Testing feasibility of traditional Malay massage compared to relaxation for patients with non-specific low back pain: A pilot randomized-controlled trial

Introduction: This study was to test the feasibility of an approach that is intended to be used in a larger scale study to investigate the immediate effect of traditional Malay massage on substance P, inflammatory mediators, pain intensity and level of disability among patients with low back pain. Method: A pilot, non-blinded, randomized controlled trial was conducted with thirty patients who fulfilled the inclusion criteria. The participants were randomly allocated to intervention and control groups. Blood samples were collected before and after 5 min of intervention, and were analyzed for the level of substance P (i.e. primary outcome) and other inflammatory mediators as secondary outcomes. Self-reported measurements for pain intensity and functional outcome using Roland-Morris Disability Questionnaire (RMDQ) were determined. Result: A significant reduction in substance P level (1.45 +/- 0.21 pg/mL versus 1.40 +/- 0.15 pg/mL; p = 0.047) after application of traditional Malay massage was noted, but no significant change was reported for inter-group comparisons. The changes in other inflammatory markers were not significant for inter-group comparisons before and after application of traditional Malay massage and the relaxation position. However, the changes in both Visual Analogue Scale (VAS) score (p < 0.001) and RMDQ score (p = 0.021) were statistically significant for inter-group comparisons at both time points. Conclusions: The traditional Malay massage was reported to have an immediate effect on substance P but not on the inflammatory markers. This finding is well correlated with the changes in pain intensity (VAS score) and daily functional abilities (RMDQ score).