MASSAGE THERAPY FOR ARTHRITIS
Massage Therapy for Arthritis By Dolly Wallace
Massage therapy is becoming increasingly recognized as a valuable component in integrative care, especially for various types of pain. This is the result of both an increasing body of research on its efficacy and the experience of people who suffer with acute or chronic pain. In a 2016 national poll of individuals who had a massage from a massage therapist in the previous 12 months, 35% said they sought their last massage for acute pain relief, chronic pain management, soreness, or spasms. Those who had a massage from a massage therapist in the previous five years reported similar reasons (1). A recently published review of research on massage therapy for pain management conducted through the Samueli Institute indicates that massage therapy can improve pain, anxiety, and health-related quality of life (2). In addition, since 2014 The Joint Commission has stated in its Standard PC.01.02.07 that massage therapy plays a significant “role in the management of pain” (3). Can massage therapy be a significant part of integrative care for those with arthritis?
WHAT THE RESEARCH SAYS Massage therapy is the manual manipulation of soft tissue intended to promote health and wellbeing. The effects of massage therapy on arthritis are therefore related to the soft tissue around the joint, impacting levels of pain and flexibility. Studies indicate that weak muscles around the knee are often associated with the development of osteoarthritis (OA) (4). Massage therapy can impact those muscles, decrease pain, increase flexibility, and improve quality of life for those with OA. While research on massage therapy for all forms of arthritis is still evolving, research indicates it can be an effective approach for pain from OA of the knee and other joints (4), as well as for rheumatoid arthritis of the wrist and upper arm (5). In a study supported by the National Center for Complementary and Alternative Medicine (NCCAM), 60-minute sessions of Swedish massage for those with osteoarthritis of the knee significantly reduced their pain (4). The study involved a group of 68 subjects divided into two equal groups. One group received 60-minute massages over a period of eight weeks, while the other group received less massage or usual care without massage. The massage group received twice-weekly sessions of standard Swedish massage in weeks 1-4 and once-weekly sessions in weeks 5-8. Each massage therapy session followed a specific protocol, including the nature of the massage strokes. These results were similar to those reported in previous investigations on massage for the pain of OA of the knee that included fewer patients. Another study examined the benefits of weekly massage in 42 adults with rheumatoid arthritis of the upper limbs over a period of four weeks (5). Researchers found that moderate-pressure massage vs. light-pressure massage reduced participants’ pain, increased grip strength, and improved range of motion in the wrist, elbows, and shoulders after one month of treatment. Several smaller previous studies have shown promise, demonstrating positive results of massage therapy and a need for further research. My own experience as a massage therapist reflects similar results. I have been working with clients with arthritis for more than 25 years and have seen definite improvements in mobility and pain. Most of the arthritis clients I see have OA.
It is the position of the American Massage Therapy Association (AMTA) that massage can aid in pain relief. A summary of general research on massage therapy for pain to support this position is available (6). More extensive research citations on massage therapy for pain are found at the Samueli Institute Research Archives website (7). AMTA also provides an online course on massage therapy for OA (8).
FIND THE RIGHT MASSAGE THERAPIST Massage therapists work in a variety of settings and environments from spas to health clubs, from independent practices to hospitals. How to best find a massage therapist who can work with those who have arthritis? First, patients and other health care providers who want to refer their patients need to find massage therapists with experience in arthritis. Obviously, the severity of the patient’s arthritis will determine the necessary level of experience of the massage therapist and the extent of the involvement of other members of the integrative health care team. As is standard professional practice, the massage therapist should do a thorough intake interview to fully understand the extent of the patient’s arthritis and any other health issues. The American Massage Therapy Association provides a free online service to locate professional massage therapists throughout the country (9). The provider or the patient can search by zip code and select a local massage therapist based on his or her credentials and areas of expertise. It may be helpful to call several massage therapists and discuss the nature of the patient’s arthritis to determine their level of experience. The patient/client should also talk to the massage therapist about their health and wellness goals to customize a treatment plan that addresses their arthritis condition. Starting with a trusted resource will ensure that patients get the most out of massage therapy. ❏ Dolly Wallace is the President of the American Massage Therapy Association. A native of Muskegon, Michigan, she has had a local massage therapy practice for more than 25 years and works in collaboration with her husband at his chiropractic practice. References 1. 2. 3. 4. 5. 6. 7. 8. 9.
AMTA Consumer Surveys 2003-2016. American Massage Therapy Association 2016. Boyd C, Crawford C, Paat C, Price A, et al. The impact of massage therapy on function in pain populations: Part I. Pain Med. 2016;17:1353-1375. The Joint Commission. Clarification of the Pain Management Standard PC.01.02.07. Joint Commission Perspectives, 2014;34(11):11. https://www.jointcommission.org/assets/1/18/Clarification_of_the_Pain_Management__Standard.pdf. Accessed March 6, 2017. Perlman AI, Sabina A, Williams AL, Njike VY, Katz DL. Massage therapy for osteoarthritis of the knee. Arch Intern Med. 2006;166(22):2533-2538. Field T, Diego M, Delgado J, Garcia D, Funk CG. Rheumatoid arthritis in upper limbs benefits from moderate pressure massage therapy. Complement Ther Clin Pract. 2013 May;19(2):101-103. American Massage Therapy Association. Massage can aid in pain relief. https://www.amtamassage.org/statement6.html. Accessed March 6, 2017. Samueli Institute. Research archives. http://www.samueliinstitute.org/research-areas/researcharchives-page.html. Accessed March 6, 2017. American Massage Therapy Association. Massage Therapy for Osteoarthritis. amtamassage.org/ learn. Accessed March 6, 2017. American Massage Therapy Association. Find a Massage Therapist. findamassagetherapist.org. Accessed March 6, 2017.
TH E PAIN PRACTITION ER
| VOLUME 27, NUMBER 2 |
17