I have worked with many patients over the years and they are always asking me if they would benefit from a massage for their lower back pain. Since I specialize in spine pain, including lower back and neck pain, I have seen many patients receive massages and benefit from them. I have seen two types of massages treat and relieve lower back pain: trigger point massage and medical massage.
Let’s look at what a trigger point is. A trigger point is a taut band of tissue located in the muscle that is painful to the touch. You actually have nerves grow into the muscle making it very sensitive. What is really interesting is that when you press on them, they can cause pain elsewhere. This is called referred pain! Trigger points are usually the size of a quarter to a half dollar. Most people can easily find these areas on their body because they are uncomfortable but yet crave some good hands on work or pressure. Trigger points can be caused by overuse, time, or just bad luck. The best way that I can describe it iss that when you press on it, it hurts so good. Deep down you know that it is what the muscle needs but you dont necessarily like it.
A trigger point massage can be the best of both worlds because massage therapists can target the trigger points and the muscle they live in. The most common areas I see are the lower back paraspinals and the upper traps. They are also very aware of referral patterns so make sure they are addressing everything!
If you work from home or feel that you carry your stress in your shoulders, there is a good chance you already know what trigger points feel like! Getting some good hands on work in the area and then learning how to stretch and strengthen the tissue can create long term change. You may already know how to do this so you may only be missing the manual hands on work from a massage therapist. Massage does very well to work the trigger point and help them relax and reduce their sensitivity. This can create a great environment for your neck pain or back pain to heal. What you need to remember is that most likely a trigger point massage will be uncomfortable in the moment but the end result will be worth it. What I always tell my patients is that it should hurt so good.
A medical massage can be focused on helping you recover from an injury, surgery, or repetitive strain. This can be a part of your home exercise program or while you are receiving physical therapy or chiropractic care. A medical massage is a great way jump start healing, improve sore muscles, and improve range of motion. This whole approach can also be safe for joint replacements or prior surgeries. Most commonly a medical massage begins with a more thorough evaluation to help determine the best areas to tackle. This may also include communicating with your team, such as a primary care provider or physical therapist.
We need to consider what your body is feeling as well as common referral patterns to make sure we are aware of how your body is builtl. A medical massage can be very good at relieving lower back pain because it considers the area of discomfort as well as the contributing areas to make sure nothing is missed.
If you are looking for a massage near you, you may consider asking if they do trigger point or medical massage, especially if you have lower back pain.
If you live in Nocatee, St. Johns, or Ponte Vedra, Florida and are interested in a massage for your lower back pain, try our trigger point or medical massage!
Most of time, no, a massage can’t make lower back pain worse. In fact, best evidence says it can very helpful! During a massage, it's hard to apply enough pressure to the muscles to actually do damage. Most of the time when we get hurt or injured, its too much force too quickly. Massages are very purposeful and methodical. The chances of actually doing any damage is low. There are things to consider to make sure you have an enjoyable experience and to ensure you are being as safe and effective as possible.
If it hurts your lower back when you are laying on your belly then don’t have a massage when you are in that position! It’s that simple. You can’t relax if you are in constant discomfort during the massage. Laying on your side or on your back can be great alternatives. Don’t worry, your massage therapist can make it work!
Communication is key when receiving a massage. The first rule in healthcare is to do no harm. The intent is for you to feel your best, so you must communicate what you are feeling.
Pain that is coming from muscles may be stiff and achy if you have had it for a while. Spasms of the muscles are very common as well. This is when you feel like you can’t walk and some say, “They have thrown out their back”. This spams like discomfort can be very painful and can impact your walking, standing, and working ability.
Nerve pain is often related to disc herniations or sciatica. Nerve pain can feel burning, electrical and tingling. You can feel one of those or all of them! Some may also report numbness. This type of pain or discomfort is very noticeable and may require a detailed examination before you receive a massage. A physical therapist is well equipped to help you figure out what is causing your nerve pain and help you determine if a massage is good for you. While not an absolute no, massages may not be as effective for nerve pain compared to muscular pain.
In summary a massage can be very good and safe for lower back pain. Trigger point and medical massages can be very effective for treating pain. They can be comfortable and be the boost your body is looking for. The chance of a massage making your worse is low but does require really good communication and some understanding of what type of pain you are feeling.
If you want to know more about improving hip and lower back pain check out this webinar I did. It covers differences between hip and back pain, common treatments for each as well as best evidence for recovery!
1. George SZ, Fritz JM, Silfies SP, Schneider MJ, Beneciuk JM, Lentz TA, Gilliam JR, Hendren S, Norman KS. Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021. J Orthop Sports Phys Ther. 2021 Nov;51(11):CPG1-CPG60. doi: 10.2519/jospt.2021.0304. PMID: 34719942.
2. Clinical Guidelines to Address Low Back Pain: Using the Evidence to Guide Physical Therapist Practice. J Orthop Sports Phys Ther. 2021 Nov;51(11):533-534. doi: 10.2519/jospt.2021.0507. PMID: 34719940.