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Assessment of sitting pressure on Malaysian bus drivers

Ahmad Rasdan Ismail, Mohd Afiq Zainal Rosli, Isa Halim, Baba Md. Deros, Mohd Nizam Ab Rahman, Md. Mustafizur Rahman

Journal of Occupational Safety and Health, 2012;9(3):1-9.
MyJurnal

The main purpose of this study was to establish the comfort zone for bus drivers in a seated position. In addition, this study is to investigate the seated pressure distribution among Malaysian bus drivers. The study consists of 10 bus drivers randomly selected to be a part of this study. The FSA pressure mat was utilized in order to investigate the force distribution of buttock to the seat pan of the drivers’ seat. This device is placed on the driver seat and backrest. Later, the subject would sit on for several minute. The finding reveals that most of the bus drivers feel discomfort by having low back pain and musculoskeletal disorder. The seat pressure distribution of Malaysian busses indicated that the seat not able to absorb high pressure generated from buttock that later may cause the discomfort and restricted the performance of drivers.

Matched MeSH terms: Low Back Pain
Call center ergonomics issues: A case study

Hari Krishnan, T.

Journal of Occupational Safety and Health, 2012;9(3):17-22.
MyJurnal

Introductions: Call center has been defined as a working environment in which uses telephone and computer for the purpose of marketing and manage communication with prospect clients or existing clients (Rocha, Glina, Morinho and Nakasato, 2005; Sprigg, Smith and Jackson, 2003).
Methodology: The study was conducted via observation of working condition and face to face interview with call center operators. Measurement of anthropometrics was also conducted.
Results: Ergonomics issues found at call center were inappropriate work condition and workstation which lead to awkward sitting posture (sitting with forward leaning posture, raised shoulder, feet not supported on floor). Besides that organizational policy which required high job demand and subsequently lead to prolonged sitting and static posture (very minimal posture changes). Combination all these factors lead to musculoskeletal symptoms and the operators reported of having neck, shoulder, upper back and lower back pain compared to other body parts.
Conclusion: The management should embark on organization wide ergonomics management program and should review the current policy and create safe and healthy working environment by providing suitable workstation for the operators in order to prevent musculoskeletal.

Matched MeSH terms: Low Back Pain
Fulltext Primary Ewing’s sarcoma of the lumbosacral spine: a case report

Zamzuri, Z., Mohd Adham, S.Y., Saufi, M.A., Azian, A.A., Fadhli, M.

International Medical Journal Malaysia, 2012;11(1):47-50.
MyJurnal

Ewing's sarcoma is a rare tumor first discovered by James Ewing in 1921. It is more common in bone or skeletal component compared to soft tissue or extraosseous Ewing's sarcoma. Among soft tissue Ewing’s, spinal cord involvement is rarer with only nine cases reported. We report a case of nine-year-old Malay girl who presented with low back pain for two months following a fall with progressive neurological deficits of bilateral lower limb. Magnetic resonance imaging was suggestive of a well-defined margin of intradural extramedullary tumor. With nerve sheath tumor in mind, surgical excision with laminectomy L2-S1 was performed. Intraoperative finding was an extradural mass from L3-L5 with extension to bilateral neuroforamen. Histopathology report defined a round cell tumour of Ewing’s sarcoma from the mass.

Matched MeSH terms: Low Back Pain
Prevalence of piriformis syndrome in chronic low back pain patients. A clinical diagnosis with modified FAIR test

Kean Chen C, Nizar AJ

Pain Pract, 2013 Apr;13(4):276-81.
PMID: 22863240 DOI: 10.1111/j.1533-2500.2012.00585.x

Piriformis syndrome is a collection of symptoms and signs of pain from piriformis muscle and is characterized by pain in buttock with variable involvement of sciatic nerve. This syndrome is often overlooked in clinical practice because its presentation has similarities with other spine pathologies. A major problem with the clinical diagnosis of piriformis syndrome is the lack of consistent objective findings and an absence of single test that is specific for piriformis syndrome. Therefore, a precise and reliable clinical method of diagnosing piriformis syndrome should be developed by clinicians.

