Originally published in Body Sense magazine, Spring/Summer 2010. Copyright 2010. Associated Bodywork and Massage Professionals. All rights reserved.

Anyone with recurring, unyielding back problems knows the beast that is called back pain. While most of us have experienced back pain that comes from overexertion or muscle pulls, the effects of back pain for many can be debilitating, excruciating, and life changing. Experts say back pain accounts for $100 billion in lost productivity and health-care costs each year and is one of the primary causes of work-related disability. Managing back pain can be a daunting and exhausting proposition. One natural avenue for finding relief is massage therapy.

Whether you've pulled a muscle in your yoga class or afternoon basketball game, or you suffer from long-term pain caused by an injury, back pain affects us all. In fact, when it comes to low-back pain specifically, researchers say that 70-85 percent of the population will experience it at some point in their lives.

Unfortunately, the back pain numbers are growing. A recent study in the Archives of Internal Medicine found that the rate of chronic low-back pain has more than doubled in North Carolina since 1992 (from 3.9 percent in 1992 to 10.2 percent in 2006), a statistic the researchers say reflects what's happening across the country.

Arizona-based massage therapist Geoffrey Bishop says approximately 95 percent of his clients come to him with some sort of back pain these days, while still other therapists report that nearly all of their massage clientele--from children to seniors to weekend warriors--experience this particular pain.

Obviously, the costs associated with back pain are also growing. According to the National Institute of Neurological Disorders and Stroke (NINDS), Americans spend at least $50 billion each year on low-back pain alone, which is second only to headaches as the most common neurological ailment in the United States.

What Causes The Pain?
Back pain is an especially debilitating condition because every movement your body makes depends on the spine functioning optimally. When back pain shows up, your whole body knows it, and sometimes exacerbates the problem by compensating in other ways to avoid the pain. It's not unusual for sufferers to have secondary problems related to those compensation patterns.

Experts say the cause of back pain can be the result of several factors. High on the list is stress. Hunched over a keyboard, late on a deadline, bogged down in worry--many are familiar with this life. When our body is stressed, we literally begin to pull inward: the shoulders roll forward and move up to the ears, the neck disappears, and the back tightens in the new posture. "It's an armoring effect," says Angie Parris-Raney, a Denver-based massage therapist who specializes in deep-tissue massage and sports therapy. She says this natural response to pain can create more problems when left unchecked. "That protective mode, with the muscles in flex, can even result in visceral problems," she says, where the pain also affects internal organs.

In addition to stress, poor posture, bad ergonomics, lack of exercise, arthritis, osteoporosis, a sedentary lifestyle, overexertion, pregnancy, kidney stones, fibromyalgia, excess weight, and more can spark back pain.

For the onsite clients Bishop sees at a manufacturing plant, the majority have some sort of back pain related to their work. While these workers have the option to sit or stand at their assembly station, Bishop says the repetitive motion they perform throughout their shift--with their arms and hands continuously extended forward--has most of them complaining of back pain. Fortunately, this employer has seen the value of massage for its employees and brought Bishop on as part of the company's wellness program.

Bishop, who owns Stay Tuned Therapeutics in Flagstaff, says mechanics is the main cause of back pain that he sees in his practice. "It's mechanics, including repetitive use and ignorance about preventative postures, and neglect by employers and employees to provide rest and recovery." The past also plays a part, he says. "Old injuries and traumatic events, left untreated and unresolved, seem to dictate where stress lands in the back as well."

Massage Offers Hope
Those who suffer with back pain know there are no easy answers for chasing the pain away. Physical therapy has proven effective for some sufferers, as has chiropractic and acupuncture, but massage therapy is also making a name for itself when it comes to providing relief. In fact, research has shown that massage can be a great friend to the back-pain sufferer.

"Massage therapists have long treated low-back pain safely and effectively," says Les Sweeney, president of Associated Bodywork & Massage Professionals. "They have done so less expensively and less invasively than is possible with other treatments."

In fact, an August 2005 issue of Consumer Reports cited deep-tissue massage as one of the remedies voted most effective by readers for back pain, while other research from the University of Miami School of Medicine and the Touch Research Institute showed that massage can decrease stress and long-term pain, improve sleep and range of motion, and help lower the incidence of depression and anxiety that often accompanies back pain.

Another study published in the Archives of Internal Medicine found that massage significantly reduced the pain of moderately severe chronic back pain sufferers. After an hour of massage, once a week for 10 weeks, clients reported that their pain had decreased by nearly 50 percent. Most study participants reported that the relief lasted at least a year after their last massage session.

For Parris-Raney's clients, the length of pain relief provided by massage therapy varies depending on the condition they are experiencing. Getting on a regular massage schedule, however, has really helped her clients manage the back pain, she says. When they go past their normally scheduled appointment, "their bodies know it's time to get a massage again." Whether it's just helping clients get through the day, or reminding the stressed-out office worker to breathe, Parris-Raney says massage can play an important part in back pain relief.

Whitney Lowe, owner of Oregon's Orthopedic Massage Education & Research Institute, says the benefits of massage for back pain depend on the primary cause of the pain. "If it is predominantly muscular pain, then massage has a great deal to offer in reducing pain associated with chronic muscle tightness, spasms, myofascial trigger points, or those types of problems. If it's something caused by a joint alignment problem or compression on a nerve, for example, then the role of massage might be somewhat different, such as helping to address the biomechanical dysfunctions, but not really being able to get pressure off the nerve itself."

When it comes to those more severe cases of back pain, Bishop says it's often good for back pain sufferers to find therapists with advanced training. "Seek out someone who has done some degree of advanced training in low-back pain mechanisms and treatment for such conditions. While Swedish-type massage has value for cooling down some of the pain receptors in the superficial tissue, if the cause of pain is from the receptors embedded in the deeper tissues, ligaments, joint capsule, nerves, etc., a more accurate assessment and treatment technique may be necessary."

Bishop says therapies that include movement, alignment, and isolation of injured tissues seem to work best for more advanced cases of pain that are a result of specific tissue damage.

Massage Works
When it comes to back pain, there are a lot of options out there. Some are more effective than others, experts say, depending on the condition for which they're being applied. Ultimately, massage, and its myriad benefits, might be a viable answer. For back pain sufferers, Parris-Raney says massage can work wonders. "Massage can help relax the body, relax the psyche, and improve a client's range of motion and circulation to the affected tissues," she says. Not only can massage help directly with the pain, but it can also make life a little easier, too. "Massage lets you tap into the parasympathetic system," she says, "and tap into all the good hormones that help you sleep better and help you handle stressors along the way." And that all helps in building a healthier back and a happier you.

Karrie Osborn is contributing editor of Body Sense magazine. Contact her at karrie@abmp.com.