The aim of this study was to verify the effectiveness of traditional Thai massage (TTM) among patients with back pain associated with myofascial trigger points (MTrPs). Swedish massage (SM) was selected as the treatment for the comparison group. One hundred and eighty patients were randomly allocated to receive either TTM or SM for 6 sessions during a 3–4 week period, with follow-up 1 month later. Results indicated that pain intensity, assessed using the visual analog scale (VAS), among patients in both groups was reduced by more than half after 3 weeks of treatment and for up to one month afterwards (P < 0.05) with no significant difference in VAS between the groups. Similar improvements were found for most other outcome measures. We conclude that TTM and SM are effective in reducing back pain among patients with MTrPs. We therefore suggest that massage therapy, and in particular Thai massage, be considered as an alternative primary health care treatment for this disorder.