NEWARK, NJ—Swedish massage therapy may help decrease pain and improve function among patients with knee osteoarthritis (OA), according to a randomized controlled trial published in the Archives of Internal Medicine.1

"Ultimately, massage may be shown to lessen a patient's reliance on medications and decrease healthcare costs." —Adam Perlman, MD, MPH
The positive results persisted and remained significant even after the massage therapy had ceased, report researchers led by Adam Perlman, MD, MPH, of the Institute for Complementary and Alternative Medicine at the University of Medicine and Dentistry of New Jersey, in Newark.

In the 16-week study of 68 adults with radiographically-confirmed knee OA, patients received either two weekly, 1-hour, full-body Swedish massages for a month, followed by a month of weekly, 1-hour massages or waited 2 months before getting the same massage treatment. The standardized massage protocol includes petrissage (compression or manipulation of soft tissue between the fingers and thumb), effleurage (gliding of hands over the skin), and tapotement (repetitive, percussive, soft striking of the tissues). The primary study outcome measures were changes in the Western Ontario and MacMaster Osteoarthritis Index (WOMAC) pain and functional scores, as well as changes in the Visual Analog Scale (VAS) assessment of pain.

Pain, stiffness, and functional ability were all significantly improved by the massage therapy, the study showed. After the first 8 weeks of massage therapy, participants experienced improved flexibility, less pain, and improved range of motion. Specifically, the study showed that the group receiving massage therapy demonstrated significant improvements in the mean (SD) WOMAC global scores (–17.44), pain (–18.36), stiffness (–16.63), and physical function domains (–17.27). Knee OA patients in the massage group also showed improvements in the VAS pain assessment (–19.38 ), range of motion in degrees (3.57), and time to walk 50 feet (15 m) in seconds (–1.77). By contrast, knee OA patients in the delayed intervention group showed no changes in symptoms. During weeks 9 through 16, they received the massage and experienced benefits similar to those receiving the initial massage therapy.

Cost-benefit analysis next up

"Our results suggest that massage therapy can be used in conjunction with conventional treatment for osteoarthritis," said Dr. Perlman in a written statement. "Ultimately, massage may be shown to lessen a patient's reliance on medications and decrease healthcare costs."

The next step is to determine if massage therapy is cost-effective. "Our hope is to show that this treatment is not only safe and effective, but cost-effective," said Dr. 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."

Safety of massage is key

Study author David L. Katz, MD, associate adjunct professor of epidemiology and public health at Yale School of Medicine and director of Yale's Prevention Research Center, in New Haven, Connecticut, added that "massage is free of any known side effects and according to our results, clearly shows therapeutic promise."

According to Dr. Katz, "so-called 'alternative' treatments like massage are most important when conventional treatments are far from ideal" as is the case with many of the currently available nonsteroidal anti-inflammatory drugs used to treat OA. Dr. Katz made his comments in a written press release.

Reference

1. Perlman AI, Sabina AM, Williams A-L, et al. Massage therapy for osteoarthritis of the knee: a randomized controlled trial. Arch Int Med. 2006;166:2533-2538.