Official websites use. Share sensitive information only on official, secure websites. Chronic unspecific back pain cBP is often associated with depressive symptoms, negative body perception, and abnormal interoception. Given the general failure of surgery in cBP, treatment guidelines focus on conservative therapies. Neurophysiological evidence indicates that C-tactile fibers associated with the oxytonergic system can be activated by slow superficial stroking of the skin in the back, shoulder, neck, and dorsal limb areas.
We hypothesize that, through recruitment of C-tactile fibers, psycho-regulatory massage therapy PRMT can reduce pain in patients with cBP. The results suggest that the superiority of PRMT over CMT may rely on its ability to activate the C-tactile fibers of superficial skin layers, recruiting the oxytonergic system.
Keywords: massage therapy, chronic back pain, depression, oxytocin, C-tactile fibers, somatoform pain ICD 10 , somatic symptom disorder DSM Chronic back pain cBP has a leading position worldwide in disease-related disability and loss of quality of life [ 1 ]. It represents a common health problem, especially among women. Modern recommendations by national and international health organizations focus on non-drug therapy options in the treatment of chronic non-specific back pain.
A variety of treatment modalities are suggested, including physical and rehabilitation interventions [ 3 ] and instrument-based techniques such as transcutaneous electrical nerve stimulation TENS [ 4 ], acupuncture [ 5 ], low-level laser therapy LLLT [ 6 ], and shock wave therapy [ 7 ]. Additional treatment with pain-relieving medication is recommended. Surgery is not recommended because there is little evidence of its effectiveness [ 5 , 8 , 9 ]. Chou et al. A central characteristic of patients with chronic pain is their negative body perception [ 11 ], inhibiting cognitive access to therapy [ 12 , 13 , 14 ].
Berg et al. A reduction in pain, mood disorders, and listlessness and fatigue was reported. Furthermore, general psychological tension was reduced, and well-being was increased. Baumgart et al. The authors concluded that the effectiveness of massage therapy depends on the design of the parameters of a pressure, b speed, c direction, and d rhythm [ 14 , 18 , 19 , 20 , 21 , 22 ]. Studies on the effects of oxytocin and its interactions with the neuro-physiological system have provided possible explanations for the effect of touch or massage therapy in chronic pain with and without depression [ 23 ].
