Rheumatoid Arthritis – physical therapies

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Manual Therapy

Most treatments for arthritis  are either drug based or through self-driven exercise programs, but there is some evidence that for some patients certain types of massage and other practitioner-orientated manual therapies can provide relief from symptoms. There are a few promising clinical studies on these therapies but more research is needed to convince a sceptical medical profession. Thai massage, pilates, self massage and tailor made physiotherapy exercises have all shown benefits.

Pilates benefits patients with rhematoid arthritis

Pilates benefits patients with rhematoid arthritis

Self massage
A study carried out in 2013 investigated whether a pain management education programme could reduce the pain in patients with Rheumatoid Arthritis. Self massage of the effective area, exercise and stress management all formed part of the programme. After six weeks, the patients had less pain and the pain was less intense.


Pilates is often cited as one of the best forms of physical exercise therapy for rheumatoid arthritis and Patient QI found a new study that investigated the effect on the quality of life of children with juvenile idiopathic arthritis. The study group followed a pilates exercise program for 6 months and this was compared to a control group that did normal exercises for 6 months. Results showed that the pilates group had lower scores on the pain analogue scale compared to the control group and also benefited psychosocially.

Physiotherapy and Exercise

Special exercises specific to the problem areas of rheumatoid arthritis have been shown to help improve movement and quality of life.  A recent German review of the treatment guidelines for Rheumatoid Arthritis recommended that physiotherapy be included systematically  as a form of treatment.  Another recent study showed that inclusion of an exercise programme led to much better sleep and less fatigue in patients with Rheumatoid Arthritis.

Thai Massage

Thai massage is used extensively in Japan and other parts of Asia as a treatment for arthritis. The massage technique is a combination of deep tissue massage and  limb manipulation, and often involves the therapist placing the patient's body in different yoga positions. Two studies have shown that the massage technique benefits elderly patients suffering from osteoarthritis of the knees.  In one study the massage was combined with herbal poultice treatments, and in the other is was compared to physical therapies. Both studies showed that the technique reduced pain, improved mobility and reduced the use of painkillers.



Nordgren at al. an outsourced health-enhancing physical activity programme for people with rheumatoid arthritis: exploration of adherence and response. Rheumatology (Oxford) Nove 2017.

Parlar et al. the effects of self-pain management on the intensity of pain and pain management methods in arthritis patients. Pain Manag Nurs. Sep 2013.

Durcan et al. The effect of exercise on sleep and fatigue in rheumatoid arthritis: a randomized controlled study. J Rheumatol. Oct 2014.

Kruger. Diagnosis and Management of Rheumatoid Arthritis. DtschMed Wochenschr. Sep 2014.  

1.Chiranthanut et al. Thai massage and Thai herbal compress versus oral ibuprofen in symptomatic treatment of osteoarthritis of the knee: a randomized controlled trial. Biomed Res Int. Sep 2014.
2. Peungsuwan et al. The effectiveness of Thai Exercise with Traditional Massage on the Pain, Walking Ability and QOL of Older people with knee Osteoarthritis: A Randomized Controlled Trial in the Community. J Phys Ther Sci. Jan 2014.

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