Capsule Commentary on Perlman et al., Efficacy and Safety of Massage for Osteoarthritis of the Knee: a Randomized Clinical Trial

Excerpt

Knee pain is a common reason patients seek attention in primary care¹, though clinicians often feel unprepared to deal with it². This is the tip of the iceberg as patients often manage knee pain at home without seeking medical advice³. Pharmacologic treatment has only limited benefit. In their trial, Perlman and colleagues evaluated the efficacy of massage therapy in managing knee osteoarthritis (OA). They randomized patients with chronic knee OA to usual care, light touch or whole body Swedish massage weekly for 8 weeks, then every other week for 52 weeks⁴. They found improvement in several knee pain parameters over the initial 8 weeks, while the patients received weekly massage, but by 52 weeks, maintenance (biweekly) massage was no better than usual care. This is particularly interesting because patients were presenting with chronic, not acute, knee pain. As the authors point out, “the underlying mechanisms of massage-mediated improvements in osteoarthritis are not well-defined, preliminary studies suggest that massage may improve systemic immune and inflammatory profiles.” This seems a good place for research effort, elucidating the mechanism for potential benefit from Swedish massage. …