Can Massage Help You With Arthritis
Can massage help people with arthritis?
Types of arthritis
The two most common types of arthritis are:
- rheumatoid arthritis
Osteoarthritis is the most common type of arthritis in the UK, affecting around 8 million people.
It most often develops in adults who are in their late 40s or older. It’s also more common in women and people with a family history of the condition. However, it can occur at any age as a result of an injury or be associated with other joint-related conditions, such as gout or rheumatoid arthritis.
Osteoarthritis initially affects the smooth cartilage lining of the joint. This makes movement more difficult than usual, leading to pain and stiffness.
Once the cartilage lining starts to roughen and thin out, the tendons and ligaments have to work harder. This can cause swelling and the formation of bony spurs, called osteophytes.
Severe loss of cartilage can lead to bone rubbing on bone, altering the shape of the joint and forcing the bones out of their normal position.
The most commonly affected joints are those in the:
In the UK, rheumatoid arthritis affects more than 400,000 people. It often starts when a person is between 40 and 50 years old. Women are three times more likely to be affected than men. Rheumatoid and osteoarthritis are two different conditions. Rheumatoid arthritis occurs when the body’s immune system targets affected joints, which leads to pain and swelling. The outer covering (synovium) of the joint is the first place affected. This can then spread across the joint, leading to further swelling and a change in the joint’s shape. This may cause the bone and cartilage to break down.
People with rheumatoid arthritis can also develop problems with other tissues and organs in their body.
There’s no cure for arthritis, but there are many treatments that can help slow down the condition.
Treatment for rheumatoid arthritis aims to slow down the condition’s progress as well and minimise joint inflammation or swelling. This is to try and prevent damage to the joints.
Many people with rheumatoid arthritis try complementary therapies, such as:
In most cases, there’s little or no evidence these are effective in the long-term, although some people may experience a short-term benefit from them.
Research and studies on the effect of massage for arthritis symptoms
Regular massage of muscles and joints can lead to a significant reduction in pain for people with arthritis, according to Tiffany Field, PhD, director of the Touch Research Institute at the University of Miami School of Medicine, who’s conducted a number of studies on the benefits of massage, including on people with arthritis. In Field’s research and other recent studies on the effects of massage for arthritis symptoms, regular use of the simple therapy led to improvements in pain, stiffness, range of motion, hand grip strength and overall function of the joints.
While most research on massage examines its effects on the general population, not specifically people with arthritis, recently more studies are underway to study the effectiveness of massage for people with arthritis. For example, one 2006 study conducted at the University of Medicine and Dentistry of New Jersey examined 68 adults with knee osteoarthritis receiving two Swedish massages per week for eight weeks, compared to a group who received no massage. The massage group reported significant improvements in knee pain, stiffness, function, range of motion and walking, the researchers found.
How Does Massage Work?
While some studies show that massage can reduce pain and anxiety for people with arthritis, how exactly does massage make these results happen? Research has shown that massage can lower the body’s production of the stress hormone cortisol, and boost production of serotonin, which, in turn, can improve mood. Additionally, massage can lower production of the neurotransmitter substance P, often linked to pain, and improve sleep as a result.
In 2010, researchers at the University of California, Los Angeles, School of Medicine and the nearby Cedars-Sinai Medical Center studied 53 healthy adults receiving just one Swedish massage therapy session and found that the participants’ levels of key hormones and white blood cells were positively affected. For example, the hormone arginine-vasopressin, which may lower blood pressure, was decreased, along with some inflammatory cytokines like IL-4 and IL-10. Cortisol levels were reduced by massage in this study as well, although not significantly.
Massage’s mechanism for reducing stress is still unclear, says Christopher Moyer, PhD, a psychologist at the University of Wisconsin in Stout, Wis. “We know that massage reduces anxiety quite well and can reduce certain painful conditions rather well. But we don’t know how those things are happening,” says Moyer, a former competitive cyclist who uses massage to ease his own muscle aches.
