Massage therapy is known to soothe and provide relief from pain, improve blood circulation and reduce stress. Massage sessions are readily prescribed to deal with chronic and minor niggles or pain. However, when it comes to rheumatoid arthritis (RA), experts wave the caution flag. Massages could worsen the condition for any type of inflammatory arthritis including rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis.
Going through a massage session when the condition is in an active state not only results in a flare up but could lead to severe deformities as well.
Deep tissue massage in rheumatoid arthritis
Rheumatoid Arthritis (RA) makes the joints vulnerable to injuries and acute pain from any form of external pressure. A deep tissue massage in the muscles around the joint can worsen the condition.
“In deep tissue massage, a sustained pressure targeting the inner layers of the muscles and connective tissue is made,” says Dr Shweta Singhai, consultant rheumatologist, Sakra World Hospital, Bengaluru. “This is a little severe than other types of massages like Swedish massage as apart from using palms and fingers, elbows are also used.”
In rheumatoid arthritis, there is inflammation of joints much like an injury swelling. Redness and soreness is also there around the joints.
“The cause for this inflammation is the cytokines which are released when RA flares up,” adds Dr Singhai. “Deep tissue massage doesn’t work because it causes the release of these cytokines during a deeper massage. When those with active rheumatoid arthritis or those having a flare up get a deep tissue massage, it worsens the condition and some even develop a deformity. For example, in the case of elbow joints, the range of motion is a little more than 180 degrees, and that range of motion is lost.”
Swedish/surface massage for rheumatoid arthritis
Swedish massage or surface massage is a much lighter form as it targets the superficial layer of the skin. As per a 2021 research paper by Farideh Sahraei et al., Swedish massage can be effective in reducing pain and the need to use painkillers in those with rheumatoid arthritis.
“One should always consult with a rheumatologist before undertaking any massage to ensure that the situation is under control,” says Dr Singhai. “It is a myth that all types of massages help in managing rheumatoid arthritis. As a rheumatologist, I would say avoid any massage therapy for those with active RA and once the situation is in control by using disease modifying agents, then after consultation with a doctor, lighter massages can be done.”
The same rule applies for psoriatic arthritis and ankylosing spondylitis as well. Experts also emphasize on using a certified professional masseuse as an untrained person may not be able to differentiate between deep tissue and surface massage, and inadvertently cause worsening of the condition.
Ayurvedic massage for rheumatoid arthritis
“Aamavata is what we call rheumatoid arthritis in ayurveda,” says Dr Sumesh Mani, chief physician-panchakarna, SVN Ayurvedic Clinic, Thiruvananthapuram, Kerala. “In aamavata, aama means some kind of toxins or having properties of kapha. As per ayurveda we don’t do oil application or massage in chronic acute condition. As it could flare up resulting in severe pain or swelling.”
Once the condition improves, massage is done while also considering certain other factors.
“Once aama is reduced, there is only vaata, at this juncture we apply oil,” explains Dr Mani. “The therapy also depends on the patient’s body type, and diet, along with various other factors.”
- Any type of massage therapy for rheumatoid arthritis when the condition is in an active stage leads to the flaring up of the symptoms. It can also cause joint deformity.
- Once the condition is under control using disease modifying agents, and after consultation with a rheumatologist, Swedish massage or light-handed surface massage can be done.