Massage Therapy for Arthritis: Benefits, Techniques, and What to Expect

Key Takeaways

• Massage therapy can reduce arthritis pain, stiffness, and improve function
• Research supports moderate benefits, especially for knee osteoarthritis
• Benefits include pain relief, reduced muscle tension, improved circulation, and stress reduction
• Different techniques work for different people—Swedish massage is often a good start
• Self-massage and partner massage can extend benefits between professional sessions
• Always communicate with your therapist about your arthritis and pain levels

When joints hurt, the surrounding muscles often tense up in response, creating a cycle of pain and stiffness. Massage therapy addresses this muscle component while providing direct pain relief and relaxation benefits.

For many people with arthritis, regular massage is a valuable part of their pain management toolkit.

How Massage Helps Arthritis

Direct Effects

Pain reduction:

• Stimulates sensory nerves, potentially “closing the gate” to pain signals
• Releases endorphins (natural painkillers)
• Interrupts pain-tension cycles

Muscle relaxation:

• Releases tight muscles around affected joints
• Reduces muscle spasms
• Improves flexibility

Improved circulation:

• Increases blood flow to tissues
• May help with healing and nutrient delivery
• Reduces swelling in some cases

Indirect Effects

Stress reduction:

• Lowers cortisol (stress hormone)
• Activates relaxation response
• Chronic stress worsens pain perception

Better sleep:

• Relaxation promotes sleep
• Better sleep reduces pain sensitivity
• Pain management and sleep reinforce each other

Improved mood:

• Touch is inherently comforting
• Reduces anxiety and depression
• Provides a sense of well-being

What Research Shows

Evidence for Knee Osteoarthritis

A significant clinical trial published in PLOS ONE examined moderate-pressure massage for knee OA:

• Weekly 60-minute massages for 8 weeks
• Significant improvements in pain, stiffness, and function
• Benefits persisted for weeks after treatment ended
• Moderate pressure was more effective than light touch

Overall Evidence

Positive findings:

• Consistent reports of pain reduction
• Improved range of motion
• Better quality of life measures
• Very few adverse effects

Limitations:

• Most studies are small
• Comparison to placebo is challenging (you know if you’re getting massage)
• Effects may be partially due to general relaxation and attention

Guidelines

The American College of Rheumatology conditionally recommends massage for knee OA, recognizing it as a reasonable complementary approach.

Types of Massage for Arthritis

Swedish Massage

What it is:

• Long, flowing strokes
• Kneading and circular movements
• Light to medium pressure
• Full-body or focused on specific areas

Best for:

• General relaxation
• People new to massage
• Reducing overall muscle tension
• Mild to moderate arthritis

Deep Tissue Massage

What it is:

• Slower strokes with more pressure
• Targets deeper muscle layers
• Focuses on areas of tension
• Can be uncomfortable but shouldn’t be painful

Best for:

• Chronic muscle tension
• Specific problem areas
• People who tolerate firmer pressure
• Not directly over inflamed joints

Myofascial Release

What it is:

• Gentle, sustained pressure on fascia (connective tissue)
• Slow stretching movements
• May hold positions for extended periods
• Works on tissue restrictions

Best for:

• Chronic pain conditions
• Movement restrictions
• People who prefer gentle approaches

Hot Stone Massage

What it is:

• Heated stones placed on and used to massage the body
• Warmth relaxes muscles deeply
• Often combined with Swedish techniques

Best for:

• Those who benefit from heat therapy
• Muscle tension and stiffness
• Relaxation

Note: May not be appropriate if joints are actively inflamed or hot.

Lymphatic Drainage

What it is:

• Very light pressure
• Rhythmic, directional strokes
• Designed to reduce swelling

Best for:

• Joint swelling
• Post-surgical recovery
• Inflammatory arthritis (gentle approach)

Finding the Right Therapist

Qualifications to Look For

• Licensed Massage Therapist (LMT) or equivalent in your state
• Training in working with arthritis or chronic pain populations
• Experience with your type of arthritis
• Willing to communicate with your healthcare team

Questions to Ask

1. Do you have experience working with arthritis patients?
2. What techniques do you typically use?
3. How will you modify the massage for my condition?
4. What should I tell you during the session?
5. How often do you recommend sessions?

