Massage for Osteoarthritis and Joint Pain: What Is Known

Check First: A Hot, Swollen or Suddenly Painful Joint

Do not book a massage for a joint that has suddenly become very painful. The NHS lists sudden severe pain in a joint, hot, swollen or red skin over the joint, and a fever as signs of septic arthritis, an infection in the joint, and says you need urgent medical help if you think you have it. [1] Redness may be harder to see on black or brown skin. If you cannot move the joint, or you also feel unwell, get medical help first. In the US, call 911 for an emergency.

Massage is at most an add-on. It does not replace the care for arthritis from your doctor or physical therapist, and nothing here is a reason to stop or change a medicine.

What Osteoarthritis Is and What Massage Is Asked To Do

Osteoarthritis (OA) is joint pain and stiffness, most often discussed for the knees, hips and hands. The NHS says exercise is one of the most important treatments for people with osteoarthritis, whatever their age or fitness. [2] Massage is usually looked at as a comfort measure for pain and stiffness, not as a way to repair a joint. No source we read says massage reverses joint wear.

What the Research Found

Evidence label: promising but limited, mostly short-term. NCCIH (the US National Center for Complementary and Integrative Health) says very few studies have evaluated massage for OA. [3] For the knee, it reports that 5 of 6 studies (408 people in total) found short-term pain relief, and that two of those used essential oils. [4]

1. Does a course of Swedish massage ease knee OA?

   One trial, moderate size

   A trial of 125 adults with knee OA compared four 8-week massage schedules with usual care. [5] Global WOMAC scores (a standard questionnaire on pain, stiffness and function) improved more in the 60-minute groups at 8 weeks. [5]

2. Did the benefit last?

   Benefits faded

   No significant effects were seen on any outcome at 24 weeks compared with usual care. [5]

3. Does manual therapy beat usual care?

   Low

   A review of 25 studies (2,376 people) found manual therapy may reduce knee OA pain, but the quality of the studies was limited. [6]

4. Is it safe in these studies?

   Small numbers, short follow-up

   No serious adverse events were reported in that review. [6]

Two cautions apply. First, "manual therapy" in that review covers hands-on treatment broadly, not only massage, so it is a clue rather than proof about massage alone. Second, nobody can be blinded to massage, and the comparison was usual care, so expectation and the pleasure of being cared for may account for some of the relief. Pain scores are self-reported.

Aromatherapy massage. One trial of 90 people with knee OA compared lavender oil massage, almond oil massage and no massage. [7] Four weeks after the intervention there was no significant difference between the groups. [7] Oils add skin-reaction questions: see essential oil safety and aromatherapy.

After knee replacement. A review of seven trials (285 patients) of manual lymphatic drainage (a specialised massage technique), found no advantage for swelling, pain or movement and did not recommend it for rehabilitation after knee replacement. [8] Ask your surgical team before any massage near a new joint or scar; see massage after surgery or injury.

Other joints and other kinds of arthritis. Proper evidence not found for massage in hip, hand or shoulder OA, or for inflammatory arthritis such as rheumatoid arthritis. We searched PubMed for massage with osteoarthritis and arthritis and the results we read concerned the knee, manual therapy in general, or surgery recovery.

How It Fits With Other Options

Exercise and physical therapy have the strongest place in OA care, per the NHS. [2] The NHS describes manual therapy as a physiotherapist using their hands to stretch, mobilise and massage tissues to keep joints supple. [2] For other options we cover, see warm-water exercise for OA and acupuncture for knee OA. For the wider picture, see massage evidence by goal.