Modulation of the human immune status by spinal thermal massage: a non-randomized controlled study

Abstract

Thermal and massage therapies have long been used to control pain. Although spinal thermal massage (STM) has been used worldwide, its effectiveness has not been proven in a controlled clinical study. We here conducted a non-randomized controlled trial to assess the pain-relieving and immunomodulatory effects of STM in old-aged patients experiencing pain or disability. The experimental group was treated with STM five times a week for 8 weeks and rehabilitative regular care (RRC). The control group was treated with only RRC. Pain and immunological parameters were tested before treatment and after 4 and 8 weeks of treatment. The scores of three pain parameters were lowered by STM, and the differences between the groups were statistically significant at the two time points (p < 0.01). Quality of life determined using the 3-level EuroQol five-dimensional questionnaire scores was significantly higher in patients in the experimental group than those in the control group. Effect sizes (ES) were in the range of medium to large in the pain-related measures (0.54–1.22). The total leukocyte counts and the proportions of lymphocytes and subsets were not significantly different between the groups, whereas the proportions of monocytes and natural killer (NK) cells were higher in the experimental group than in the control group after 8 weeks (p < 0.05). The production of interleukin (IL)-4 and interferon γ in T cells was not significantly different between the groups, whereas the production of IL-2 was high in the control group. However, there was a significant increase in IFN-γ production by NK cells in the experimental group (at 4 weeks, p < 0.05). ES were medium in the immunological measures (0.53–0.68). No significant difference was observed in the production of proinflammatory cytokines, IL-1β, tumor necrosis factor α, or IL-6 between the groups. In conclusion, STM treatment has a positive effect on subjective pain and quality of life. It also enhanced NK cell proportion and activity, suggesting that STM may be beneficial in the prevention of viral diseases and cancer in old-aged people.

Computational Modeling of Deep Tissue Heating by an Automatic Thermal Massage Bed: Predicting the Effects on Circulation

“…Moreover, our findings suggest that blood flow can be increased four-fold at depths of 2–3 cm, corresponding to the lumbar musculature. These findings are consistent with clinical observations performed with the same thermo-mechanical massage bed ( 10 – 12 , 18 ).…”

“…Therefore, the effects on heating and circulation predicted here have direct implications for understanding (and further optimizing) results from clinical trials using the same device. As both temperature and blood flow are known to impact immune function, antioxidant and anti-inflammatory processes, and autonomic function ( 31 – 36 ), these predictions help to explain the clinical biomarkers observed during application of the device modeled here ( 10 – 12 ). In turn, these biomarkers provides a mechanistic substrate for thermal massage therapy in pain ( 10 , 12 ).…”

“…Medical devices that provide thermal stimulation are becoming increasingly sophisticated. For example, automatic thermal-mechanical massage beds are equipped with multi-axis traction and far-infrared thermal projectors ( 10 – 12 ). Such devices allow in-home, self-managed treatment that may potentially leverage the numerous degrees of freedom governing the stimulation “dose.” In theory, stimulation parameters such as temporal dynamics (pulsed vs. continuous), intensity (temperature), duration, and position may be individualized to maximize therapeutic benefit.…”

Computational modeling of posteroanterior lumbar traction by an automated massage bed: predicting intervertebral disc stresses and deformation

“…The stress and strain levels predicted by the models in the intervertebral discs are below the reported thresholds for damage of the disc (ultimate stress = 2.94 ± 1.05 MPa and ultimate tensile strains = 21.3 ± 2.1%) (54), consistent with the established safety of the commercial automatic massage bed system. The tensile stresses produced by this device in the disc tissue may reduce the compressive IVD stresses and thus potentially explain clinical observations on pain reduction (7,8,11,12,59,60) and intervertebral space changes (42) reported using the same automatic massage device.…”

“…), thermal therapy (e.g., heat/cold) and gentle exercise and physical stretching. In turn, chronic back pain may require a progressive care approach, starting with early treatments including medication (6) and self-managed thermal therapy (7)(8)(9). These approaches may be followed by complementary techniques such as acupuncture, transcutaneous electrical nerve stimulation (TENS), physical therapy, spinal manipulation/mobilization, spinal injections, spinal traction and surgery.…”