Massage Impact on Pain in Opioid-dependent Patients in Substance Use Treatment
Open accessAbstract
BACKGROUND: Chronic pain is a common cause of health care utilization and high levels of pain are pronounced in individuals engaged in methadone maintenance treatment. Although massage has been demonstrated to alleviate chronic pain symptoms, its use as an adjunctive therapy to modify pain during opioid-replacement treatment is absent from the literature. PURPOSE: To consider the efficacy of Swedish massage in reducing pain in opioid-dependent patients with chronic pain receiving methadone treatment. SETTING: Trial was conducted at a nonprofit methadone treatment center serving low-income patients. RESEARCH DESIGN: A randomized clinical trial with randomized to either 1) massage plus treatment-as-usual (TAU) (n = 27) or 2) TAU (n = 24). Durability of treatment effect was evaluated at Week 12. INTERVENTION: Eight weekly 50-minute Swedish massage sessions plus TAU or TAU alone. MAIN OUTCOME MEASURES: Pain, anxiety, depression, physical functioning, decreased substance use, and improvement in treatment engagement. RESULTS: Randomized participants were comparable at Baseline for demographic, pain, physical, and emotional variables. Massage group reported improved pain scores; worst pain had a clinically significant 2-point improvement while the other pain scores did not. Overall improvements were not observed in treatment engagement or levels of anxiety, depression, or physical functioning. A subgroup of the participants, who felt they could be pain-free, consistently reported improvements in pain from Baseline to Week 8, and this was most pronounced and clinically significant in the massage group. CONCLUSIONS: These preliminary findings do not support an overall clinically significant positive effect of Swedish massage on reduction in pain ratings or improvement in anxiety, depression, or treatment engagement in a substance-using, opioid-dependent population with chronic pain. Future nonpharmacologic pain research in marginalized substance-using populations may wish to consider some of the challenges and limitations faced in this project.
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Trials from Cooperman and colleagues and Wiest and colleagues also included measures for depression and anxiety, with both finding significant improvements in these outcomes.
“Trials from Cooperman and colleagues 27 and Wiest and colleagues 36 also in cluded measures for depression and anxiety with both finding significant improvements in these outcomes.”
From The Effectiveness of Interventions for Improving Chronic Pain Symptoms Among People With Mental Illness: A Systematic Review (2024) · cites this paper as [36]
The Methods (Measures) confirm that Wiest and colleagues measured depression and anxiety using the Hospital Anxiety and Depression Scale. But the Results (HADS) say both scores remained stable throughout the trial, and the Discussion explicitly reports no changes in either outcome for the massage or treatment-as-usual groups—not significant improvements. (LLM, conf=0.95)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredOf the 4 trials that examined a body-based intervention, no evident effect was reported on pain reduction and mental health outcomes for people with PTSD.
“Of the 4 trials that examined a body-based interven tion, 33-36 no evident effect was reported on pain re duction and MH outcomes for people with PTSD.”
From The Effectiveness of Interventions for Improving Chronic Pain Symptoms Among People With Mental Illness: A Systematic Review (2024) · cites this paper as [36]
The Discussion (page unavailable) reports no overall clinically significant improvement in pain and no change in anxiety or depression after massage, supporting the reported lack of an overall effect. But this was one trial in opioid-dependent patients with chronic pain, not a trial identified as involving people with PTSD. The Results also report a clinically significant improvement in worst pain, so the pain finding needs that qualification. (LLM, conf=0.88)
Experimental — accuracy not yet measuredFor one of those trials, the improvement in pain intensity was not sustained at follow-up.
“however, this improvement was not sustained at follow-up for 1 trial. 36”
From The Effectiveness of Interventions for Improving Chronic Pain Symptoms Among People With Mental Illness: A Systematic Review (2024) · cites this paper as [36]
Of the 4 SUD trials with a short-term follow-up, two out of 4 studies reported statistically significant improvements in pain intensity in the intervention group.
“Of the 4 trials with a shortterm follow-up, 20,27,28,36 two out of 4 studies reported statistically significant improvements in pain intensity in the intervention group, 27,36”
From The Effectiveness of Interventions for Improving Chronic Pain Symptoms Among People With Mental Illness: A Systematic Review (2024) · cites this paper as [36]
Of all 3 trials recording adverse events, no severe adverse events were reported related to the intervention.
“Of the all 3 trials recording AEs, 35,36,45 no severe AEs were reported related to the intervention.”
From The Effectiveness of Interventions for Improving Chronic Pain Symptoms Among People With Mental Illness: A Systematic Review (2024) · cites this paper as [36]
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- Authors
- Wiest, P., Asphaug, M., Carr, K. E., Gowen, L., & Hartnett, M.
- Venue
- International Journal of Therapeutic Massage & Bodywork: Research, Education, & Practice
- Publisher
- Massage Therapy Foundation
- Published
- 2015-03-10
- Volume
- 8
- Issue
- 1
- Pages
- 12-24
- ISSN
- 1916-257X (ISSN-L)
- PMC
- PMC4353208
- OpenAlex
- W2126923536
- Cited by
- 6
- References
- 57
- Citations by year
- 2025: 1 · 2023: 1 · 2022: 1 · 2018: 1 · 2016: 1 · 2015: 1
- FWCI
- 1.07
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- International Journal of Therapeutic Massage & Bodywork Research Education & Practice (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Massage Therapy Foundation
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Keywords
- Swedish massage, chronic pain, opioid use disorder, methadone maintenance treatment, substance use disorders, adjunctive therapy, analgesia, anxiety, depression, treatment engagement, low-income patients, non-pharmacological pain management
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