Low Back Pain Clinical Trial
Official title:
The Effects of Massage With Frankincense and Myrrh Oil in Treating Chronic Low Back Pain: A Randomized Controlled Trial
This randomized controlled study was conducted to determine the effect of massage with
frankincense and myrrh oil in treating chronic low back pain.
A total of 91 individuals over the age of 18 who agreed to participate in the study, who had
no verbal communication problems, and who had complaints of low back pain for at least the
past three months were included in the study. In this research, 3x2 (experiment, control and
plasebo group x pre-test post-test) split plot design was used The data were collected using
the data sheet, Visual Analogue Scale (VAS), Aberdeen Low Back Pain Scale (ALBPS) and
Roland-Morris Disability Scale (RMDS). Standard treatment was applied to all three groups for
three weeks, every weekday. In addition to the standard treatment, 2 sessions of waist
massage per week were applied to the aromatherapy Group with frankincense and myyrh essential
oil and to the Placebo Group with jojoba fixed oil in accordance with the aromatherapy
protocol. Massage was not applied to the control group.
In the results of working, the decrease in RMDS (p <0.001), ALBPS (p <0.001) and VAS (p
<0.001) scores of the aromatherapy group was found to be statistically higher than the other
two groups.
As a result, aromatherapy massage with Fankincense and Myyrh essential oil can be added to
traditional treatments as an easy-to-apply complementary health application with no
significant side effects to relieve pain and reduce disability in an individual's daily life
in chronic low back pain patient care.
The research was conducted as a randomized, double-blinded, placebo-controlled study to
examine the effect of massage with frankincense and myrrh essential oils on pain and
disability in individuals with chronic low back pain. In this research, 3x2 (experiment,
control and placebo group x pre-test post-test) split plot design was used. The measurements
and evaluations of the patients were conducted by an independent surveyor (assessor-blind) to
ensure that the study was double-blind. Massage application, the main intervention of the
study, was carried out by another nurse who was trained on this subject.
Individuals presenting with chronic low back pain, who were admitted to the physical medicine
and rehabilitation outpatient clinic of a training and research hospital and who were
prescribed a physical therapy session constituted the target population of the study.
For the sample size, 30-31-30 patients were included in the experimental, placebo and control
groups, between June and October 2019, respectively, and power analysis was performed with
the obtained data. As a result of power analysis, the effect size for Roland-Morris
Disability Scale (RMDS) was 0.44 and statistical power was 100%; the effect size for Aberdeen
Low Back Pain Scale (ALBPS) was 0.53 and the statistical power was 100%; and the effect size
for Visual Analogue Scale (VAS) was 0.29 and statistical power was 100%, and the research was
completed.
Individuals who meet the inclusion criteria were included in the randomization pool and then
assigned to one of the following groups:
1. Aromatherapy Group which had classical massage with essential oil,
2. Placebo Group which had classical massage with a fixed oil,
3. Control Group. Pre-application was made to 5 individuals to check the functionality of
the forms and application. In the pre-application, it was decided that only effleurage
and friction should be performed, since the individuals were disturbed by petrissage
during massage. After pre-application, the study was finalized. Individuals who
participated in pre-application were not included in the study.
Informed consent of the individuals randomly assigned to the groups was obtained. There was
no intervention in the standard treatment applied in the clinic. At the beginning of the
study, VAS, ALBPS, RMDS were applied to all three groups prior to the intervention by
face-to-face interview method. Then, all three groups received standard treatment for three
weeks, every weekday. In addition to the standard treatment, aromatherapy group was applied 2
sessions of 15 min lumbar massage per week (2nd and 5th day) with frankincense and myrrh
essential oils, and the placebo group was applied lumbar massage with jojoba fixed oil in the
same frequency. Massage was not applied to the control group. After three weeks, VAS, ALBPS,
RMDS were applied to all 3 groups after the intervention Massage Application: Although there
are many massage techniques, the most widely used technique is Swedish massage technique
applied with light pressure. Swedish massage is a superficial massage and has a stimulating
effect on soft tissues and blood circulation. The main maneuvers of classical massage are
effleurage, petrissage, friction, tapotement and vibration. In this study, effleurage and
friction were applied from these maneuvers.
Effleurage is a stroking movement applied on the skin with one hand or both hands. In the
stroking technique, palms, fingers, thumb and back of hand is applied with one or two hands.
The aim is to accelerate blood flow in superficial veins and excretion of metabolites from
the body. Friction is the pressing, scrubbing and sliding movements with small circular
movements using fingertips, thumbs, four fingers and palms. The purpose of friction is to
remove adhesions in skin and subcutaneous tissue, to relax stiffness and thickening, to
reduce fluid in tissues around joints and to remove metabolites.
Essential oils from plants are used topically for massaging, often by adding them into
carrier oil The use of essential oils in massage is called aromatherapy massage. In this
study, frankincense and myrrh essential oils were used as essential oil and jojoba oil was
used as carrier oil.
Intervention: The standard physical therapy session of the clinic lasts for three weeks
(3x5=15 sessions in total, 30 minutes on average per session) on a weekday basis. During the
session, hot pack, ultrasound therapy and TENS (trans electrical nerve stimulation) were
applied. The lumbar massage performed as a research intervention was performed immediately
after the physical therapy session to increase the effectiveness of the intervention.
Intervention applied to the aromatherapy group: In addition to the standard physical therapy
session, 30 patients in this group received a total of six sessions of lumbar massage for
three weeks with frankincense and myrrh essential oils, two sessions per week (2nd and 5th
days of each week), each lasting 15 minutes. During the massage, an average of 3ml mixture
prepared by adding 2% frankincense oil and 2% myrrh essential oil to jojoba carrier oil was
used as an oil mixture.
Intervention applied to the placebo group: In addition to the standard physical therapy
session, 31 patients in this group received a total of six sessions of lumbar massage for
three weeks with jojoba oil, two sessions per week (2nd and 5th days of each week), each
lasting 15 minutes.
Intervention applied to the control group: 30 patients in this group received standard
physical therapy sessions, and no massage was applied.
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