In his study published in 2010, Moyer and his colleagues determined that massage therapy could slightly reduce levels of cortisol. However, this reduction was so slight that the researchers determined that its effects on cortisol levels was not the reason why massage seemed to reduce anxiety and stress.
“Cortisol is a key stress hormone, but it doesn’t mean that if we know a person’s cortisol level, we know how much stress this person is having,” he says. “Massage must be working in some other way.”
There are many variables involved in how massage may work to ease pain, stiffness and anxiety, says Rosemary Chunco, a licensed massage therapist in Plano, Texas, who treats many patients with arthritis and related diseases. “The actual mechanism that comes into play is still under investigation. For example, a more restful sleep that results from a massage may help with arthritis pain.”
Best Types of Massage for Arthritis
If you’re interested in trying one of the many types of massage as a way to ease your arthritis symptoms, it’s important to consult your rheumatologist or primary-care physician first to ensure that massage is safe for you. Some techniques may involve strong pressure to sensitive tissues and joints, or moving limbs into various positions that may be difficult for someone with damaged joints from a disease like rheumatoid arthritis or ankylosing spondylitis.
Use caution when considering massage if you have:
- Damaged or eroded joints from arthritis
- Flare of inflammation, fever or a skin rash
- Severe osteoporosis (brittle bones)
- High blood pressure
- Varicose veins
“It’s always a good idea to get the thumbs up or down from a doctor if you are having even the slightest worry about using massage for your condition,” says Chunco. “It’s also very important to tell the therapist if you are experiencing pain or if you are uncomfortable with the work that she is doing. A good therapist will want feedback on what you are feeling during the session.”
Be sure to have a conversation with your massage therapist beforehand about your arthritis, and what parts of your body are most affected by the disease, advises Field.
“Therapists should be very cognizant and careful, as they all have a list of contraindications for massage in their brains already,” she says. “They can usually tell if you have an area of inflammation” but it’s wise to discuss it first, she says. In addition, if you have any concerns about the therapist using scented oils or lotions that might cause a rash, speak up – these lubricants are commonly used but are probably not necessary.
Your goals for massage may vary. You may be interested in relieving anxiety and stress caused by dealing with arthritis, or you may be seeking relief for pain and stiffness in a specific area of your body. Talk openly with your massage therapist about your goals for the session so she can adjust the technique accordingly. There is no set way to perform a massage; she should be flexible to your needs.
Most importantly, massage should make your arthritis pain and stiffness feel better, not worse, says Veena Ranganath, MD, a rheumatologist at the University of California, Los Angeles Department of Medicine. “I do tell my patients that if it hurts, don’t do it,” says Dr. Ranganath. Your doctor also can refer you to a massage therapist, which may not only lead you to a qualified professional, but also help you qualify for reimbursement if your insurance policy covers massage treatments.
Massage is not medicine. It’s a complement to your doctor-prescribed arthritis treatment. You should enjoy experiencing a massage, and it should not increase your pain or anxiety. Communication with your doctor and massage therapist beforehand can ensure that massage is right for you and help you achieve beneficial results.
Like many people with arthritis, Connie DeIanni has days when her pain is hard to manage. One tactic she uses to fight her pain, as well as the stress that comes along with it, is a soothing massage.
“I’ve used massage as a therapy, but more for the sore muscles that are compromised due to flares,” says DeIanni, a Farmington, Utah, bank employee and college student who has rheumatoid arthritis. “There’s a calming effect on the tension and stress of the constant pain that is rewarding.”
Although there is no diet cure for arthritis, certain foods have been shown to fight inflammation, strengthen bones and boost the immune system. Adding these foods to your balanced diet may help ease the symptoms of your arthritis.
Source: NHS choices – your health, your choice, nhs.uk, Arthritis Foundation, arthritis.org, NCCAM Report 2007.