Matched MeSH terms: Low Back Pain/complications*; Low Back Pain/diagnosis; Low Back Pain/epidemiology
Are psychosocial factors associated with low back pain and work absence for low back pain in an occupational cohort?

Urquhart DM, Kelsall HL, Hoe VC, Cicuttini FM, Forbes AB, Sim MR

Clin J Pain, 2013 Dec;29(12):1015-20.
PMID: 23370089 DOI: 10.1097/AJP.0b013e31827ff0c0

OBJECTIVES: To examine the relationship between individual and work-related psychosocial factors and low back pain (LBP) and associated time off work in an occupational cohort.
METHODS: A self-administered questionnaire was completed by nurses working across 3 major public hospitals. Participants provided sociodemographic data and information on the occurrence of LBP, time off work, and psychosocial factors.
RESULTS: One thousand one hundred eleven participants (response rate 38.6%) were included in the study. Fifty-six percent of participants reported LBP in the previous year. When individual psychosocial factors were examined in the same model, the relationship between somatization and LBP persisted (OR 1.64; 95% confidence interval [CI], 1.35, 2.01). Low job security was also significantly associated with LBP independent of the other work-related factors (OR 0.82; 95% CI, 0.69, 0.98). Of those participants with LBP, 30% reported absence from work due to LBP. When absence from work was examined, negative beliefs (OR 0.97; 95% CI, 0.94, 1.00) and pain catastrophizing (OR 1.33; 95% CI, 1.04, 1.71) were independently associated with time off work, along with low job satisfaction (OR 0.71; 95% CI, 0.51, 0.97) and high job support (OR 1.35; 95% CI, 1.04, 1.75).
CONCLUSIONS: Somatization and low job security were found to be independently associated with occupational LBP, whereas negative beliefs, pain catastrophizing, reduced job satisfaction, and high job support were independently related to time off work. Longitudinal studies are needed to determine whether these individual and work-related psychosocial factors predict, or alternatively, are outcomes of pain and time off work associated with LBP.

Matched MeSH terms: Low Back Pain/psychology*
Do manual therapies help low back pain? A comparative effectiveness meta-analysis

Menke JM

Spine (Phila Pa 1976), 2014 Apr 1;39(7):E463-72.
PMID: 24480940 DOI: 10.1097/BRS.0000000000000230

STUDY DESIGN: Meta-analysis methodology was extended to derive comparative effectiveness information on spinal manipulation for low back pain.
OBJECTIVE:
Determine relative effectiveness of spinal manipulation therapies (SMTs), medical management, physical therapies, and exercise for acute and chronic nonsurgical low back pain.
SUMMARY OF BACKGROUND DATA: Results of spinal manipulation treatments of nonsurgical low back pain are equivocal. Nearly 40 years of SMT studies were not informative.
METHODS: Studies were chosen on the basis of inclusion in prior evidence syntheses. Effect sizes were converted to standardized mean effect sizes and probabilities of recovery. Nested model comparisons isolated nonspecific from treatment effects. Aggregate data were tested for evidential support as compared with shams.
RESULTS: Of 84% acute pain variance, 81% was from nonspecific factors and 3% from treatment. No treatment for acute pain exceeded sham's effectiveness. Most acute results were within 95% confidence bands of that predicted by natural history alone. For chronic pain, 66% of 98% was nonspecific, but treatments influenced 32% of outcomes. Chronic pain treatments also fit within 95% confidence bands as predicted by natural history. Though the evidential support for treating chronic back pain as compared with sham groups was weak, chronic pain seemed to respond to SMT, whereas whole systems of clinical management did not.
CONCLUSION: Meta-analyses can extract comparative effectiveness information from existing literature. The relatively small portion of outcomes attributable to treatment explains why past research results fail to converge on stable estimates. The probability of treatment superiority matched a binomial random process. Treatments serve to motivate, reassure, and calibrate patient expectations--features that might reduce medicalization and augment self-care. Exercise with authoritative support is an effective strategy for acute and chronic low back pain.

