Massage Therapy for Rheumatoid Arthritis and Other Rheumatic Diseases

Is It Effective?

Woman receiving massage therapy.
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Massage therapy is a popular CAM (complementary and alternative medicine) approach used for rheumatoid arthritis and other rheumatic diseases. Not long ago, CAM was dismissed as unproven and its effectiveness was questioned. But, CAM gained in popularity and became more respected—especially treatments that seemed to offer evidence of benefit in scientific journals.

People with rheumatoid arthritis are often drawn to the holistic approach of complementary medicine, especially those who have become dissatisfied with traditional medicine.

Their dissatisfaction may be linked to drug side effects or an inadequate response to traditional treatments.

It cannot be said that all CAM therapies are natural or harmless. Each individual CAM therapy must be evaluated for potential benefits versus potential risk of adverse events. Massage therapy is an example of a CAM treatment approach that is used for pain relief—and with little risk, especially if you use the services of a licensed massage therapist who is mindful of your medical history and makes accommodations and adjustments accordingly. Some physical therapists include massage in their protocol for treating people with rheumatoid arthritis.

Reaping the Benefits of Massage Therapy

While a person with rheumatoid arthritis may benefit from massage, they may require light to moderate touch as opposed to deep pressure. According to the American Massage Therapy Association, using techniques such as effleurage, Swedish massage, and craniosacral therapy for about an hour, focusing primarily on the painful areas, tends to be a good plan for people with arthritis.

Adjustments are made as needed for individuals with arthritis. Adjustments may include avoiding joints that are flaring, leaving clothes on if preferred, and rescheduling appointments when necessary. That goal of massage therapy is to bring comfort, not add to discomfort.

Interestingly, a massage therapist can instruct people with rheumatoid arthritis about self-massage and it can help greatly with reducing pain, especially in the upper limbs.

Self-massage techniques include:

  • Stroking - Use a stroking motion with moderate pressure from wrist to shoulder, and then shoulder down to the wrist. Also, this can be done on the top of the hand from wrist to fingertips, and reversed. The underside of the arm can be stroked as well.
  • Milking - On the arm, first the top and then later it is repeated on the bottom, cup fingers with the thumb and pull on the flesh as you move from wrist to shoulder, and reverse from shoulder to wrist.
  • Friction - Circular movements using four fingers as you move up the top of the arm to the shoulder, across the shoulder, and back down the arm to the hand. Repeat on the underside of the arm.
  • Another mode of self-massage involves using foam rollers or rolling massagers. There are also hand-held personal massagers that are available.

What Studies Have Shown About Massage Therapy for Rheumatoid Arthritis

A systematic review was conducted of randomized controlled trials that assessed massage therapy as a stand-alone therapy for pain and function associated with osteoarthritis and rheumatoid arthritis. Results were published online in the February 2017 issue of the American Journal of Physical Medicine and Rehabilitation.

There were seven relevant trials found which involved 352 study participants. It was determined that there was low to moderate quality evidence that massage therapy is superior to "non-active therapies" for reducing pain and improving functional outcomes in osteoarthritis and rheumatoid arthritis patients. Researchers concluded that it was unclear if massage therapy was more effective than other forms of treatment. Larger studies are needed.

Another study published in April 2016 in Pain Management Nursing concurred that non-pharmacologic treatment options for symptom management of rheumatoid arthritis are under-investigated.

That said, the researchers evaluated and compared the effects of aromatherapy massage and reflexology on pain and fatigue in rheumatoid arthritis patients. In the study, aromatherapy massage was applied for 30 minutes to both knees. To a second group of study participants, reflexology was administered for 40 minutes to both feet. A control group received neither treatment. In both the aromatherapy massage and reflexology groups, pain and fatigue scores decreased significantly compared to the control group.

Often with rheumatoid arthritis, there is hand involvement. A few studies have examined the effect of massage therapy on hand arthritis. A study published in the January 2007 issue of the Journal of Bodywork and Movement Therapies compared massage therapy of the hand and wrist to a standard treatment control group. The 22 study participants were randomly assigned to one of the two groups. The massage group received treatment once a week for 4 weeks and they were also taught self-massage for the hand to be done daily at home. Results showed that compared to the control group, the massage therapy group had lower anxiety and depressed mood following the first and last sessions, and less pain and improved grip strength after the sessions.

In yet another hand arthritis study, published in the July 2014 issue of the Journal of Bodywork and Movement Therapies, 20 adult arthritis (type unspecified) patients were randomly assigned to massage therapy or massage therapy with a topical analgesic—with both groups receiving massage from a therapist once a week for four weeks and taught self-massage to be done daily. The massage plus topical analgesic had better results including greater improvement in hand function, greater increase in perceived grip strength, as well as a greater decrease in hand pain, depressed mood, and sleep disturbances over the course of the study period.

A Word From Verywell

While there is not an abundance of scientific study pertaining to massage therapy for rheumatoid arthritis or other rheumatic diseases, there is enough to suggest that it may be worth a try, especially as complementary treatment to possibly enhance your usual treatment. Be sure to check with your rheumatologist first and get their approval. Also, be certain that you are getting massage therapy from a credible business and from a licensed therapist. Make sure you disclose your full medical history during your initial visit, and remind them as often as necessary (e.g., if you switch therapists). Be sure that you are comfortable with every aspect of the massage therapy experience. And finally, consider keeping a diary so that you can track symptom improvement.

Sources:

Field, T et al. Massage Therapy Plus Topical Analgesic Is More Effective Than Massage Alone for Hand Arthritis Pain. Journal of Bodywork and Movement Therapies. July 2014.

Field, T, et al. Hand Arthritis Is Reduced by Massage Therapy. Journal of Bodywork and Movement Therapies. January 2007.

Gok Metin Z et al. The Effects of Aromatherapy Massage and Reflexology on Pain and Fatigue in Patients With Rheumatoid Arthritis: A Randomized Controlled Trial. Pain Management Nursing. April 2016.

Massage and Arthritis. American Massage Therapy Association. August 15, 2013. 

Nelson NL et al. Massage Therapy for Pain and Function in Patients With Arthritis: A Systematic Review of Randomized Controlled Trials. American Journal of Physical Medicine & Rehabilitation. February 7, 2017.

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