What question did this study set out to answer?

The study aimed to evaluate how different mechanical massage techniques affect chronic low back pain and functional limitations.

April 18, 2026Open Access

Mechanisms of influence of Tok Sen Massage techniques on chronic muscle pain in the back

Key Points

The study aimed to evaluate how different mechanical massage techniques affect chronic low back pain and functional limitations.
Conducted a prospective, randomized, controlled, assessor-blinded study with 96 participants.
Participants received 10 sessions of massage over 4 weeks using percussive-vibration, classical manual, or myofascial techniques.
Pain intensity was measured on a numerical rating scale before and after treatment.
Pressure pain threshold and functional limitations were assessed using the disability index.
The percussive-vibration group showed the greatest pain reduction with 81.3% achieving a clinically significant decrease in pain.
Functional limitations decreased most in the myofascial group, with an 11.6 percentage point improvement.
All groups reported decreased pain intensity, with pressure pain thresholds increasing for all techniques.

Abstract

Chronic non-specific low back pain is maintained by a combination of peripheral mechanical hyperalgesia and changes in central pain modulation; therefore, comparing standardised mechanical interventions is of practical value. The study aimed to compare the clinical and sensory effects of three mechanical intervention models over the same treatment duration. A prospective, randomised, controlled, assessor-blinded study was conducted in 96 patients who received 10 sessions of 30 minutes each over 4 weeks using the percussive-vibration (PV), classical manual (CM) or myofascial (MF) model. Baseline pain intensity on a numerical rating scale was 5.9±1.3 points. Two weeks after completion of the course, pain intensity decreased in all groups, with the greatest reduction observed in the SV group, an intermediate reduction in the MF group, and the smallest in the CM group. The proportion of participants who achieved a clinically significant reduction in pain of at least 2 points was 81.3% in the PV group, 75.0% in the MF group and 62.5% in the CM group, reflecting differences not only in mean values but also in the probability of achieving noticeable relief at the individual patient level. The pressure pain threshold increased by 0.95, 0.72 and 0.61 kg/cm², respectively. Functional limitations, as measured by the disability index, decreased by 8.4, 11.6 and 7.5 percentage points, with the greatest functional improvement recorded in the MF group, indicating differences in the response profile between the mechanical intervention models. CM The practical significance of the study is determined by the fact that, given the same treatment duration and standardised treatment areas, mechanical models demonstrate different advantages; therefore, the choice of intervention can be guided by the dominant clinical need: increasing the probability of a rapid, clinically significant reduction in pain, or prioritising the improvement of daily function, incorporating tolerability profile

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