How Massage Therapy Helps Ease Rheumatoid Arthritis Pain

Moderate pressure massage is among the massage therapies that can help relieve rheumatoid arthritis pain. Know what to look for and what to avoid when adding this therapy to your treatment plan.

Massage with firm, but not deep, pressure helps relieve RA pain and stiffness.Trevor Adeline/Getty Images

Massage isn't just an occasional feel-good indulgence — it can be a great form of rheumatoid arthritis treatment. Need proof? According to research published in Complementary Therapy in Clinical Practice, study participants reported relief from pain and stiffness after four once-a-week moderate-pressure massages on arms affected by rheumatoid arthritis, supplemented with daily self-massage at home. They also reported having a stronger grip and a greater range of motion than those who were given only a light-touch massage.

Earlier research, published in the same journal, found that massage had similar benefits for RA pain in the hands and also reported that the combination of weekly massage therapy and daily self-massage led to improved mood and better sleep.

Yet another study, published in the November 2019 issue of Chronic Pain and Management, established that moderate massage of hips also reduced pain and sleep disturbances.

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Massage therapy expert Tiffany Field, PhD, founder and director of the Touch Research Institute at the University of Miami Miller School of Medicine in Florida, led the latter two studies. For the research that looked at massage for RA pain on the arms, she defined moderate pressure as “pressure that moves the skin.” In an earlier study, her team found moderate pressure was more effective than light pressure. However, each person has his own comfort level. “Massage therapists will ask you where you feel pain and also whether the pressure they are applying is enough,” Dr. Field says. If you want to duplicate the results of her research, aim for pressure that is firm but not so deep as to be painful.

Though the bodywork treatment has benefits for people with rheumatoid arthritis, the question of how long those benefits might last remains unanswered. You might need ongoing treatments or tune-up visits when your symptoms of pain and stiffness return. A review of research published in February 2022 in Complementary Therapies in Clinical Practice found that massage therapy for arthritic knees may lead to short-term improvement in pain, stiffness, and functionality but the benefits were not long-term.

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“Massage has been shown to be useful in reducing pain temporarily,” explains A. Lynn Millar, PhD, physical therapist and professor of physical therapy at Winston Salem State University in North Carolina. And best of all, she adds, there's no reason not to include massage as part of your RA treatment. However, The Arthritis Foundation urges you to check with your rheumatologist first before starting any massage therapy to make sure it is appropriate for your individual health needs.

Types of Massage Therapy Treatment Options for Rheumatoid Arthritis

Although there are many types of massage, only two — moderate-pressure massage and myofascial release — have research support for pain relief for RA, but you can explore others as well.

Results are encouraging. For instance, in another study led by Field, published in?Complementary Therapies in Practice, the research team found participants who received a moderate-pressure massage targeted to the knees reported reduced pain and greater range of motion. Researchers speculate that the pain relief may be tied in part to an increase in the brain’s serotonin output, which the authors note is the body’s natural pain suppressant.

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A massage treatment, whether weekly or more frequently, could be a soothing addition to your RA treatment plan.

Consider these four massage choices:

  • Myofascial Release This is a style of hands-on therapy that involves longer pressure on select areas of the body to break up tight connective tissue. Research shows this style of therapy, applied three times a week for two weeks, can provide relief of pain and other RA symptoms. As part of the research, myofascial release physical therapist, Carol Davis, EdD, professor emerita in the department of physical therapy at the University of Miami Miller School of Medicine, studied the use of myofascial release in the treatment of various conditions, including rheumatoid arthritis. She explains that many researchers and therapists believe pressure-induced mechanotransduction (the process by which cells convert physical cues into a biological response) works to lessen stiffness and reduce pain. Myofascial release could be effective by stimulating blood flow and triggering the body’s natural anti-inflammatory actions, she suggests.
  • Swedish Massage The best-known massage technique, Swedish massage uses long strokes of varying pressure to ease and unknot muscles. You might ask for a moderate-pressure version of this style to achieve results similar to those in the research studies. Massage therapists who use this style might include lotions or oils during the session.
  • Hot Stone Massage This style of massage combines hands-on therapy for knotted muscles with the application of hot stones that can relax muscles and ease pain. Hot stone massage is sometimes offered at spas. Dr. Millar advised caution with heat, however, as it might aggravate inflamed joints.
  • Deep-Tissue Massage Deep-tissue massage uses intense pressure and tissue manipulation to address stiffness and soreness. However, if the pressure seems too great, don’t continue with this style of massage.

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Finding the Right Massage Therapist

Try these strategies to get the best massage treatment for you:

Ask for referrals. Talk to your medical team, physical therapist, or others with rheumatoid arthritis to get a recommendation for a massage therapist.

Check with professional associations. The American Massage Therapy Association and the Associated Bodywork Massage Professionals can provide names in your area, as well as their qualifications and credentials. The National Certification Board for Therapeutic Massage and Bodywork can tell if a massage therapist is certified.

Look for experience with RA. “You want a massage therapist who understands the rheumatoid arthritis disease process,” Millar notes.

Be up front about your goals. Discuss what you hope to achieve with the therapist so you can work together as a team.

RELATED: Can Mindfulness Meditation Ease Arthritis Pain?

When You Go for Your Massage Treatment

Explain your pain. Be specific about the joints that hurt and how much they hurt. For example, even though moderate-pressure massage is helpful, Millar warns that deep pressure or high heat applied to joints that are actively inflamed could actually make pain and swelling worse. Be sure to tell your masseuse if you feel pain at any time during the massage.

Drink lots of water to avoid dehydration. Dr. Davis explains that massage with any degree of pressure will affect the water flow in your body and will be more effective if you are well-hydrated. It’s important for people to drink six to eight glasses of water a day, notes Davis, to stay hydrated.

DIY Tips and Pointers for Self-Massage With RA

Self-massage also can help relieve pain and improve movement, whether done alone or in between massage therapy sessions, says Bob McAtee, CSCS, licensed massage therapist and owner of Pro-Active Massage Therapy in Colorado Springs, Colorado, who offers these suggestions:

  • Moderate pressure is more effective than light. However, don’t push too deep. Stop or lighten up if it feels painful, to avoid irritating inflamed joints.
  • Use longer strokes rather than short pinpoint pressure. Your aim is to mobilize tissue and warm up the whole area, as opposed to specific pressure against certain joints.
  • If needed, just a little direct moderate pressure at the end of the self-massage after tissue is warmed up can be helpful. Do only 15 to 30 seconds at a time on a hot spot, as long as it isn’t painful. You should be comfortable at all times.
  • Massage only for more than 5 to 10 minutes total at any given time on any given spot.
  • If RA is in your hands and fingers make massage difficult, place one hand palm up on thigh and use your forearm to massage the palm. Flip your palm down and massage the back with your forearm. You can also use a handheld portable massager for other areas.
  • Gently warm up the area with topical painrelievers. (McAtee likes Cryoderm Heat.)
  • In general, the best times to massage are in the morning, when you wake up feeling stiff, and in the evening, to encourage comfortable sleep.

Additional reporting by Deborah Shapiro.