Massage Therapy for Osteoarthritis of the Knee: A Randomized Controlled Trial

Adam I. Perlman, MD, MPH; Alyse Sabina, MD; Anna-Leila Williams, PA-C, MPH; Valentine Yanchou Njike, MD;
David L. Katz, MD, MPH

Author Affiliations: Institute for Complementary and Alternative Medicine, University of Medicine and Dentistry of New Jersey, Newark (Dr Perlman); Yale Prevention Research Center, Yale University School of Medicine, Derby, Conn (Drs Sabina, Njike, and Katz and Ms Williams).

Arch Intern Med. 2006;166(22):2533-2538. doi:10.1001/archinte.166.22.2533.


Background  Massage therapy is an attractive treatment option for osteoarthritis (OA), but its efficacy is uncertain. We conducted a randomized, controlled trial of massage therapy for OA of the knee.

Methods  Sixty-eight adults with radiographically confirmed OA of the knee were assigned either to treatment (twice-weekly sessions of standard Swedish massage in weeks 1-4 and once-weekly sessions in weeks 5-8) or to control (delayed intervention). Primary outcomes were changes in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and functional scores and the visual analog scale of pain assessment. The sample provided 80% statistical power to detect a 20-point difference between groups in the change from baseline on the WOMAC and visual analog scale, with a 2-tailed α of .05.

Results  The group receiving massage therapy demonstrated significant improvements in the mean (SD) WOMAC global scores (−17.44 [23.61] mm; P<.001), pain (−18.36 [23.28]; P<.001), stiffness (−16.63 [28.82] mm; P<.001), and physical function domains (−17.27 [24.36] mm; P <.001) and in the visual analog scale of pain assessment (−19.38 [28.16] mm; P<.001), range of motion in degrees (3.57 [13.61]; P = .03), and time to walk 50 ft (15 m) in seconds (−1.77 [2.73]; P<.01). Findings were unchanged in multivariable models controlling for demographic factors.

Conclusions  Massage therapy seems to be efficacious in the treatment of OA of the knee. Further study of cost effectiveness and duration of treatment effect is clearly warranted.

Trial Registration Identifier: NCT00322244

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Holistic Care: Can We Handle the Truth?

By David L. Katz, MD; Chief Medical Officer of the Community Pain Center


Colleagues and I first opened the doors of the Integrative Medicine Center at Griffin Hospital in Derby, CT in 2000. We developed a model of care that was virtually unprecedented at the time, and remains extremely novel today. Our patients, who tend to be very complex, frustrated by the need for help they can’t find, and at times rather desperate, are seen and evaluated by both a naturopathic physician, and either me or my conventionally trained counterpart (I am a product of conventional medical school education, and sequential residencies in Internal Medicine and Preventive Medicine). We then put our two heads, and our two perspectives, together with those of the patient—and explore treatment options across a broader spectrum than either kind of practitioner could offer alone. The basic motivation for the model was the simple notion that two heads are better than one, and that holistic care was better than reductionism.
Elderly patient
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