Massage Therapy for Managing Arthritis Pain

More than 2,000 years ago, the ancient Greek physician Hippocrates wrote that doctors should be experienced in "rubbing that can bind a joint that is loose and loosen a joint that is too hard." Today, massage is still a popular way to manage arthritis pain. Proponents claim that massage therapy, done correctly, can help improve joint movement, relax tense muscles, and stimulate the flow of blood and nutrients to the skin and underlying tissues. What's more, it just feels good, and the relaxation it brings can help break the cycle of pain and stress that often goes along with arthritis.


Pressing the Flesh

Technically speaking, massage involves the manipulation of soft tissues with the hands through rubbing, stroking, pressure, and so on. Trained practitioners use massage therapy techniques to improve the well-being of clients. Today, there are more than a quarter-million massage therapists in the United States, and nearly one-fifth of American adults now get a professional massage each year. The American Massage Therapy Association (AMTA), the field's leading professional organization, lists arthritis as one of the conditions for which massage can help. But how well does it work? A recent journal article (Medical Clinics of North America, 2002) reviewed the medical literature on the use of massage to manage arthritis pain. The authors concluded that few people would dispute the short-term benefits for arthritis pain relief. However, studies of the long-term effects of the technique are still lacking.

Hands-on Approaches

Massage therapy can take a wide variety of forms. These are some of the most common ones:

  • Swedish massage—This is what most people think of when they hear the word "massage." It's a full-body treatment that combines stroking, kneading, and friction on the top layer of muscles with gentle movement of the joints.
  • Deep tissue massage—This technique uses slow strokes and strong pressure on the deeper layers of muscle tissue. The goal is to release tension there. However, the deep pressure can cause some soreness, so it's not for everyone.
  • Myofascial release—This approach uses long, stretching strokes to release tension in the fascia, the connective tissue around the muscles.
  • Trigger point therapy—This method uses concentrated finger pressure on knots of tension or pain that can trigger pain elsewhere in the body.
  • Acupressure and shiatsu—These Asian techniques use finger pressure on specific points on the body—the same points that are stimulated in acupuncture. The pressure is supposed to unblock the flow of life energy, called qi ("chee").
  • Reflexology—This method involves rubbing certain points on the feet, hands, or ears that are believed to correspond to various parts of the body.

Much-Kneaded Advice

A typical massage therapy session lasts about 60 to 90 minutes. To see real improvement, though, you may need four to six sessions about a week apart. The cost runs $30 to $125 or more per hour, but insurance sometimes covers the treatment if a doctor prescribes it. The first session usually begins with the massage therapist asking questions about your current physical condition, medical history, and goals for the treatment. Next, you'll be asked to remove some or all of your clothing and lie on a padded table. A sheet or towel should be provided, and the therapist should uncover only the part of your body being massaged. This not only protects your modesty, but also helps you stay warm. Often, the therapist will use oil or lotion, so if you know you have skin allergies, be sure to mention them up front. During the massage, don't hesitate to speak up if anything feels inappropriate or causes pain. While massage therapy may provide short-term pain relief, massage therapy that is too rough may aggravate arthritis pain and symptoms.

Hand-y Self-help

In addition to giving you a massage, a good therapist can show you techniques to use on yourself at home. Giving yourself a massage isn't as relaxing as having someone else do it, but it can still help ease pain and tension. Not only will the part being rubbed feel better, but so may your hands, since they're getting a workout in the process. Self-massage works best for localized trouble spots that are easily accessible. For hard-to-reach places, you might ask a partner to lend a hand or buy an electric massager. But don't try massage on an inflamed joint or when you have an infection, since it could make these problems worse.

Here are some simple techniques to try:

  • Kneading—Grasp the muscle between your palm (or thumb) and fingers. Then lift slightly and squeeze, as if you were kneading dough. Don't just pinch the skin. Work into the muscle itself with a slow, regular squeeze-and-release motion. Be careful not to overdo it. Fifteen to 20 seconds on the same spot is enough.
  • Stroking—Cup your hand over the muscle you want to massage. Then firmly glide your hand over the length of the muscle in a slow, repeated movement. A little oil or lotion may help. Try using different amounts of pressure until you find out what works best for you.

One key to a good experience is finding the right massage therapist. Always ask about credentials and education. The main credential to watch for is Nationally Certified in Therapeutic Massage and Bodywork (NCTMB). Also, look for a graduate of a training program that has been accredited by the Commission on Massage Therapy Accreditation (COMTA). In addition, ask about which techniques the therapist uses and whether he or she has experience working with other people who have arthritis.