Therapist delivered massage for Veterans with chronic neck pain: A randomized control trial

Abstract: PURPOSE: Chronic neck pain is challenging to treat in Veterans. Massage therapy benefit evidence for musculoskeletal pain is building and massage is now included in Veteran health benefits. This randomized control trial compared therapist-delivered massage (TT-M) versus waitlist control for Veterans with chronic neck pain. METHODS: TT-M involved twice-weekly massage therapist-delivered 60-min standardized sessions for 12-weeks. The Neck Disability Index and Brief Pain Inventory measured neck disability and pain severity at baseline, 1-, 3-, and 6-months. Linear mixed-model approach examined primary analysis at 3 months; responsiveness analysis examined clinically meaningful change, ≥5 point improvement in neck disability and ≥30% decrease in pain severity. RESULTS: Participants (N=290; n=145/group) were aged 55.8±14 years, 71% White, and 15% Female. Compared to control, TT-M participants had statistically significant reductions in pain-related disability at 1-month (-2.2; P=0.007) and 3-months (-3.1; P<0.001) and pain severity at 1-month (-0.8; P=0.001), 3-months (-1.3; P<0.001), and 6-months (-0.8; P=0.003), respectively. TT-M participants were more likely to experience clinically meaningful benefits in neck disability at 3-months (35% v 16%; P=0.003) and pain severity at 1-month (27% v 14%; P=0.021), 3-months (43% v 15%; P<0.001), and 6-months (36% v 16%; P=0.005). CONCLUSION: Therapist applied massage led to greater clinical benefits and reductions in neck disability and pain severity compared to waitlist control. Less robust outcomes at 6-months may suggest longer treatment windows or booster sessions are needed to maintain benefits. Engaging Veterans with massage therapy as part of their health benefits for chronic neck pain can provide an effective, non-pharmacological approach to pain management. TRIAL REGISTRATION: ClinicalTrials.gov Identifier-NCT03100539.