Having been frantically searching for a decent quality study reporting a positive result, I am delighted to announce that I might have had some luck.
This study examined the effects of whole-body massage on knee osteoarthritis, compared to active control (light-touch) and usual care. Assessments were done at baseline and weeks 8, 16, 24, 36, and 52. Subjects in massage or light-touch groups received eight weekly treatments each lasting one hour, then were randomized to biweekly intervention or usual care to week 52. The original usual care group continued to week 24. Analysis was performed on an intention-to-treat basis. Five hundred fifty-one screened for eligibility, 222 adults with knee osteoarthritis enrolled, 200 completed 8-week assessments, and 175 completed 52-week assessments.
The primary endpoint was the ‘Western Ontario and McMaster Universities Arthritis Index’. Visual analog pain scale, PROMIS Pain Interference, knee range of motion, and timed 50-ft walk were secondary outcome measures.
At 8 weeks, massage significantly improved WOMAC Global scores compared to light-touch and usual care. Massage also improved pain, stiffness, and physical function WOMAC subscale scores compared to light-touch and usual care. At 52 weeks, the omnibus test of any group difference in the change in WOMAC Global from baseline to 52 weeks was not significant, indicating no significant difference in change across groups. Adverse events were minimal.
The authors concluded that the efficacy of symptom relief and safety of weekly massage make it an attractive short-term treatment option for knee osteoarthritis. Longer-term biweekly dose maintained improvement, but did not provide additional benefit beyond usual care post 8-week treatment.
Massage therapy is supported by encouraging evidence from several systematic reviews, for instance:
- One overview identified 31 systematic reviews of massage for pain control, of which 21 were considered high-quality. The most common type of pain included in systematic reviews was neck pain (n=6). Findings from high-quality systematic reviews describe potential benefits of massage for pain indications including labour, shoulder, neck, back, cancer, fibromyalgia, and temporomandibular disorder. However, no findings were rated as moderate- or high-strength.
- A systematic review showed that massage therapy has promise for caner palliation: massage can alleviate a wide range of symptoms: pain, nausea, anxiety, depression, anger, stress and fatigue. However, the methodological quality of the included studies was poor, a fact that prevents definitive conclusions. The evidence is, therefore, encouraging but not compelling. The subject seems to warrant further investigations which avoid the limitations of previous studies.
So, should massage be recommended for knee osteoarthritis?
Yes and NO.
Yes, because it does seem to alleviate pain with only few adverse effects.
No, because it is merely symptomatic and does not cure the problem. Patients who want to treat the ‘root cause’ of knee osteoarthritis (which is often possible) ought to see an orthopaedic surgeon.
Come to think of it, this is almost a general rule: Patients who want to treat the ‘root cause‘ of any disease (which is often possible) ought to see a real doctor and not an alternative practitioner.