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17-04-2013 | Rheumatology | Article

Moderate- outweighs light-pressure massage for rheumatoid arthritis pain


Free abstract

medwireNews: Moderate-pressure massage benefits people with rheumatoid arthritis in their upper limbs by reducing pain and improving grip strength and range of motion, say researchers.

"Moderate pressure was critical for these effects," note Tiffany Field and colleagues in Complementary Therapies in Clinical Practice.

They randomly assigned 42 adults with rheumatoid arthritis in the upper limbs to receive moderate-pressure or light-pressure massage in the affected arm and shoulder once a week for 4 weeks. The therapist also taught the participant self-massage to be done once a day.

The 15-minute massage procedure consisted of moderate or light pressure being applied via stroking on the top of the forearm, from the wrist to the shoulder; milking on the top and bottom of the arm between the shoulder and wrist; circular movements to create friction on the top of the arm and hand; and skin rolling on the top and underside of the arm.

Patients receiving moderate-pressure massage showed significantly greater improvements in pain, perceived grip strength, and depression than those receiving light massage therapy.

Indeed, average scores on the pain assessment VITAS decreased from 4.8 out of a possible 10 (worst possible pain) at baseline to 1.8 following moderate-pressure massage. The corresponding scores for patients receiving light massage therapy were 3.7 and 2.9.

Physical measures also improved significantly more following moderate- than light-pressure massage, with greater increases seen for grip strength (18 vs 3 points on a talking digital exerciser), wrist flexion (12 vs 5 points on goniometer), elbow flexion (14 vs 2 points on goniometer), and shoulder abduction (13 vs 1 point on goniometer).

The researchers suggest that one potential mechanism underlying the effect of moderate-pressure massage on pain relief is an increase in vagal activity and serotonin levels as a result of pressure receptor stimulation.

They conclude: "The combination of therapist and self-massage as a more intensive therapy is effective and would likely be more cost-effective for reducing pain and increasing range of motion.

"The clinical implications are noteworthy in that individuals can learn to massage themselves to reduce pain during occupational and recreational activities, and the increased grip strength and range of motion, would enhance their activities of daily living."

medwireNews ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013

By Lucy Piper, Senior medwireNews Reporter

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