Pain may be under-treated for 2 reasons. First, patients fear becoming dependent on medications, are concerned about side effects, believe that they should endure pain without complaining, or worry about bothering nurses. Second, physicians and nurses may administer ineffective doses of pain relievers because of personal biases, cultural attitudes, or a lack of knowledge.

Researchers wanted to establish if a 20-minute back massage might help to relieve pain and reduce anxiety following major surgery when given in addition to pain medications.

Allison R. Mitchinson, M.P.H., N.C.T.M.B., Department of Veterans Affairs, Ann Arbor, Michigan, and colleagues conducted a randomized controlled trial involving 605 veterans undergoing major surgery for either chest or abdominal operations—average age of 64-years. The veterans were divided into one of 3 groups; 1) 203 received routine care. 2) 200 received a daily 20-minute back massage. 3) 202 received 20 minutes of individual attention each day from a massage therapist, but without the massage.

Daily the patients were asked to rate the intensity and unpleasantness of their pain, including their level of anxiety.

The researchers report that the group receiving a massage, when compared to the other 2 groups that did not receive a massage, experienced short-term decreases in pain intensity, pain unpleasantness, and anxiety. In addition, patients in the massage group experienced a faster rate of decrease in pain intensity and unpleasantness during  the first 4 postoperative days than the other two groups.

All 3 groups showed no difference in long-term anxiety, length of hospital stay, or the amount of pain-relieving medications used.

Researchers note that historically, a massage was a common experience for post-surgical patients. Unfortunately, health care systems are more complex today and administrative demands on nursing time has increased. As a result the tradition of nurse-administered massage has been largely lost. The recent emphasis on assessing pain as the fifth vital sign has renewed interest in re-introducing massage as an effective and less dangerous approach to relieve a patient’s distress and pain.