A Randomized Trial Evaluating Connective Tissue Massage on Pain in Post-Cesarean Section Primiparous Women

Purpose:  Pain creates physiological responses that can prolong the body’s recovery after surgery including cesarean surgery which may impact a woman’s ability to establish a maternal-newborn bond and effective breastfeeding. In the United States 77% of current heroin users claim to have used opioid pain medications prior to their heroin initiation (Jones, 2013).With today’s opioid crisis, it is imperative that nurses find alternative strategies to the current administration of opioids to manage postoperative pain. The purpose of this study was to evaluate the efficacy of connective tissue massage on reducing postoperative pain in primiparous patients on their first postoperative day after cesarean section.

Methods: In this research sixty women were randomized into three groups; Massage, Standard Care and Birth Story. The study sample was comprised of primiparous women aged 17-44 who underwent an unplanned cesarean birth in the previous 24-48-hour time period. A retrospective chart review was conducted to gather data on pain score, opioid and NSAID use for entire postoperative hospitalization.

Results: Data were analyzed using analysis of variance and post hoc Tukey tests. One-way ANOVA revealed a significant difference between groups for Pain, Stress and Relaxation scores at time 2 (p=.017, .004, .000 respectively). Additionally, opioid and NSAID use day 2 were significantly different (p=.032, .022 respectively). Post hoc Tukey’s evaluating the interaction between Massage and Standard Care groups were approaching significance for Total opioid use/BMI and Total NSAID use/BMI during the hospitalization (p=.09,.06 respectively).

Conclusion:  Using massage therapy during postoperative hospitalization decreased pain, stress and improved relaxation and had the potential to decrease overall pain medication use in this sample of childbearing women. Nurses using massage therapy for post-surgical patients can decrease the pain, stress, and increase relaxation associated with unplanned cesarean birth and impact their overall opioid use. Further research Is needed to determine the "dose" of alternative therapies that would sustain this Impact.