Matched MeSH terms: Low Back Pain/therapy*
Fulltext Psycho-behavioural risks of low back pain in railway workers

Ganasegeran K, Perianayagam W, Nagaraj P, Al-Dubai SA

Occup Med (Lond), 2014 Jul;64(5):372-5.
PMID: 24727561 DOI: 10.1093/occmed/kqu039

BACKGROUND:
Low back pain (LBP) is the most costly ailment in the work force. Risky work behaviour and psychological stress are established risk factors.

AIMS:
To explore the associations between workplace risk factors, psychological stress and LBP among Malaysian railway workers.

METHODS:
A cross-sectional study was carried out on railway workers in Malaysia. Socio-demographics, workplace risk factors for LBP, perceived psychological stress and history of LBP over the previous month were obtained by direct interviews using a structured closed-ended questionnaire. Descriptive, bivariate and logistic regression analyses were conducted.

RESULTS:
There were 513 study participants (70% response rate). The prevalence of LBP in the previous month was 69%. Multivariate analysis yielded four significant predictors of LBP: employment of ≥ 10 years, lifting and lowering heavy loads, prolonged standing posture and psychological stress.

CONCLUSIONS:
The high prevalence of LBP and its significant associations with physical and psychological stress factors in railway workers points to an urgent need for preventive measures, particularly among workers in high-risk occupations.

Matched MeSH terms: Low Back Pain/etiology*; Low Back Pain/epidemiology; Low Back Pain/psychology
Musculoskeletal symptoms and orthopaedic complications in pregnancy: pathophysiology, diagnostic approaches and modern management

Bhardwaj A, Nagandla K

Postgrad Med J, 2014 Aug;90(1066):450-60.
PMID: 24904047 DOI: 10.1136/postgradmedj-2013-132377

Low back pain is a common musculoskeletal symptom in pregnancy that can present as lumbar pain or pelvic girdle pain, with significant physical and psychosocial implications. Pelvic girdle pain is more prevalent and results in greater disability than lumbar pain. It is possible to distinguish between these two conditions from a detailed history based on the site of the pain, its intensity, disability and pain provocation tests. Management of low back pain in pregnancy is conservative, with physical exercise for lumbar pain and minimising activities that exacerbate pain, analgesics and bed rest for pelvic girdle pain, as well as avoiding abduction beyond the pain-free zone in labour. There is evidence that stabilising exercises in patients with pelvic girdle pain postpartum have a beneficial effect. Other treatment modalities that have been shown to be safe and effective include pelvic belts, transcutaneous electrical nerve stimulation, spinal manipulative therapy, acupuncture and complementary therapy with yoga. Other orthopaedic complications in pregnancy such as carpal tunnel syndrome, pubic symphysis rupture, transient osteoporosis and osteonecrosis are usually self-limiting with a satisfactory outcome. However, a lack of awareness and failure to recognise these complications can result in long-term morbidity. Knowledge of the preoperative diagnostic investigations, surgical approaches and intraoperative positioning of the mother to avoid gravid uterus compression is vital in orthopaedic emergencies such as lumbar disc herniation, cauda equina syndrome, fractures and acute compartment syndrome of the lower limb to ensure a safe maternal and fetal outcome and to prevent serious disability. Pregnancy is not contraindicated in women with pre-existing orthopaedic complications such as kyphoscoliosis and total hip arthroplasty as there is no evidence to suggest increased maternal or fetal risks.