Communication Is Key

Before your massage:

• Tell the therapist about your arthritis (which joints, how severe)
• Mention all medications, especially blood thinners
• Describe your current pain levels
• Note any areas to avoid

During your massage:

• Speak up if pressure is too much or too little
• Say something if any technique causes pain
• Let them know if something feels particularly good
• Don’t suffer in silence

What to Expect

Your First Session

Before:

• Complete intake forms about your health history
• Discuss your goals and concerns
• Undress to your comfort level (you’ll be draped)

During:

• The therapist works around problem joints carefully
• Pressure is adjusted to your tolerance
• Session typically lasts 30-60 minutes for arthritis focus

After:

• You may feel relaxed and slightly fatigued
• Drink water
• Some soreness the next day is normal but shouldn’t be severe
• Note how your joints feel over the next few days

Typical Treatment Course

• Initial: Weekly sessions for 4-8 weeks
• Maintenance: Every 2-4 weeks
• During flares: May need to postpone or use very gentle techniques

Self-Massage Techniques

Between professional sessions, self-massage can help maintain benefits.

For Hands

1. Apply lotion or oil
2. Use thumb of one hand to massage palm of other
3. Squeeze and roll each finger
4. Massage the web spaces between fingers
5. Rub the back of the hand in circular motions

For Knees

1. Sit comfortably with leg supported
2. Apply lotion or oil
3. Use both hands to massage around (not directly on) the kneecap
4. Knead the muscles above and below the knee
5. Use gentle pressure to massage the sides of the knee

For Neck and Shoulders

1. Apply gentle pressure with fingertips at base of skull
2. Work down the muscles along the spine
3. Squeeze and release shoulder muscles (trapezius)
4. Roll a tennis ball between your back and a wall for deeper pressure

Tools That Help

• Foam rollers: For larger muscle groups
• Tennis balls: For targeted pressure
• Massage sticks: For legs and accessible areas
• Heated massagers: Combine heat and massage
• Electric massagers: For hands-free options

Safety Considerations

When to Avoid or Modify Massage

Avoid massage over:

• Actively inflamed, hot, or swollen joints
• Skin infections or open wounds
• Recent fractures or injuries
• Areas of severe osteoporosis

Caution with:

• Blood thinners (very light pressure to avoid bruising)
• Joint replacements (check with surgeon first)
• Inflammatory arthritis flares (very gentle only)

Signs the Massage Was Too Much

• Increased pain lasting more than 1-2 days
• Significant bruising
• Swelling of joints
• Feeling worse instead of better

If these occur, communicate with your therapist and adjust future sessions.

Cost and Access

Typical Costs

• Professional massage: $60-$120 per session
• Medical massage (through PT): May be partially covered
• Massage schools: Reduced rates ($25-$50) from supervised students

Insurance Coverage

• Most massage: Not covered by insurance
• Prescribed massage: May have partial coverage
• Through physical therapy: More likely to be covered
• HSA/FSA: Often eligible expenses

Increasing Access

• Massage schools often need practice clients
• Some therapists offer sliding scale fees
• Chair massage is less expensive than table massage
• Self-massage extends benefits between sessions

Frequently Asked Questions

How often should I get massage for arthritis?

For chronic arthritis, starting with weekly sessions for 4-8 weeks, then transitioning to every 2-4 weeks for maintenance is a common approach. During stable periods, monthly massage may be sufficient. Adjust based on your response.

Can massage make arthritis worse?

When done appropriately, massage shouldn’t worsen arthritis. However, too much pressure, working directly on inflamed joints, or vigorous techniques could cause temporary increased pain. Communication with your therapist prevents this.

Is there a “best” type of massage for arthritis?

No single type is best for everyone. Swedish massage is a good starting point for most people. The key is moderate pressure (not too light, not too deep) and avoiding inflamed areas. Work with your therapist to find what helps you.

Should I use heat or cold before massage?

Many people find heat before massage helps relax muscles. If joints are swollen, ice before massage might reduce inflammation. Discuss with your therapist—many incorporate heat into the session.

Can I get massage during an arthritis flare?

Very gentle massage focusing on surrounding muscles (not inflamed joints) may be appropriate during mild flares. During severe flares, it’s often best to wait until inflammation subsides. Always communicate your current status to your therapist.

---

Exploring complementary therapies? Read about acupuncture for knee osteoarthritis or learn about stress management for chronic pain.

Last medically reviewed: February 2025

Medical Disclaimer: This article is for informational purposes only and is not a substitute for professional medical advice. Discuss massage therapy with your healthcare provider, especially if you have inflammatory arthritis, are on blood thinners, or have other health concerns.