Massage Therapy for Arthritis
In recognition of May as Arthritis Awareness Month, we explore how this painful condition can be helped with massage therapy. Arthritis is an umbrella term used to describe over 100 medical conditions and diseases, known as rheumatic diseases.
According to the Arthritis Foundation, massage can help with arthritis in two ways. First, it reduces muscle pain caused by spasms. Second, it increases production of endorphins which reduces pain.
For greatest benefit, massage therapy is most effective on a regular basis with a therapist trained and experienced in working with arthritis. The optimum treatment schedule is once a week for one month, then 1-2 times per month thereafter.
Two studies involving arthritis of the hands and knees each concluded that massage therapy is beneficial:
1. A 2006 study at the Touch Research Institute in Miami demonstrates effects of hand massage in arthritis patients. Dr. Field shows by grip strength pre and post treatment that the treatment group had significant improvement in mobility and function compared to the non-massage control group. Also, to increase synovial fluid production in affected joints, treating the surrounding joint tissues and establishing a methodical treatment interval is suggested (Wine, 1995). As a systemic disease, RA can create blockage in lymph nodes proximal to affected joints, contributing to pain. Gentle friction techniques increase the delivery of oxygen and nutrients, and assist in the removal of waste products surrounding the affected joints. Massage is contraindicated during an acute inflammatory stage, but when in remission, massage can effectively manage symptoms, prevent inflammation, and reduce joint damage.
2. Massage therapy is safe and effective to reduce pain and improve function in adults with osteoarthritis of the knee, researchers at the Yale Prevention Research Center and at the University of Medicine and Dentistry of New Jersey (UMDNJ) report in the first clinical trial to assess the effectiveness of this treatment.
The 16-week study identifying the benefits of massage on osteoarthritis patients with pain, stiffness and limited RoM was published in the December 2006 Archives of Internal Medicine. Osteoarthritis, affecting 21 million Americans, causes more physical limitation than lung disease, heart disease and diabetes mellitus, according to the CDC.
The 68 study participants were randomly assigned either to an intervention group that received massage therapy immediately, or to a wait-list control group that received massage after an 8-week delay. Both groups continued previously prescribed medications and treatments.
Participants in the intervention group received a standard 1-hour massage twice a week for 4 weeks, followed by massage once a week for the next 4 weeks at the Siegler Center for Integrative Medicine at St. Barnabus Ambulatory Care Center in Livingston, NJ. After the first 8 weeks of massage therapy, participants had improved flexibility, less pain and improved range of motion.
The primary study outcomes were changes in the Western Ontario and McMaster Universities Osteoarthritis Index pain and functional scores, as well as changes in the Visual Analog Scale assessment of pain. Measures of pain, stiffness and functional ability were all significantly improved by the intervention as compared to the control group.
Those who continued with only their usual care without massage showed no changes in symptoms. During weeks 9 through 16, they received the massage intervention and experienced benefits similar to those in the original control group. When reassessed 8 weeks after completion of the massage intervention, the benefits of massage persisted at significant levels, with slight reduction in magnitude.
“Massage is free of any known side effects and according to our results, clearly shows therapeutic promise,” said senior investigator of the study David L. Katz, MD, associate adjunct professor in the Dept. of Epidemiology & Public Health at Yale School of Medicine and director of Yale Prevention Research Center. “Massage is important when conventional treatments are far from ideal. NSAIDs are often not well-tolerated. Cox-II inhibitors like Vioxx were developed as substitutes for traditional anti-inflammatory drugs, but pose toxicity problems.”
Katz conducted the study with Adam Perlman, MD, executive director of the Institute for Complementary and Alternative Medicine at the UMDNJ-School of Health-Related Professions.. Perlman said “Our results suggest that massage therapy can be used in conjunction with conventional treatment for osteoarthritis,” said Perlman. “Ultimately, massage may be shown to lessen a patient’s reliance on medications and decrease health care costs.”
Perlman and Katz say that further study of the cost-effectiveness and the lasting impact of the intervention is warranted. They have begun collaborating on a follow-up study.”
Our hope is to show that this treatment is not only safe and effective, but cost-effective,” said Perlman. “That could serve to change practice standards so that massage is a more common option for the many patients with osteoarthritis of the knee.”