Matched MeSH terms: Low Back Pain/diagnosis*; Low Back Pain/physiopathology; Low Back Pain/prevention & control
Manual therapy researchers are misled by natural history and placebo effects

Menke JM

Spine (Phila Pa 1976), 2014 Nov 1;39(23):1997.
PMID: 25365716 DOI: 10.1097/BRS.0000000000000585
Matched MeSH terms: Low Back Pain/therapy*
Fulltext Challenges in determining occupational related chronic low back pain among employees: a review of the literature

Tam, Jenn Zhueng, Sharifa Ezat Wan Puteh, Noor Hassim Ismail

Malaysian Journal of Public Health Medicine, 2014;14(3):0-0.
MyJurnal

Chronic low back pain is a common preventable occupational health illness affecting most workers. Large amount of financial and benefit cost had been spent by the developed countries to prevent, treat and rehabilitate a large number of workers who are exposed to hazards that are attributed to low back pain. Efforts on primary prevention of low back pain had been challenging due to difficulties in affirming work- relatedness of chronic back pain among workers. As such, efforts have to be focused on existing literatures to propose acceptable variables to develop the definition of workrelatedness specific to chronic low back pain. Such identified variables or factors could be used to develop a set of criteria in defining work- related chronic back pain. Literature search using specific work- related and chronic low back pain key words were used. Comparable articles were judged and a summarized result was obtained. These variables could be grouped into individual characteristics, health behaviours, physical conditions at work, work organizations and ergonomic factors. With proper methodology and statistical analysis, tools could be developed to aid physicians in determining work- related chronic low back pain among employees.

Matched MeSH terms: Low Back Pain*
Fulltext Physical activity and low back pain among automotive industry workers in Selangor

Noor Sazarina Mad Isa @ Yahya, Baba Md Deros, Mazrura Sahani, Ahmad Rasdan Ismail

Malaysian Journal of Public Health Medicine, 2014;14(2):34-44.
MyJurnal

Substantial studies reported musculoskeletal disorders among the working population in the developed country, however, a limited number of studies were conducted in Malaysia. The objective of this cross sectional study was to determine the physical activity risk factors for low back pain among automotive workers in Selangor. Modified Risk Factors Questionnaire (RFQ) was used to assess physical activity with the occurrence of low back pain. The significant physical activities associated with the 12 months point prevalence are lifting weight (

Matched MeSH terms: Low Back Pain
Fulltext Low back pain and associated risk factors among health science undergraduates

Mohd Nordin NA, Ajit Singh DK, Lim K

Sains Malaysiana, 2014;43:423-428.

Identification of associated risk factors is important to enable successful implementation of low back pain prevention strategies. To date, there is limited research data on back pain among young adults in Malaysia despite an increasing incidence of this disabling condition worldwide. A cross-sectional survey was conducted to determine the incidence of low back pain (LBP) and associated factors among health science undergraduates. A self-administered questionnaire was distributed to full time students of a main public university. One hundred and forty undergraduates; mean age 21.4±1.3 years, 70% female, 60% in year 3 of study, participated in the survey. The results showed that 31% spent between 6 and 8 h and another 31% spent more than 9 h sitting in a day. Twelve percent of the undergraduates rated their fitness level as ‘poor’. The incidence of LBP was 40.3% among the undergraduates. LBP incidence was associated with age (X2=12.1, p=0.007), years of study (X2=8.7, p=0.03), self-rated physical fitness (X2=7.0, p=0.02) and hours spent sitting (X2 =8.7, p=0.03). Gender, body mass index and hours spent in sports and physical activity were not associated with LBP. The findings from this study demonstrate that physical fitness and sitting duration is associated with low back pain among health science undergraduates. Health science undergraduates should improve their physical fitness, practice frequent breaks and stretching during sitting. This will help to minimize LBP related to decreased fitness levels and prolonged sitting.

Matched MeSH terms: Low Back Pain*
Fulltext Personal and psychosocial risk factor for low back pain among automotive manual handling workers in Selangor, Malaysia

Noor Sazarina Mad Isa @ Yahya, Baba Md Deros, Ahmad Rasdan Ismail, Mazrura Sahani

Int J Public Health Res, 2014;4(1):412-418.
MyJurnal

Introduction It is well known that low back pain among working population is a global
problem throughout the world. However, the current situation of occupational
low back pain in Malaysia is still vague due to limited number of studies
conducted locally.

Objective A cross sectional study was conducted among three automotive industry
workers in Selangor, Malaysia from October 2010 to April 2011.
Methods This study aims to determine the prevalence and risk factors of low back pain
among automotive industry workers performing manual material handling
tasks using self-administered questionnaire survey.

