Case Review:
BK is a 69-year-old woman who presents with persistent lower back pain for several days. It has been accompanied by feeling "ill" but with no other specific concerns. She has been generally healthy with a diagnosis of hypertension and a remote history of recurrent urinary tract infections. She has intermittent urinary incontinence without recent change. She would like to avoid medication for her back pain as she as tolerated it poorly in the past.
What recommendations do you have?
Are they likely to help?
Is there other evaluation you would like to do?
Are there a down side to a trial of massage?
Discussion:
Low back pain often responds well to massage therapy and is one of the most common reasons people see a massage therapist. A complete evaluation, however, would explore the possibility of a non-musculoskeletal cause of her pain, such as an occult urinary tract infection. If that evaluation is negative, a trial of massage therapy, in addition to the typical advice we would provide such as stretching, ice, cautious use of anti-inflammatories is reasonable.