Back pain is the second leading chronic pain condition for physician’s visits, and a top reason for work absenteeism. It is associated with physical symptoms such as depression, anxiety, sleep disturbances, and distress. (1) Lower back pain (LBP) affects 85-90% of people in both developing and developed countries (2). Massage therapy and relaxation therapy are two prevalent, holistic treatments for LBP. Massage therapy consists of visiting a massage therapist or physical therapist on a regular basis for targeted massages. All licensed physical therapists are capable of providing massage therapy to their clients (3). Psychotherapy, or relaxation therapy, focuses on mental relaxation and involves deep breathing and relaxation exercises. (2) Both massage therapy and relaxation therapy address the mental symptoms associated with LBP, but only massage therapy simultaneously addresses the physical symptoms. (1)

A study performed over six months evaluated the impact of massage therapy versus relaxation therapy on patients with chronic LBP. Even after the first session, massage therapy patients described feeling less depressed. Overall, the massage therapy patients expressed reduced physical pain, depression, anxiety and sleep disturbance compared to the relaxation therapy group. (1) Another study compared massage therapy to spinal manipulation and acupuncture for the treatment of back pain. Massage therapy was found to be more effective in reducing pain than spinal manipulation, and acupuncture had inconclusive results. Massage therapy was determined to be the only treatment that reduced costs of care after initial therapy. (4) Based on the aforementioned studies, massage therapy is an effective tool to combat LBP and has a significant impact on overall health compared to other holistic treatment options.

Massage therapy may be a powerful tool that can be utilized by physical therapists. It can be combined with classical physiotherapy to enhance treatment and further improve the health of LBP patients. Whereas physiotherapy traditionally focuses on physical health, massage therapy can be used to improve physical and mental health outcomes. 

In order to maximize the effectiveness of physical therapy, biofeedback products such as Esurgi’s Biostabilizer may be used to ensure spinal stabilization during exercises. The Biostabilizer provides real-time feedback to determine whether patients are performing core strengthening exercises correctly, such as Transversus Abdominis. The Biostabilizer gives corrective feedback and determines if the patient is using the appropriate core muscle. It is designed to decrease time demands on physical therapists. The use of pressure biofeedback units (PBUs), such as the Biostabilizer, has been shown to result in better outcomes for patients with chronic LBP. (5) Using PBUs in tandem with massage therapy can result in the best outcome for patients and physical therapists alike.


1. Field, T., Hernandez-Reif, M., Diego, M., & Fraser, M. (2007). Lower back pain and sleep disturbance are reduced following massage therapy. Journal of Bodywork and Movement Therapies, 11(2). 

2. Shariat, A., Alizadeh, R., Moradi, V., Afsharnia, E., Hakakzadeh, A., Ansari, N. N., . . . Shaw, I. (2019). The impact of modified exercise and relaxation therapy on chronic lower back pain in office workers: A randomized clinical trial. Journal of Exercise Rehabilitation, 15(5).

3. NYSED. (2016, August 11). Office of the professions – Practice Alerts. Retrieved February 03, 2021, from

4. Cherkin, D. C., Sherman, K. J., Deyo, R. A., & Shekelle, P. G. (2003). A Review of the Evidence for the Effectiveness, Safety, and Cost of Acupuncture, Massage Therapy, and Spinal Manipulation for Back Pain. Annals of Internal Medicine, 138(11), 898. 5. Sielski, R., Rief, W., & Glombiewski, J. A. (2017). Efficacy of Biofeedback in Chronic back Pain: A Meta-Analysis. Int.J. Behav. Med., (24), 25-41.