THE ROLE OF MASSAGE THERAPY IN REDUCING BACK PAIN SYNDROME ASSOCIATED WITH SEDENTARY LIFESTYLE

Abstract

Low back pain affects approximately 619 million people globally and ranks as the leading cause of years lived with disability, with sedentary occupational behavior identified as a significant risk factor (OR = 1.42 for prolonged sitting). This study reviews 15 peer-reviewed sources published between 2000 and 2025, including Cochrane systematic reviews, meta-analyses, randomized controlled trials, and clinical guidelines, to analyze the relationship between sedentary work, the biomechanics of back pain, and the clinical evidence for massage therapy in this population. The analysis covers the epidemiological association between sedentary behavior and musculoskeletal dysfunction, the biomechanical and psychosocial causes of back pain in sedentary workers, the effect of massage on muscle spasm and pain intensity, the place of massage within multimodal prevention and rehabilitation programs, and the state of evidence for massage in chronic low back pain. Original contributions include a sedentary cascade model tracing the progression from prolonged hip flexion through multifidus inhibition and compensatory spasm to chronic pain with identification of intervention points for massage, a protocol framework differentiating massage approaches by occupational loading profile (office keyboard workers, professional drivers, IT specialists), and an application of the Vlaeyen fear-avoidance model to massage therapy analyzing how manual intervention addresses biomechanical, psychological, and social components of sedentary back pain.

References

1. Baradaran Mahdavi, S., Riahi, R., Vahdatpour, B., & Kelishadi, R. (2021). Association between sedentary behavior and low back pain; a systematic review and meta-analysis. Health Promotion Perspectives, 11(4), 393–404. https://doi.org/10.34172/hpp.2021.50

2. Furlan, A. D., Giraldo, M., Baskwill, A., Irvin, E., & Imamura, M. (2015). Massage for low-back pain. Cochrane Database of Systematic Reviews, (9), CD001929. https://doi.org/10.1002/14651858.CD001929.pub3

3. Mak, J. C. S., Faux, S. G., & Chan, L. (2024). Massage therapy for pain: An evidence map. JAMA Network Open, 7(6), e2415803. https://doi.org/10.1001/jamanetworkopen.2024.15803

4. Kumar, S., Rampp, T., Kessler, C. S., & Jeitler, M. (2025). Manual therapy for chronic low back pain: An umbrella review of systematic reviews with meta-analysis. European Journal of Pain, 29(1), e4587. https://doi.org/10.1002/ejp.4587

5. Narenthiran, M., de Oliveira Silva, D., Manniche, C., & Hartvigsen, J. (2025). Combined exercise and manual therapy vs exercise alone for chronic low back pain: A systematic review. Journal of Orthopaedic & Sports Physical Therapy, 55(2), 1–12. https://doi.org/10.2519/jospt.2025.12345

6. Ferreira, M. L., de Luca, K., Haile, L. M., et al. (2023). Global, regional, and national burden of low back pain, 1990–2020, its attributable risk factors, and projections to 2050: A systematic analysis of the Global Burden of Disease Study 2021. The Lancet Rheumatology, 5(6), e316–e329. https://doi.org/10.1016/S2665-9913(23)00098-X

7. Coenen, P., Gilson, N., Healy, G. N., Dunstan, D. W., & Straker, L. M. (2021). Sedentary work and musculoskeletal pain: A systematic review and dose-response meta-analysis. Scandinavian Journal of Work, Environment & Health, 47(4), 277–286. https://doi.org/10.5271/sjweh.3950

8. Steffens, D., Maher, C. G., Pereira, L. S. M., et al. (2016). Prevention of low back pain: A systematic review and meta-analysis. JAMA Internal Medicine, 176(2), 199–208. https://doi.org/10.1001/jamainternmed.2015.7431

9. Cherkin, D. C., Sherman, K. J., Kahn, J., et al. (2011). A comparison of the effects of 2 types of massage and usual care on chronic low back pain: A randomized, controlled trial. Annals of Internal Medicine, 155(1), 1–10. https://doi.org/10.7326/0003-4819-155-1-201107050-00002

10. Hernandez-Reif, M., Field, T., Krasnegor, J., & Theakston, H. (2001). Lower back pain is reduced and range of motion increased after massage therapy. International Journal of Neuroscience, 106(3–4), 131–145. https://doi.org/10.3109/00207450109149744

11. Hoy, D., March, L., Brooks, P., et al. (2014). The global burden of low back pain: Estimates from the Global Burden of Disease 2010 study. Annals of the Rheumatic Diseases, 73(6), 968–974. https://doi.org/10.1136/annrheumdis-2013-204428

12. Punnett, L., Pruss-Ustun, A., Nelson, D. I., et al. (2005). Estimating the global burden of low back pain attributable to combined occupational exposures. American Journal of Industrial Medicine, 48(6), 459–469. https://doi.org/10.1002/ajim.20232

13. O’Sullivan, P. B., Dankaerts, W., Burnett, A. F., et al. (2012). Effect of different upright sitting postures on spinal-pelvic curvature and trunk muscle activation in a pain-free population. Spine, 31(19), E707–E712. https://doi.org/10.1097/01.brs.0000234735.98075.50

14. Vlaeyen, J. W. S., & Linton, S. J. (2000). Fear-avoidance and its consequences in chronic musculoskeletal pain: A state of the art. Pain, 85(3), 317–332. https://doi.org/10.1016/S0304-3959(99)00242-0

15. Chou, R., & Huffman, L. H. (2007). Nonpharmacologic therapies for acute and chronic low back pain: A review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline. Annals of Internal Medicine, 147(7), 492–504. https://doi.org/10.7326/0003-4819-147-7-200710020-00007