Comparative effectiveness of slow-stroke back massage and hot stone massage for postoperative pain after orthopedic surgery: A randomized controlled trial.

OBJECTIVE: Postoperative pain represents a complex interplay of neurophysiological and psychosocial processes involving nociception, autonomic regulation, and stress responses. This study compared the effectiveness of slow-stroke back massage and hot stone massage, alongside standard care, in reducing acute postoperative pain following orthopedic surgery.

METHODS: This three-arm randomized controlled trial included 99 male orthopedic surgery patients assigned to slow-stroke back massage (n = 33), hot stone massage (n = 33), or routine care (n = 33). Pain intensity was assessed using the Visual Analog Scale before and after the intervention. Analysis of covariance (ANCOVA), adjusted for baseline pain scores and type of surgery, was used to compare postoperative pain among groups. Adjusted mean differences with 95% confidence intervals were calculated for pairwise comparisons RESULTS: A significant overall treatment effect was observed after adjustment (p < 0.001, partial η² = 0.382). Compared with routine care, slow-stroke back massage (AMD = -2.59, 95% CI -3.52 to -1.66) and hot stone massage (AMD = -2.52, 95% CI -3.44 to -1.60, p < 0.001) significantly reduced postoperative pain (p < 0.001). No significant difference was found between the two massage interventions.

CONCLUSION: Slow-stroke back massage and hot stone massage demonstrated comparable analgesic benefits in orthopedic postoperative care. The findings suggest that diverse sensory stimulation pathways may contribute to similar pain-relieving effects, highlighting massage therapy as a promising complementary intervention within multimodal pain management frameworks.