People often think of massages as a luxury. But for people living with arthritis or related musculoskeletal pain, the right type of massage isn’t just a way to pamper yourself — it can help you manage your condition, says Freesia Vickman, a licensed massage therapist for Soothe, who has specialized in clients with arthritis for years. “Massages can help reduce pain and inflammation by releasing the muscles around the joints and helping to increase blood flow to them,” she explains.
Consider these studies: People with osteoarthritis in their knees who got a one-hour Swedish massage once a week for eight weeks reported less pain, greater mobility, and a better range of motion than people who didn’t get a massage, according to a study from Duke University researchers published in the journal PLoS One. Research in the journal Pain Medicine found that people with chronic low back pain had improvement in their symptoms after they received a series of 10 massages.
Massage therapy can help with inflammatory types of arthritis as well. A case study published in Massage Today found that regular massage helped alleviate pain and swelling from rheumatoid arthritis and also helped improved joint function, sleep quality, and daytime energy levels.
For people with arthritis and other chronic illnesses, consider thinking of massage not as a sometimes “treat” but rather a part of your overall treatment plan, Vickman says.
To help you get the most out of your time on the table, we asked massage therapists to share what they wish their clients with arthritis knew.
Before Your Massage
1. Be consistent: Make regular appointments (and keep them)
To get the most benefit from your massages, you need them on a regular ongoing basis, Vickman says. In the Duke study, researchers compared the following groups: people who got a 60-minute weekly massage, people who got a 30-minute weekly massage, people who got infrequent massages, and people who got no massages at all. They found that the group who did an hour a week saw the best results.
However, just because a little is good doesn’t mean more is better. Going for very long sessions or multiple times a week isn’t necessarily a good idea, says Vickman, because your muscles need time to recover and repair between sessions.
2. Not all massages are created equal — and the best one for you depends on your symptoms
There are dozens of different types of massage and there may be one that works better for your particular symptoms, says Jamie Bacharach, an acupuncturist and shiatsu massage therapist in Jerusalem, Israel. “The type of massage you need will depend on what kind of arthritis you have and the severity of your disease,” she explains. The first step is to find a massage therapist who has experience treating arthritis, she says. Tell them your concerns before you lie down on the table. She also recommends consulting with your doctor about what kind of massages would be safe and effective to treat your personal case of arthritis.
3. Tell your massage therapist about any current injury or joint damage
If you know that you have significant damage to a particular joint or have an injury, you need to tell your massage therapist before you start, says Margo Benge, a massage therapist in Houston, Texas. “We would need to adjust the type of massage and the level of pressure used,” she explains. “If you have severe damage from arthritis, you absolutely need to have a therapist with specific skills and training in treating arthritis.”
4. Let your therapist know about rashes, bruising, or cuts
If your arthritis (or other health condition) causes any type of skin issue, you should let your massage therapist know in advance, says Beth Rose, a licensed massage therapist in Coral Springs, Florida. “Tell us what it is and how you would like us to handle it,” she says. “For instance, should we avoid using lotion in that area or would you like it to stay covered or just use a lighter touch there?” This means the therapist won’t have to interrupt your massage to ask you.
During the Massage
5. Don’t be afraid to go deep
Both clients and massage therapists may be hesitant to use anything but a light touch so as not to cause additional pain. But a little extra pressure may help you achieve better symptom relief, according to a study published in the journal Complementary Therapies in Clinical Practice. Researchers took patients with rheumatoid arthritis and gave half massages with light pressure and the other half massages with moderate pressure. After eight weeks, those who had the firmer massages had less pain and better strength. “It shouldn’t be extremely painful but don’t be afraid to ask for medium or a little extra pressure,” Rose says.
6. Speak up if something hurts
“Your comfort is our first priority and we definitely want to know if you’re pain,” Rose says, adding she’s had clients who suffered through an entire massage only confessing at the end that they were miserable. The problem is that each person is different in their tolerance of pressure and technique — and that’s even more true for someone with a condition like arthritis — so your therapist won’t know if something’s not working for you unless you speak up, she explains. “A little discomfort can be a good sign but you should never be in a lot of pain,” she says.
7. Don’t worry: We see lots of different types of bodies
Some people with arthritis may be embarrassed by parts of their body that are visibly affected by their condition, such as rashes from psoriatic arthritis or hand deformities. Let those worries go, Rose says. “Bodies come in all shapes and sizes and conditions and trust me, we’ve seen them all,” she says. “We’re not going to be grossed out or worried about it. We just want you to be as comfortable as possible.” If you really don’t want a certain body area to be seen or touched, tell your therapist to keep it covered with the sheet during the massage, she adds.
8. Try massages with different tools
Heat therapy helps soothe stiffness and pain in arthritic joints so incorporating it into your massage is a great way to increase the benefits of both, Vickman says. This usually involves the therapist heating smooth stones, about the size of the palm of your hand, to 110 to 130 degrees Fahrenheit, and then placing them in specific locations on your back where you hold tension. The stones are not hot enough to burn you and the localized heat can help open up your blood vessels in that area, allowing your massage therapist to better work those muscles without causing pain, she says.
9. Consider acupuncture or acupressure massages
Acupuncture and acupressure are both types of massage based in traditional Chinese medicine and can be good for people with arthritis, Bacharach says. Acupuncture uses very thin needles inserted into trigger points to release muscle tension. Similarly, acupressure involves pushing on specific trigger points on the body. “Acupuncture has long been utilized to reduce the pain and symptoms of arthritis and can be used in conjunction with conventional medical therapies,” she says. People with arthritis who completed an entire course of acupuncture treatment experienced results that were significantly better than in the control group, reporting less pain and swelling and greater mobility, according to a study published in The Journal of Acupuncture.
After the Massage
10. You might feel worse before you feel better
On a cellular level, massage is similar to exercise in the response it provokes in your body, which can lead to some temporary pain and soreness afterwards, Rose says. As the Cleveland Clinic explains, massage “forces blood into the muscle, bringing nutrients and removing toxins. This process can temporarily increase inflammation (the healing response) to areas that the body feels need attention and this inflammation can bring discomfort.” You don’t have to be sore for it to be an effective massage but if you are a little sore the next day, it’s usually nothing to worry about, she says.
11. Drink up
Drinking some fresh, cool water right after your massage is one of the best things you can do to help your muscles and joints recover, Rose says. This is why many massage therapists will bring you water after you’re finished or offer it in the waiting room. “Staying well hydrated can help reduce soreness or inflammation that may have occurred from the massage,” she explains.
12. Take an Epsom salt bath
What you do right after your massage can be just as important as the massage itself. Many therapists recommend that you take a warm bath with Epsom salts at home after the massage, Vickman says. The heat and magnesium may help keep your muscles loose and limber and will help you stay in a relaxed state.
13. Ask your therapist to examine your posture
Arthritis is hard on your joints to begin with, but many people unwittingly exacerbate their symptoms with bad posture when they sit at their desk, drive, or use their smartphone or tablet. No matter how great your massage therapist is at working out the kinks causing you pain, these effects will be quickly lost if you walk out of the office with terrible posture, Bacharach says. Ask your therapist to look at your posture and provide some guidance for how improve it.
14. Maintain your gains between massages with exercise
One of the main goals of massage is to loosen up tight areas and increase your range of motion. To maintain that effect between sessions, Bacharach recommends doing some type of gentle daily exercise that will get your blood flowing and keep your joints moving, like yoga or swimming.
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