time to assess clinical change. Certain massage techniques (traditional Chinese massage, classical and modified strain/counterstrain technique) seemed to be more effective than control or placebo treatment in improving function and tenderness. Massage was more beneficial than education in the short term for pain bothersomeness. Ischaemic compression and passive stretch were more effective in combination rather than individually for pain reduction.
Only 4 of the 15 studies reported side effects. All four studies reported post-treatment pain as a side effect and one study showed that 22% of the participants experienced low blood pressure following treatment.
Comment: The quality of evidence is downgraded by study limitations (lack of/unclear allocation concealment and lack of blinding), by imprecise results (few patients for each comparison), and by inconsistency (unexplained variability in results).
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