]>
IRCT2012061810060N1 IRCT 2013-10-09 Research Institute for Islamic and Complementary Medicine (RICM), Iran University of Medical Science The effectiveness of of Iraninan traditional massage on low-back-pain The effectiveness of one type of Iranian Traditonal massage on lumbar radiculopathy 2012-12-21 anticipated 60 Complete https://irct.ir/trial/10539 interventional Randomization: Randomized, Blinding: Not blinded, Placebo: Not used, Assignment: Parallel, Purpose: Treatment. N/A Lumbar radiculopathy. Intervention 1: Traditional massage explanation The Maneuvers done in therapy sessions consist of: • Lower limb massages (Anterior, posterior, internal & external borders); this massage is done 1 time by massager's palm in each therapy session and 5 times every day by someone else (family) at home. - Anterior massage; in supine position massage starts from inguinal region to ankle without significant pressure on the knee -Internal lateral massage; in supine position massage starts on internal lateral of lower limb, starts from inguinal to ankle. -External lateral massage; in supine position massage starts on external lateral of lower limb, starts from hip to ankle. - Posterior; in prone position lower limbs given massage from hip to ankle. • Plantar Massage: Feet palms are massaged by a cylinder shape instrument or wood rolling pin. • Lumbar massage (7 parts) 1- Lumbar region is massaged several minutes using almond oil for relaxing muscles and fascias. 2- Cross massage; patient lays in supine position crosses one lower limb over the other, fixing his or her body grasping bed sides. The massager massages the above limb which is stretched from proximal to distal regarding same general conditions. 3- knee-chest (prostrate) or fetus position massage; patient is given massage in knee-chest (prostrate) position. If this position is difficult he/she may lie on the side folding lower limbs like fetus position, instead. 4- Stretching upward (in case of severe lumbar stiffness); Patient lies in supine position, someone raises lower limbs one to one to separate lumbar region from bed then the massager massages stretched back. 5- Massage paraverterbral muscles; patient's paravertebral muscles are given massage in prone position by massager's thumb (circulating pressure by thumb) from neck to end of spine several times. 6- Skin pinch; different parts of back skin and subcutaneous tissue are pressed between 1th and 2nd fingers of both massager's hand and pulled out in prone position to recover skin and fascia elasticity. Cupping is a replacement for this maneuver. 7- Kneading back muscles & stretch; Patient lies in prone extending his/her upper limbs fixing body by grasping bed top, someone pulls the lower limbs. The massager massages his/her back and lower limbs in stretched position. • Trigger points release; tender points found in massage process are being pressed to release. • Cupping; cupping with several size cups is done to improve blood circulation if signs and symptoms of poor circulation are present. • Dressing; after massage session and rubbing oil, patient's back is dressed and wrapped by cotton cloth (30 cm * 400 cm). • Abdomen massage; since constipation delays low back pain recovery, abdomen is massaged by massager's palm clockwise to help stool movement. *All massages done by massager's hand, apply pressure about 1 kg force. Intervention 2: Control group: standard medical treatment for lumbar radiculopathy by neurosurgeon.
