JGIM paper: Massage Helps Ease Knee Osteoarthritis Pain

Sunday, December 23, 2018

Need a medical reason for a massage? A new report just published in the Journal of General Internal Medicine suggests massage could complement treatment for patients with knee osteoarthritis.

This was a collaborative study across four institutions including co-author Oliver Glass, PhD, assistant professor in medicine (general internal medicine), Director of Research, Duke Health and Wellness and Duke Integrative Medicine. The paper's lead author, Dr. Adam Perlman is adjunct associate professor of medicine also in the division of general internal medicine. The other sites with participating investigators in this NIH research included Yale, Rutgers, and the Atlantic Health system in New Jersey. 

Massage is popular but is it efficacious?
Osteoarthritis affects over 30 million Americans and is one of the leading causes of disability. Due to concerns over side effects of medications and potentially invasive treatments, there has been increased interest in other treatment modalities to combat pain and stiffness associated with osteoarthritis. Massage therapy is perhaps the most popular one for osteoarthritis, but its efficacy had not been rigorously tested in a randomized controlled trial until this study.

Here's what was found:

Over 200 patients were randomized to one-hour massage, light-touch, or standard of care for 8 weeks. After 8 weeks, groups were re-randomized to massage or light-touch every-other week, or standard of care for the remaining 44 weeks (52 weeks total). Patients were assessed using every two months using a questionnaire called the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). The WOMAC is a survey to measures pain, stiffness and function.

At 8 weeks massage improved pain!

At 8 weeks massage improved pain, stiffness, and function compared to light touch and standard of care. At 52 weeks, there were no between group differences. Overall, massage improved pain, stiffness, and function quicker than light touch or usual care. However, the maintenance massage dose of every other week for the remaining 52 weeks may have been too infrequent. It is possible that the same initial dose of weekly massage for 1-hour may be needed to see continued benefit. 

Full citation, a first online 12/12/18:
Perlman, A., Fogerite, S.G., Glass, O. et al. J GEN INTERN MED (2018). https://doi.org/10.1007/s11606-018-4763-5
PMID: 30543021