Abstract

Background: Lumbosacral fusion is a common surgical procedure intended to stabilize the spine and alleviate low-back pain resulting from disc degeneration. Depression has been linked with chronic low-back pain in numerous studies. The conditions of both disc degeneration and clinical depression are characterized by elevated levels of pro-inflammatory cytokines (PICs).

Purpose: The objective of this case report is to provide the outcome of a personalized therapeutic massage treatment intervention for a patient presenting with both severe low-back pain and depression.

Participant: The subject is a 53-year-old male who underwent a lumbosacral fusion procedure that was unsuccessful in alleviating low-back pain resulting from three herniated discs. He has an extensive history of anxiety, depression, and emotional trauma and is currently being treated with nine different medications for control of various symptoms and pathologies.

Intervention: Hour-long sessions were administered by a student of massage therapy twice a week for five weeks (with the exception of one missed session by the client). A period of roughly 15-20 minutes at the beginning of each session was dedicated to both postural and subjective assessment procedures involving the use of visual and numeric pain scales. Techniques used during treatment consisted of gliding and friction strokes as well as compression and compression with opposition. Treatment was designed to treat hypertonic musculature thought to be preventing the client from achieving optimal biomechanical functionality.

Results: A raw change of 5 points was noted in the overall post-intervention Bournemouth Questionnaire scores. This was equivalent to a percentage change of 8.62%. The BQ depression subcategory showed a raw change of 5 points as well. This was equivalent to a 50% improvement between pre- and post-intervention scores in this subcategory.

Conclusion: The lack of positive results in this case reflects the importance of understanding the role of co-morbid psychiatric disorders in inhibiting the normal therapeutic effects of massage on low back pain.

Key words: lumbosacral fusion, spinal fusion, low-back pain, disc herniation, disc degeneration, inflammatory, depression, anxiety, massage, posture