Results A modified Standardised Nordic Questionnaire was used to assess low back
pain problem, to obtain personal and psychosocial risk factors information.
The prevalence of low back pain showed increment in the point prevalence of
57.9%, 49.5%, and 35.1 % for 12 months, one month, and of 7 days
respectively. Working hour, frequency of overtime, stress at work, work
pace, and faster movement were found to be significantly associated with the
12 months prevalence for low back pain.

Conclusions This finding indicates that psychosocial risk factors are associated to the
occurrence of low back pain.

Matched MeSH terms: Low Back Pain
Fulltext Bertolotti's syndrome: A commonly missed cause of back pain in young patients

Manmohan S, Dzulkarnain A, Nor Azlin ZA, Fazir M

Malays Fam Physician, 2015;10(2):55-8.
PMID: 27099663

Bertolotti's syndrome must be considered as a differential diagnosis for lower back pain in young people. Treatment, whether conservative or operative, is still debatable. In this paper, we report a case of a 20-year-old girl presenting with lower back pain for 8 years. We administered injection with local anaesthetic and steroid injections within the pseudo-articulation; however, the pain was relieved for 3 weeks. Surgical excision of the pseudo-articulation successfully treated her back pain and the sciatica.

Matched MeSH terms: Low Back Pain
Changes in transversus abdominis muscle thickness after lumbo-pelvic core stabilization training among chronic low back pain individuals

Leonard JH, Paungmali A, Sitilertpisan P, Pirunsan U, Uthaikhup S

Clin Ter, 2015;166(5):e312-6.
PMID: 26550815 DOI: 10.7417/T.2015.1884

OBJECTIVE: Lumbo-pelvic core stabilization training (LPST) is one of the therapeutic exercises common in practice for rehabilitation of patients with chronic low back pain. This study was carried out to examine the therapeutic effects of LPST on the muscle thickness of transversus abdominis (TrA) at rest and during contraction among patients with chronic non-specific low back pain.
MATERIALS AND METHODS: A total of 25 participants (7 males and 18 females) with chronic non-specific low back pain participated in a within-subject, repeated measures, double-blinded, placebo-controlled comparisons trial. The participants received three different types of experimental therapeutic training conditions which includes the lumbo-pelvic core stabilization training (LPST), the placebo treatment with passive cycling (PC) and a controlled intervention with rest (CI). The interventions were carried out by randomization with 48 hours between the sessions. The effectiveness of interventions was studied by measuring the changes in muscle thickness of TrA at rest and during contraction using a real time ultrasonography.
RESULTS: Repeated measures ANOVA demonstrated that the LPST provided significant therapeutic benefits as measured by an increase in the muscle thickness of the TrA at rest (p<0.05) and during contraction (p<0.01). The percentage change of the muscle thickness observed during LPST was significantly higher (p<0.01) when compared to the other two experimental training conditions.
CONCLUSIONS: The findings indicated that the LPST might provide therapeutic benefits by increasing the muscle thickness and function of TrA. Therefore, it is suggested that LPST technique should be considered as part of management program for treatment of low back pain.
KEYWORDS: Back pain; Core stabilization; Lumbo-pelvic exercise; Rehabilitation; Transversus abdominis

Matched MeSH terms: Low Back Pain
Fulltext The relationship between carrying activity and low back pain: a critical review of biomechanics studies

Hanif Farhan, M. R., White, P. J, Warner, M., Adam, J. E.

