Knee pain and massage therapy

A recent study conducted by investigators at the Touch Research Institute showed that a 30-minute session of massage therapy once a week for four weeks resulted in decreased knee osteoarthritis pain, as well as increased range of motion.

The study’s authors were Tiffany Field, Ph.D., Miguel Diego, Gladys Gonzalez and C.G. Funk.

Prevalence of Knee Arthritis

Osteoarthritis is the most common joint disorder in the U.S., according to experts, and knee osteoarthritis is present in 13 percent of woman and 10 percent of men aged 60 and older.

According to the article “Epidemiology of Osteoarthritis,” published in the Clinics in Geriatric Medicine, “Old age, female gender, overweight and obesity, knee injury, repetitive use of joints, bone density, muscle weakness, and joint laxity all play roles in the development of joint osteoarthritis, particularly in the weight-bearing joints.”

Previous research on Feldenkrais Method and Thai massage have indicated that other forms of health touch for osteoarthritis benefits people suffering from this condition.


Study Design

The Touch Research Institute study, “Knee arthritis pain is reduced and range of motion is increased following moderate pressure massage therapy,” involved 48 females with an average age of 47, all of whom had been diagnosed with knee arthritis pain, and looked at massage for arthritis in the knee.

The women were randomly assigned to either a massage for arthritis group or a wait-list control group.

Those in the massage group received 30 minutes of massage therapy once a week for four weeks, using a 15-minute protocol two times in a row for each session.

The protocol “consisted of moderate pressure stroking (moving the skin) focused on the quadriceps, the hamstrings, and the tendons and ligaments surrounding the patella,” according to the study’s authors.

Outcome Measures

The outcome measures in this massage for arthritis in the knee study included range of motion (ROM) and ROM-associated pain, along with knee flexion and physical performance. These were measured both before and after massage on the first and last days of the four-week study period.

Two self-report measures were completed right before massage on the first and last days of the study as well—the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and the Pittsburgh Sleep Quality Index (PSQI).

In the wait-list control group, the same evaluations and self-report measures took place one time on both the first and last days of the four-week study period.


Massage for Knee Arthritis

Within the massage for arthritis group, the intervention resulted in significant immediate changes, such as an increase in internal rotation ROM on the first day of the study; an increase in standing flexion ROM on the last day of the study; and an increase in supine flexion ROM on both the first and last days of the study.

The research also revealed that external rotation pain decreased in the massage group and increased in the wait-list control group over the four-week study period.

Internal rotation ROM increased in the massage group throughout the intervention period as well. Internal rotation pain decreased in the massage group during the four-week period and increased in the wait-list control group. Both standing flexion ROM and supine flexion ROM increased for the massage group throughout the intervention period.

As far as performance, as measured by the adapted Short Physical Performance Battery, the data suggested that the massage group, as opposed to the wait-list control group, experienced decreased sitting pain, reduced time walking an eight-foot distance, and decreased standing-on-one-leg pain.

Standing-on-one-leg pain actually increased in the wait-list control group.

On the self-report measures, the massage group versus the wait-list control group had a decreased WOMAC pain score, a decreased WOMAC activity score, a decreased WOMAC total score and a decreased sleep disturbance global score.


Massage for Greater Effects

“The clinical implications of these data include the advisability of using moderate pressure massage and focusing the massage on both the hamstrings and the quadriceps to achieve the ROM effects,” stated the authors.

“As in our previous research, the addition of self-massage on the days between massage therapy sessions might lead to even greater therapy effects.”

Studies such as this indicate that massage therapists can play an important role in reducing knee arthritis’ pain and stiffness.

Sources: University of Miami School of Medicine, Fielding Graduate University and Massage Envy. Originally published in November 2015 in Complementary Therapies in Clinical Practice, 21(4), 233-237.