title: The effectiveness of massage therapy for the treatment of nonspecific low back pain: a systematic review of systematic reviews.
abstract: BACKGROUND
  The last decade has seen a growth in the utilization of complementary and alternative medicine therapies, and one of the most popular and sought-after complementary and alternative medicine therapies for nonspecific low back pain is massage. Massage may often be perceived as a safe therapeutic modality without any significant risks or side effects. However, despite its popularity, there continues to be ongoing debate on the effectiveness of massage in treating nonspecific low back pain. With a rapidly evolving research evidence base and access to innovative means of synthesizing evidence, it is time to reinvestigate this issue.
  
  
  METHODS
  A systematic, step-by-step approach, underpinned by best practice in reviewing the literature, was utilized as part of the methodology of this umbrella review. A systematic search was conducted in the following databases: Embase, MEDLINE, AMED, ICONDA, Academic Search Premier, Australia/New Zealand Reference Centre, CINAHL, HealthSource, SPORTDiscus, PubMed, The Cochrane Library, Scopus, Web of Knowledge/Web of Science, PsycINFO, and ProQuest Nursing and Allied Health Source, investigating systematic reviews and meta-analyses from January 2000 to December 2012, and restricted to English-language documents. Methodological quality of included reviews was undertaken using the Centre for Evidence Based Medicine critical appraisal tool.
  
  
  RESULTS
  Nine systematic reviews were found. The methodological quality of the systematic reviews varied (from poor to excellent) although, overall, the primary research informing these systematic reviews was generally considered to be weak quality. The findings indicate that massage may be an effective treatment option when compared to placebo and some active treatment options (such as relaxation), especially in the short term. There is conflicting and contradictory findings for the effectiveness of massage therapy for the treatment of nonspecific low back pain when compared against other manual therapies (such as mobilization), standard medical care, and acupuncture.
  
  
  CONCLUSIONS
  There is an emerging body of evidence, albeit small, that supports the effectiveness of massage therapy for the treatment of non-specific low back pain in the short term. Due to common methodological flaws in the primary research, which informed the systematic reviews, recommendations arising from this evidence base should be interpreted with caution.
authors.affiliation: International Centre for Allied Health Evidence, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia.
authors.forename: Saravana
authors.initials: S
authors.lastname: Kumar
authors.forename: Kate
authors.initials: K
authors.lastname: Beaton
authors.forename: Tricia
authors.initials: T
authors.lastname: Hughes
keywords: complementary and alternative medicine; evidence-based practice; massage therapy; systematic review
references.citation: BMJ. 2009 Jul 21;339:b2700
references.pmid: 19622552
references.citation: Med J Aust. 2006 Jan 2;184(1):27-31
references.pmid: 16398628
references.citation: Spine J. 2008 Jan-Feb;8(1):121-33
references.pmid: 18164460
references.citation: Spine (Phila Pa 1976). 2009 Jul 15;34(16):1669-84
references.pmid: 19561560
references.citation: Maturitas. 2011 Feb;68(2):116-20
references.pmid: 21111551
references.citation: Clin Rehabil. 2002 Dec;16(8):811-20
references.pmid: 12501942
references.citation: BMC Med Res Methodol. 2009 Jun 11;9:34
references.pmid: 19519887
references.citation: Lancet. 1999 Aug 14;354(9178):581-5
references.pmid: 10470716
references.citation: Eur Spine J. 2003 Apr;12(2):149-65
references.pmid: 12709853
references.citation: Eur Spine J. 2006 Mar;15 Suppl 2:S192-300
references.pmid: 16550448
references.citation: Spine J. 2004 May-Jun;4(3):335-56
references.pmid: 15125860
references.citation: J Bodyw Mov Ther. 2012 Oct;16(4):424-55
references.pmid: 23036876
references.citation: BMJ. 1996 Jan 13;312(7023):71-2
references.pmid: 8555924
references.citation: Control Clin Trials. 1996 Feb;17(1):1-12
references.pmid: 8721797
references.citation: Eur Spine J. 2011 Jan;20(1):19-39
references.pmid: 20640863
references.citation: Psychol Bull. 2004 Jan;130(1):3-18
references.pmid: 14717648
references.citation: Evid Based Complement Alternat Med. 2012;2012:953139
references.pmid: 22203884
references.citation: Eur Spine J. 2011 Jul;20(7):1024-38
references.pmid: 21229367
references.citation: Spine (Phila Pa 1976). 2002 Sep 1;27(17):1896-910
references.pmid: 12221356
references.citation: Ann Intern Med. 2007 Oct 2;147(7):478-91
references.pmid: 17909209