Elucidation of neural mechanisms in massage therapy for chronic low back pain.

We investigated effects of compression at myofascial trigger point (TP) in patients with chronic neck and low back pain on cerebral hemodynamic responses, brain activity, and autonomic nervous activity using near infrared spectroscopy (NIRS), electroencephalogram (EEG) and hart rate variability analysis (HRV). Compression at TP in patients with chronic neck pain significantly improved subjective feeling of pain, decreased Oxy-Hb concentration in the prefrontal cortex, sympathetic nervous activity and increased parasympathetic nervous activity compared with compression at Non-TP. The changes in autonomic nervous activity were significantly correlated with changes in cerebral hemodynamic responses in the prefrontal cortex and subjective score of pain feeling. Furthermore, compression at TP in patients with chronic low back pain significantly increased alpha band EEG and cortical coherence among the frontal lobe, parietal lobe, and occipital lobe compared with rest.