January/February 2013 Pain Research Updates
60-minute Massage Improves Knee Pain
A 60-minute “dose” of Swedish massage therapy delivered once per week for pain due to osteoarthritis of the knee in an NCCAM-funded trial was both optimal and practical, establishing a standard for use in future research.1 This trial builds on an earlier pilot study of massage for knee osteoarthritis pain, which had promising results but provided no data to determine whether the dose was optimal. The researchers defined an optimal, practical dose as producing the greatest ratio of desired effect compared to costs in time, labor, and convenience. Osteoarthritis, a degenerative disease of the joints, is the most common type of arthritis, affecting approximately 27 million Americans.
In the current study, researchers randomly assigned 125 participants with osteoarthritis of the knee to receive one of four 8-week doses of Swedish massage (30 or 60 minutes weekly or twice weekly) or usual care. The usual care group continued with their current treatment and did not receive massage therapy. The researchers assessed participants’ pain, function, joint flexibility, and other measures at the start of the study and then at 8, 16, and 24 weeks thereafter.
At 8 weeks, participants in the 60-minute massage groups (both once and twice per week) had significant improvements in pain, function, and global response compared with participants in the usual care group. Pain intensity had the greatest reduction in the 60-minute, once-per-week group and was significantly reduced compared to both the usual care and 30-minute groups. There was no significant difference in outcomes between the 60-minute groups, which led to the conclusion that the optimal dose of massage was, on average, 60 minutes once per week.
Compared to usual care, all the massage groups had similar reductions in stiffness, though range of motion was not significantly affected by usual care or massage. At 24 weeks, the clinical benefits had reduced for all groups and were not significantly different between the groups, though they were still improved compared to the start of the study.
The researchers noted that there is promising potential for the use of massage therapy for osteoarthritis of the knee and that future, larger trials should use this dose as a standard. Further, they suggest that more definitive research is needed on massage for osteoarthritis of the knee, in terms of efficacy, how it may work in the body, and its cost-effectiveness for patients.