Full-Body Massage Improves Short-term Knee OA Pain


A weekly full-body massage may be an effective way to help patients with knee osteoarthritis (OA) manage pain, data from a randomized trial show.

Osteoarthritis is a leading cause of disability and affects more than 30 million people in America," lead author Adam Perlman, MD, program director of the Leadership Program in Integrative Healthcare at Duke University School of Medicine, Durham, North Carolina, said in a press statement. "Medications are available, but many patients experience adverse side effects, raising the need for alternatives. This study demonstrates that message has the potential to be one such option."

The study, published online December 12 in the Journal of General Internal Medicine, assessed initial and long-term effects of an 8-week course of weekly 60-minute massage and the efficacy of subsequent biweekly maintenance message.

Standardized Protocol

The message was delivered following a standardized protocol. The active control arm was light-touch treatment in which the massage therapists touched the major muscle groups and joints in a specific sequence but without massaging the muscles. The passive control arm was the continuation of the patient's usual care.

Perlman and colleagues at four institutions enrolled 222 adults with knee OA; 200 patients completed an assessment at eight weeks, and 175 completed an evaluation at 52 weeks. Patients were eligible if they met the American College of Rheumatology radiographic knee OA criteria and had a baseline visual analog scale (VAS) pain score of 40 to 90. Users of nonsteroidal anti-inflammatory drugs or other analgesics were included if the doses of their medications had remained stable for three months.

Exclusion criteria were severe comorbidities, double knee replacements, recent use of corticosteroids or hyaluronate, knee arthroscopy or injury within the past year, or regular use of massage therapy.

At eight weeks, patients in the massage group showed significant improvements in the WOMAC Global Score, which was the primary outcome, compared with the light-touch group (-8.16) and with the usual-care group (-9.55). The difference between the light-touch and usual-care groups (-1.40) was not significant. The massage group also improved significantly more than the light-touch or usual-care groups on the WOMAC subscales for pain (-10.98 and -10.83, respectively), stiffness (-7.53 and -10.53), and physical function (-6.21 and -8.15). The light-touch and usual-care groups did not differ significantly on these subscales.

The message was not significantly better than light touch for reducing pain, as measured on a 0 to 100 VAS (-7.21; 95% confidence interval [CI], -14.93 to 0.52) but was significantly better than usual care (-11.20; 95% CI, -18.53 to -3.08). The light-touch and usual-care groups did not differ significantly on the VAS.

Similarly, massage was not significantly more effective than a light touch on the NIH PROMIS Pain Interference Questionnaire (-0.79) but was more effective than usual care (-2.09). Light feel and usual care were not significantly different on this measure.