Massage therapy in rheumatoid arthritis
Moderate EvidenceIn Plain Language
Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterized by joint inflammation, pain, and reduced mobility. Although pharmacological treatments, such as therapies with disease-modifying antirheumatic drugs and biologic agents, have improved disease outcomes, many patients continue to experience residual symptoms that impair their quality of life. This review examines the role of massage therapy as a complementary intervention in RA, focusing on its clinical benefits and underlying mechanisms. A systematic search of Medline/PubMed, Scopus, and the Directory of Open Access Journals (DOAJ) up to February 2025 was conducted using relevant MeSH terms. Evidence from clinical studies suggests that massage modalities-including Swedish massage, aromatherapy massage, and foot reflexology-can reduce pain, improve joint function, and modulate inflammatory markers (e.g., IL-6, TNF-α) and cortisol levels, thereby promoting neuroendocrine balance and lymphatic drainage. Furthermore, massage therapy may offer additional benefits in managing comorbid conditions and enhancing psychological well-being. This review also underscores the pivotal role of nurse-led care in integrating massage therapy into comprehensive treatment plans, despite existing challenges in training and standardization of protocols. Future research with larger sample sizes and longer follow-up periods is essential to establish robust guidelines and optimize the use of massage therapy as an adjunct treatment in RA.
Key Findings: what this systematic review found
- ✓Massage therapy modalities including Swedish massage, aromatherapy massage, and foot reflexology reduce pain and improve joint function in rheumatoid arthritis patients.
- ✓Massage therapy modulates inflammatory markers such as IL-6 and TNF-α while reducing cortisol levels, thereby promoting neuroendocrine balance in RA patients.
- ✓Massage therapy serves as an effective complementary intervention for managing residual symptoms in rheumatoid arthritis patients who continue to experience impaired quality of life despite pharmacological treatments.
What This Means for You
While massage therapy shows promise for reducing pain and improving function in rheumatoid arthritis, current evidence is moderate—more large-scale studies are needed before it can be recommended as a primary treatment.
What This Means for Practitioners
Foot reflexology and other massage modalities may complement conventional RA treatment by reducing pain and inflammatory markers, but practitioners should work within integrated care teams and advocate for standardized protocols and better training.
Common questions about this study
What does this study mean in practice?
While massage therapy shows promise for reducing pain and improving function in rheumatoid arthritis, current evidence is moderate—more large-scale studies are needed before it can be recommended as a primary treatment.
What did this study find?
Massage therapy modalities including Swedish massage, aromatherapy massage, and foot reflexology reduce pain and improve joint function in rheumatoid arthritis patients. Massage therapy modulates inflammatory markers such as IL-6 and TNF-α while reducing cortisol levels, thereby promoting neuroendocrine balance in RA patients. Massage therapy serves as an effective complementary intervention for managing residual symptoms in rheumatoid arthritis patients who continue to experience impaired quality of life despite pharmacological treatments.
How strong is this evidence?
This is a systematic review and we rate its evidence moderate. It was published in Rheumatology international. This study is indexed here for context; it did not test reflexology itself.
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