Can an age-old therapy reduce the pain associated with arthritis of the knee better than the usual medical care? According to one recent medical study, massage was significantly better than the usual medical care in reducing the pain and loss of function associated with knee arthritis or osteoarthritis.
Massage is possibly the oldest medical therapy known to man. Egyptian hieroglyphs from 2330 B.C. show that massage was commonly used. Massage is part of every culturally based medical system in the world, including Western medicine. Massage is one of the most commonly used nontraditional therapies used today, and until about 1929, it was taught in medical schools to physicians. Surprisingly, there is little medical research on its use in pain conditions, like arthritis of the knee.
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The pain and loss of function associated with arthritis of the knee is increasingly common. Knee pain affects more than 27 million Americans and is increasing. As we live longer, the chance of osteoarthritis increases. Obesity, sedentary lifestyles and chronic inflammation are also risk factors for knee pain and the number of people affected by osteoarthritis may double in the next 10 years. The annual medical costs exceed $180 billion.
Traditional medical therapies for osteoarthritis include anti-inflammatory medications, physical therapy, rest, heat, ice and activity as tolerated. Unfortunately, the bulk of the medical therapy consists of anti-inflammatory medications. These medications can have significant side effects and are sometimes fatal.
Each year, an estimated 100,000 Americans are hospitalized and between 15,000 and 20,000 die each year from ulcers and gastrointestinal bleeding linked to NSAID use, even at the correct dose. Treating the side effects of NSAID medication exceeds $4 billion per year. It seems that this medical approach is less than optimal.
The lead author of this current medical study is an old friend of mine, Dr. Adam Perlman. He heads up the integrative medicine program at Duke medical school. His study enrolled 125 patients with stable osteoarthritis of the knee. They were randomly separated into four different Swedish massage protocols and one group, as a control, continued the usual medical care.
The study discovered that 60 minutes of massage, once or twice per week for eight weeks seemed to yield the best results. However, all of the massage protocols were better than the usual medical treatment. The massage groups had significant reductions in pain and increases in some measures of function compared to the usual medical treatment. These improvements persisted in all massage groups for at least eight weeks beyond the massages. For those receiving the 60-minute massages, the benefits were still apparent 16 weeks after completion of the massages.
This study demonstrated that, for osteoarthritis of the knee, a simple, nontoxic procedure is better than the usual medical care. In addition, the lack of side effects makes massage more attractive than the usual medical care. It should be a "first line" therapy.
• Patrick B. Massey, M.D., Ph.D is medical director for complementary and alternative medicine for the Alexian Brothers Health System. His website is www.alt-med.org.