Jurnal Sains Kesihatan Malaysia, 2015;13(2):1-10.
MyJurnal

The aim of this review was to systematically explore the underlying musculoskeletal biomechanical mechanisms of carrying and to describe its potential relationship with low back pain. This literature review was carried out using AMED, CINAHL, Compendex and MEDLINE electronic databases. Articles published from 2004 to 2012 were selected for consideration. Articles were considered if at least one measurement of kinetics, kinematics or other related musculoskeletal parameters related to biomechanics were included within the study. After combining the main keywords, 677 papers were identified. However, only 10 studies met all the inclusion criteria. Age, body mass index, gender and level of physical activity were identified as the factors that may influence the biomechanics of carrying activity. Carrying a loaded backpack was reported leading to posterior pelvic tilt, reduced lumbar lordosis, but increased cervical lordosis, thoracic kyphosis and trunk forward lean. Furthermore, while carrying bilaterally, lumbo-pelvic coordination was also reported to be more in-phase, as well as reduced coordination variability in transverse plane. Future studies investigating the biomechanics of a standardized carrying activity for clinical test are recommended.

Matched MeSH terms: Low Back Pain
Fulltext Integrated Care Pathway (ICP) on management of Occupational Related Chronic Low Back Pain (OCLBP) in Malaysia: a critical review

Shahruz Idzwan Azmi, Sharifa Ezat Wan Puteh, Noor Hassim Ismail

Malaysian Journal of Public Health Medicine, 2015;15(2):60-68.
MyJurnal

Occupational Related Chronic Low Back Pain (OCLBP) is a globally recognized illness that causes reduction in productivity and substantial economic burden to the countries. It requires a multidisclipinary approach involving employer, healthcare provider, compensatory and enforcement agencies. However there is no specific guideline or pathway that has integrated the roles of each responsible agency. The objective of this article is to highlight the need and to propose a coordinated approach through the concept of Integrated Care Pathway (ICP). Therefore, we reviewed international and local guidelines as well as published articles on chronic low back pain and care pathway. We believed that development of a pathway will be able to organize the role of management at every level, reducing the variations in the management, addressing issues of communicating the findings between the responsible stakeholders, fulfilling the requirements as the laws, allows effective and feasible approaches to take place in terms of cost and practicality, and increase the awareness on occupational diseases. Expected challenges such as limitation of resources, unawareness and lack of understanding on OCLBP from every level are issue that we agreed can be bridged through ICP.

Matched MeSH terms: Low Back Pain
Fulltext A cross sectional study of chronic pain relief after bekam (traditional malay "cupping") therapy

Lim KG, Chuah SW, Ee MST, Wong ZG, Murugesan A, Syed Azman SA

International e-Journal of Science, Medicine & Education, 2015;9(2):32-36.
MyJurnal

Introduction: Bekam, an Islamic variant of cupping, is an ancient form of traditional medicine still practised today in Malaysia. There are published findings indicating that cupping benefits patients with low back pain, other musculoskeletal pain and even pain from cancer, herpes zoster and trigeminal neuralgia when pain is measured on an analogue scale. We proposed to investigate whether in addition to pain improvement on an analogue scale we could show if pain relief might be demonstrated in terms of reduction of analgesic use.

Methods: We carried out a retrospective cross sectional study on subjects who had been for outpatient clinic treatment with chronic pain of at least one month and who completed at least two bekam therapy sessions. In addition to documenting a pain score before and after therapy we documented their analgesic consumption.

Results: A total of 77 respondents, with overlapping symptoms of headache, backache and joint pains were included. The mean pain score before bekam therapy was 6.74±1.78, and was 2.66±1.64 after two sessions of therapy. Twenty eight respondents completed six sessions of bekam therapy and had a mean pain score of 2.25±1.32 after. Thirty-four patients consumed analgesic medication before starting bekam therapy and only twelve did so after. The consumption of analgesics was significantly lower after bekam therapy.

Conclusions: Bekam therapy appears to help patients experience less pain and reduce the amount of analgesic medication they consume. Nevertheless only a randomised prospective study will eliminate the biases a retrospective study is encumbered with and we believe would be worth doing.

Matched MeSH terms: Low Back Pain
Fulltext Low back pain problem amongst port crane operator

Kadir, Z. A., Mohammad, R., Othman, N.

