Massage Treatment for Arthritis

Massage can increase blood flow and increase warmth to a stressed area, which may help relieve the pain associated with arthritis.  Because there are many types of massage, some are likely to be more suitable than others.  A recent (2012) study found that a 60 minute treatment of Swedish massage therapy once a week for pain related to osteoarthritis of the knee gave the optimal results.  These treatments had resulted in significant improvements in pain, function and global response.  Massage can also help with the sore muscles that result from flare-ups in arthritis.

Massage therapy is a broad discipline which includes various forms of hands-on therapy, all of which are based on manually manipulating soft-tissues and muscles to ease pain and promote relaxation.   Massage promotes blood flow, loosens muscles and joints and promotes the clearing of lactic acid and other waste products which can impair joint and muscle movement and cause pain. It also lowers stress, possibly by restricting the functioning of cortisol - a stress hormone as well as enhancing the function of the immune system.

What You Can Do Right Now

Frequently Asked Question about Massage

What is a Massage Session Like?

Because of the many different types of massage therapy, this question can only be answered very broadly.  The experience can differ widely depending on the type of massage therapy you have decided to try.

During your first massage therapy session, you can expect that the massage therapist will gather some preliminary information.   They may ask you questions to identify your current condition/challenges, your over-all health and what benefits or results you want to gain from the massage therapy session. The massage therapist (particularly for types of therapeutic massage as opposed to massage purely for relaxation/enjoyment) is also likely to ask about your physical condition, medical history, stress levels, lifestyle, medications taken and any physical pain that they need to be aware of during the massage therapy session.

A typical massage therapy session will last between 40 and 90 minutes depending on the type of massage, the reason you are going for massage, your present condition and your desired result. Massage therapy generally requires you to undress (for some massage types you keep your underwear on, for others you undress completely - this option may also depend on your level of comfort with the massage and with undressing) but your privacy will generally be maintained with a light covering. You will be asked to lie face down under a sheet on a padded massage table. A light oil or lotion may be used and applied to your skin to start the massage. A full body massage usually starts on the back then eventually moves down to the legs then you will be asked to turn over face up to continue with the massage of your arms, legs and neck. During the massage session, you are under the sheet all the time and only part of the body being massaged or treated is uncovered.

Is Massage Therapy Painful?

Massage therapy should not hurt (with certain exceptions for types of massage therapy like deep tissue massage or Swedish massage). Occasionally there will be a mild ache when therapist applies pressure to body points, over "knots" and other areas of muscle tension but it should not be painful. Although the degree of pressure being applied varies widely with the type of massage, it is always a good idea to draw the attention of the massage therapist to any pain and they can then tell you whether that is to be expected with that type of massage or they can ease off on the pressure.

what Does Massage Therapy Cost?

The frequency of massage sessions will vary depending on the condition being treated. The cost per session also depends on the methods that will be used (i.e. Swedish, Deep tissue, etc) but other than luxury massages (i.e. at spas), the cost generally ranges from $30 to approximately $130 per session.

Is Massage Therapy Covered by Insurance?

Most extended health insurance plans in Canada and the United States cover some or all of the costs of therapeutic massage depending on the type of plan and massage.  Ask your employer or contact your provider for details on how the coverage works.  Massage for relaxation and enjoyment may or may not be covered.  Generally for the massage to be covered by your insurance, you need to be seeing a licensed Massage Therapist.

How to Select a Good Massage Therapist

There are a variety of considerations when selecting a massage therapist.  These include considerations about the massage therapist's training and certification, questions about their fit with you (i.e. chemistry - is this someone you will trust and be able to relax with), and possibly their answers to questions you may want to ask them.

Personal referrals from friends or health professionals are a great way to find massage therapists.  Equally, looking at reviews of massage therapists on VitalityLink.com can help you see what past clients have to say about the massage therapist.  Reading articles they have written can also give you a sense of their personality and degree of expertise and knowledge.  You can also ask the massage therapist questions that are important to you.  Some questions that you may want to consider include:

  • What certifications do you hold?  
  • How long have you been practicing?  
  • What types of oils or lotions do you use?  
  • What are your rates? Is there a payment option?
  • Do you have experience in providing massage to people with (my physical condition)?

If you are considered about whether or not you will have to undress fully, you can also ask about that.

Licensing and training differs for massage therapists depending on 

  • the location you are in, and
  • the type of massage the therapist offers

Different countries, states and provinces have varying but usually similar requirements that need to be met before a massage therapist can be certified.  This usually involves a combination of training, practical experience and some type of certification and/or licensing. In most states in the US, Massage therapists are required to have a license to practice. Most states also require massage therapists to have at least 500 to 1000 hours of training which has resulting in them obtaining a certificate, diploma or degree depending on the school they attended. The Commission on Massage Therapy Accreditation (COMTA) is one of the organizations that regulates and works with massage therapy schools in the U.S.

The website of the American Massage Therapy Association (AMTA) provides a state-by-state guide to requirements for therapist education and experience and National Certification Board for Therapeutic Massage and Bodywork (NCBTMB).

Generally, it is advisable to seek a massage therapist who has trained at least 500 hours and to look for someone who is CMT (a Certified Massage Therapist).

Licensed therapists will have the initials LMT after their name (which stands for Licensed Massage Therapist) or LMP, which stands for Licensed Massage Practitioner.

In late 2007, the Federation of State Massage Therapy Boards (FSMTB) launched a new certification exam titled the MBLEx. To date, there are fewer than 10 states that are not regulated by the FSMTB.

Training for massage therapists consists of courses in body mechanics and motion, massage techniques, ethics and the study of organs and tissue.  