public Mamak Hashemi Habibabadi
Behesht St, Vahdat Islami St, Hafez Ave
Tehran Iran (Islamic Republic of) +98 21 5560 1274 m-hashemi@tums.ac.ir; mamak.hashemi@yahoo.com Traditional Medicine Faculty, Tehran University of Medical sciences scientific Mamak Hashemi Habibabadi
Behesht St, Vahdat Islami St, Hafez Ave
Tehran Iran (Islamic Republic of) +98 21 5560 1274 m-hashemi@razi.tums.ac.irmamak78@gmail.com Traditional medicine faculty, Tehran university of medical sciences. Iran (Islamic Republic of) Iran (Islamic Republic of) Inclusion criteria: lumbar radiculopathy radiating below the knee; pain lasting longer than 8 weeks (continuous or non- continuous); age between 25-55 years old; no indication for surgery or patient's disagreement or medical problem interfering surgery in case of surgery indication. Exclusion criteria: history of low-back surgery; any suspicious sign during the treatment period requiring further evaluating or intervention; red flag signs; sign & symptoms of "Quadra Equina" syndrome (Numbness or weakness of the muscles of the lower extremeties,Anus pain, perineal or saddle anesthesia, bowel and bladder disturbances, absent lower spincture reflexes, sexual dysfunction); accelerating picture of pain in acute phase; sever or exacerbated pain picture; patient's disagreement. 25 years 55 years Both M51.1+ Lumbar and other intervertebral disc disorders with radiculopathy Rehabilitation Treatment - Drugs Traditional massage explanation The Maneuvers done in therapy sessions consist of: • Lower limb massages (Anterior, posterior, internal & external borders); this massage is done 1 time by massager's palm in each therapy session and 5 times every day by someone else (family) at home. - Anterior massage; in supine position massage starts from inguinal region to ankle without significant pressure on the knee -Internal lateral massage; in supine position massage starts on internal lateral of lower limb, starts from inguinal to ankle. -External lateral massage; in supine position massage starts on external lateral of lower limb, starts from hip to ankle. - Posterior; in prone position lower limbs given massage from hip to ankle. • Plantar Massage: Feet palms are massaged by a cylinder shape instrument or wood rolling pin. • Lumbar massage (7 parts) 1- Lumbar region is massaged several minutes using almond oil for relaxing muscles and fascias. 2- Cross massage; patient lays in supine position crosses one lower limb over the other, fixing his or her body grasping bed sides. The massager massages the above limb which is stretched from proximal to distal regarding same general conditions. 3- knee-chest (prostrate) or fetus position massage; patient is given massage in knee-chest (prostrate) position. If this position is difficult he/she may lie on the side folding lower limbs like fetus position, instead. 4- Stretching upward (in case of severe lumbar stiffness); Patient lies in supine position, someone raises lower limbs one to one to separate lumbar region from bed then the massager massages stretched back. 5- Massage paraverterbral muscles; patient's paravertebral muscles are given massage in prone position by massager's thumb (circulating pressure by thumb) from neck to end of spine several times. 6- Skin pinch; different parts of back skin and subcutaneous tissue are pressed between 1th and 2nd fingers of both massager's hand and pulled out in prone position to recover skin and fascia elasticity. Cupping is a replacement for this maneuver. 7- Kneading back muscles & stretch; Patient lies in prone extending his/her upper limbs fixing body by grasping bed top, someone pulls the lower limbs. The massager massages his/her back and lower limbs in stretched position. • Trigger points release; tender points found in massage process are being pressed to release. • Cupping; cupping with several size cups is done to improve blood circulation if signs and symptoms of poor circulation are present. • Dressing; after massage session and rubbing oil, patient's back is dressed and wrapped by cotton cloth (30 cm * 400 cm). • Abdomen massage; since constipation delays low back pain recovery, abdomen is massaged by massager's palm clockwise to help stool movement. *All massages done by massager's hand, apply pressure about 1 kg force. Control group: standard medical treatment for lumbar radiculopathy by neurosurgeon. Pain. Timepoint: Before intervention, 1 & 3 months after intervention initiation. Method of measurement: Visual analog scale. Low back Pain disability. Timepoint: Before intervention, 1 & 3 months after intervention initiation. Method of measurement: Standard Rolland-Morris Questionnaire. Quality of life. Timepoint: Before intervention, 1 & 3 months after intervention initiation. Method of measurement: W.H.O Quality of life Questionnaire (BREF). Tehran University of Medical Sciences Research Institute for Islamic and Complementary Medicine (RICM), Iran University of Medical Science Tehran University of Medical Sciences Approved 2010-09-23 Medical Ethics Comittee in research, Tehran University of Medical Sciences Tehran University of Medical Sciences, Keshavarz Blvd, Qods St, Tehran Iran (Islamic Republic of)