Journal of Advanced Research in Applied Sciences and Engineering Technology, 2015;1(1):13-26.
MyJurnal

Purpose of this study to be conducted is to identify the risk factor of low back pain amongst port crane operator and to improve the health management program in the company. The objectives of this study are to evaluate the major group of port crane operator that having low back pain problem, to analyse the risk factors that associated to low back pain problem (WBV, Awkward prolonged sitting and shift work-psychological) , individual characteristics (sport activity or hobby), to analyse the associated rate operator’s absence from work (medical leave) and low back pain problem and to propose the basic ergonomic assessment checklist for management to investigate health incident cases and fit-to-work (ergonomics) screening checklist for new recruitment. A survey research design through the distribution of the questionnaire and interview & field observation will
be used for research methodology. The population of this study consists of port crane operatorsRubber Tyred Gantry Operator (RTG). Questionnaire method used to collect all relevant information from correspondence. Interview also will be conducted to gain further details information. Data were analyzed with the usage of Statistical Package for the Social Sciences (SPSS) to make the process of analysis easier. As result, firstly, the study shown that there are association of risk factor for working posture and years of exposure with Low back Pain. The null hypothesis was rejected and there is probability that these risk factors have influence the low back pain. It was also concluded that the null hypothesis was accepted which means there are no correlation of risk factors for heavy physical works, previous job experience, previous accident with low back pain problem. Thirdly, the study
shown there are no correlation of rate operator’s absence from work (medical leave) with low back pain problem as the null hypothesis was accepted with p value <0.05
Keywords: Port, Low Back Pain, Ergonomics, Occupational Safety & Health, Rubber tyre gantry, Back Pain

Matched MeSH terms: Low Back Pain*
Fulltext The immediate effect of traditional Malay massage on substance P, inflammatory mediators, pain scale and functional outcome among patients with low back pain: study protocol of a randomised controlled trial

Sejari N, Kamaruddin K, Ramasamy K, Lim SM, Neoh CF, Ming LC

BMC Complement Altern Med, 2016 Jan 15;16:16.
PMID: 26767971 DOI: 10.1186/s12906-016-0988-1

BACKGROUND: The treatment of low back pain is very challenging due to the recurrent nature of the problem. It is believed that traditional Malay massage helps to relieve such back pain but there is a lack of scientific evidence to support both the practice of traditional Malay massage and the mechanism by which it exerts its effect. The aim of this study is to investigate the immediate effect of traditional Malay massage on the pain scale, substance P, inflammatory mediators, and functional outcomes among low back pain patients.
METHODS: A non-blinded, randomised controlled trial will be conducted. A total of sixty-six patients who fulfil the inclusion criteria will be recruited. The participants will be randomly allocated into intervention (traditional Malay massage) and control (relaxation position) groups. Blood and saliva samples will be collected before and immediately after intervention. All collected samples will be analysed. The primary outcomes are the changes in the level of substance P in both saliva and blood samples between both groups. The secondary outcomes include the levels of inflammatory mediators [i.e. TNF-α, IL-1β, IL-8, monocyte chemotactic protein-1, IL-6 and IL-10, and the soluble form of the intercellular adhesion molecule], the pain intensity as measured by a visual analogous scale and functional outcomes using the Roland-Morris Disability Questionnaire.
DISCUSSION: Massage is a type of physical therapy that has been proven to be potentially capable of reducing unpleasant pain sensations by a complex sensory response and chemical mediators such as substance P and various inflammatory mediators. Previous studies conducted using Thai, Swedish, or other forms of massage therapies, have showed inconsistent findings on substance P levels pre and post the interventions. Each massage genre varies in terms of massage and joint mobilization points, as well as the lumbar spinous process. Traditional Malay massage, known locally as "Urut Melayu", involves soft-tissue manipulation of the whole body applied using the hands and fingers. This massage technique combines both deep muscular tissue massage and spiritual rituals. This trial is expected to give rise to new knowledge underlying the mechanisms for pain and inflammation relief that are activated by traditional Malay massage.
TRIAL REGISTRATION: Australian New Zealand Clinical Trials ACTRN12615000537550 .

Matched MeSH terms: Low Back Pain/therapy*

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