A Pilot Feasibility Study of Massage to Reduce Pain in People with Spinal Cord Injury during Acute Rehabilitation

OBJECTIVE: To determine the feasibility of conducting a randomized controlled trial of massage therapy for patients with new spinal cord injury (SCI) during acute inpatient rehabilitation. DESIGN: A pilot single-center, randomized, single-blind, cross-over clinical trial. SETTING: Free-standing, not-for-profit, comprehensive rehabilitation center specializing in SCI rehabilitation PARTICIPANTS: Forty adults ages 18 years and older undergoing acute rehabilitation following spinal cord injury reporting any type of pain. INTERVENTION: Rehabilitation nurses trained to give broad compression massage (BCM) and a control light contact touch (LCT) treatments. Participants were randomized to receive either BCM or LCT first, in six 20 minute treatment sessions over two weeks, with a one week wash-out between the two-week treatment periods. MAIN OUTCOME MEASURES: Primary outcomes were changes in pain intensity and in fatigue, measured daily. Secondary outcomes included depressive symptoms measured by the Patient Health Questionnaire-9 (PHQ-9) and an assessment of pain medication usage. RESULTS: Pain intensity was higher at baseline and reduced more in the LCT-first group compared to the BCM-first group in period 1 (p=0.014); although this pattern was not found in period 2 (p=0.58). LCT and BCM groups did not significantly differ on any secondary measures except PHQ-9. CONCLUSIONS: This study demonstrates the feasibility of using rehabilitation nurses to provide tactile therapy to patients with SCI and suggests a model for controlled clinical trials examining the efficacy of massage therapies. While efficacy was difficult to assess, broad compression massage was safe and well tolerated.