title: Massage therapy in outpatient pediatric chronic pain patients: do they facilitate significant reductions in levels of distress, pain, tension, discomfort, and mood alterations?
abstract: OBJECTIVE
  This study was designed to look at the efficacy of adjuvant massage therapy in children and adolescents who presented to a chronic pediatric pain clinic for management.
  
  
  METHODS
  After Institutional Review Board approval and informed consent and assent was obtained, all pediatric patients who presented to the outpatient chronic pain clinic at Children's Memorial Hospital from July 2006 to May 2007 were invited to participate in a study that offered massage therapy as an adjunct to conventional pain treatment. Patients (n = 80 sessions, 57 patients) were asked to rate their levels of distress, pain, tension, discomfort, and degree of upset mood on a scale of 1-5 (e.g. for distress 1 = very calm; 5 = very distressed) before and after massage therapy. Paired t-tests were used to compare pre- and postmassage ratings and probability values were corrected for multiple comparisons using the Bonferroni procedure.
  
  
  RESULTS
  After massage therapy, patients reported highly significant improvement in their levels of distress, pain, tension, discomfort, and mood compared with their premassage ratings (all t-values >6.1, ****P < 1 x 10(-8). To control for the possible effects of patients reporting improvements simply as a result of rating their symptoms, we collected control ratings before and after a comparable 'no intervention' time period in a subset of 25 patients. The 'no intervention' time period typically took place in the treatment room with the therapist present. Approximately 60% of the control ratings were obtained before the intervention and 40% were obtained after the massage therapy. None of the differences between the pre- and postratings associated with the 'no intervention' control time period were significant. In these same patients, the difference between the pre- and postmassage ratings were significant, all t-values >3.8, **P < 0.001.
authors.affiliation: Department of Pediatric Anesthesiology, Children's Memorial Hospital, and Feinberg School of Medicine, Northwestern University, Chicago, IL 60614, USA. ssuresh@childrensmemorial.org
authors.forename: Santhanam
authors.initials: S
authors.lastname: Suresh
authors.forename: Sheila
authors.initials: S
authors.lastname: Wang
authors.forename: Suzanne
authors.initials: S
authors.lastname: Porfyris
authors.forename: Richard
authors.initials: R
authors.lastname: Kamasinski-Sol
authors.forename: David M
authors.initials: DM
authors.lastname: Steinhorn