Because of the pain of arthritis and the many types of massage, it is important to do three things when trying massage for arthritis:

  1. Select your massage therapist carefully
  2. Select a type of massage that will be appropriate for arthritis
  3. Start gently and be aware of how your body is responding

Check out the regulations for massage therapists in your location, and make sure that the massage therapist you are considering seeing is both well trained and certified, as well as, ideally, having experience with massage for arthritis.

Do some research into different types of massage.  Many people who suffer from arthritis recommend types of massage such as Shiatsu, Trigger Point Therapy, Bowen Therapy, Deep Tissue Massage and Swedish massage.

History of Massage

No one really knows definitively how Massage Therapy started and where it originated. There is evidence and writings about massage that have been found in many ancient civilizations including China, Greece, Rome, India, Japan and Egypt, to name a few. The first known record of massage in China was during the second century in a Chinese book “The Yellow Emperor's Classic of Internal Medicine” and in Egypt there are paintings of people being massaged found in tombs. Massage Therapy was one of the popular methods used for relieving pain by Greek and Roman physicians. Regardless of the mystery of the exact origin, it is clear that Massage Therapy is one of the oldest traditional holistic treatments.

Over the years, many different types of massage therapy have been developed, refined and or named. In the early 19th century, for example, Per Henrik Ling (known as the father of therapeutic massage) developed a method of massage that is now called Swedish massage.

Massage began to become popular in the United States in the mid 19th century when it was introduced by two New York physicians.

There are many methods of massage that have been practiced from antiquity up until the present in different parts of the world.  A few examples include:

  1. Acupressure, a traditional Chinese medicine.
  2. Anma, a traditional Japanese massage which involves deep tissue work
  3. Ayurvedic massage comes from a natural health care system which originated and is widely practiced in India (using aromatic oils and spices) 
  4. Balinese Massage, in which the massage movements include skin folding, kneading, stroking and other techniques
  5. Deep tissue massage which focuses on the muscles located below the surface of the skin. 

Theory behind Arthritis Treatment using Massage

Massage therapy can ease the effects of arthritis by combating symptoms and even potentially dealing with some of the causes of the condition.

In terms of the symptoms of arthritis, massage is able to loosen joints by breaking up adhesions in muscles or ligaments. Massage can also stimulate the production of synovial fluid providing additional cushioning between joints and reducing stiffness. Massage therapy is also known to stimulate production of endorphins which reduce pain and it can reduce muscle spasms which can exacerbate the symptoms of arthritis.

The secondary psychological effects of Arthritis can also be treated effectively using massage including a reduction in stress hormone production, improving the function of the immune system, allowing patients to sleep longer and better and lowering blood pressure.

Research of Arthritis Treatment using Massage

Many studies have shown that massage can be effective in treating various forms of arthritis - below are summaries of a few of these studies.  Massage is accepted as an effective form of treatment for the symptoms of arthritis.

Effect of stiletto needle intervention combined with massage on dysfunction and pain of knee-joints in patients with knee osteoarthrosis, published in 2012

Summary: This study was done to determine the effectiveness of stiletto needle stimulation combined with massage for the treatment of the dysfunction and pain of knee joins in knee osteoarthritis patients.  One hundred patients with knee osteoarthritis were randomly divided into treatment and control groups; one group receiving massage combined with stiletto needle stimulation and the other group receiving massage therapy alone.  Both groups had improvement in the measures of displacement values and scores of pain and joint movement and malformation.  The researchers concluded that 'Stiletto needle intervention in combination with massage can effectively relieve dysfunction and pain of the knee joint in knee osteoarthritis patients."

Source: http://www.ncbi.nlm.nih.gov/pubmed/22574571

Massage Therapy for Osteoarthritis of the Knee: A Randomized Dose-Finding Trial, published in 2012

Summary: This study was a follow-up to another study where the researchers "demonstrated feasibility, safety and possible efficacy, with benefits that persisted at least 8 weeks beyond treatment termination [of massage therapy for osteoarthritis]."  This study was done to determine the optimal dose of massage within an eight week treatment regimen and to further examine the durability of response.  There were 125 participating patients.  The study found that the best results (decreases in pain and improvements in functionality) were found with a once a week massage session of sixty minutes.

Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3275589

Juvenile rheumatoid arthritis: benefits from massage therapy, published in 1997

This study showed massage to be effective in reducing levels of cortisol (stress hormone) and anxiety and easing pain in children with juvenile arthritis.

Source: http://www.ncbi.nlm.nih.gov/pubmed/9383925

Stories of Arthritis Treatment using Massage

There are many stories about the efficacy of massage for arthritis - here is a small sampling of some of those anecdotes.

One woman uses massage as a regular arthritis therapy, but says that the biggest benefits for her come from the relief for sore muscles that have been compromised during flares.  She says it gives her a 'calming effect on the tension ans tress of the constant pain that is rewarding'.

Another woman says that she has been receiving Swedish massage for over 20 years for her rheumatoid arthritis.  "The relaxed feeling I get afterwards along with the pain reduction is priceless."

Another person recommends a combination of Swedish/Shiatsu massage, and recommends soaking in a warm bath afterwards to prolong the pain relieving effects.

Anorhter woman says that it is amazing how much it helps (she gets massage at least twice a month) and how much better she feels after a massage.  Not only does the massage relieve pain, but she says it helps her avoid getting sick as much and that she highly recommends it.

It is very important for massage for arthritis to be careful about selecting your practitioner and to be aware of your personal pain thresholds and then to try it gently and select the type of massage carefully.

If you have stories to share about the use of massage for arthritis, please do so below.

Questions and Comments about Massage for Arthritis

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