Journal of General Internal Medicine

, Volume 34, Issue 3, pp 379–386 | Cite as

Efficacy and Safety of Massage for Osteoarthritis of the Knee: a Randomized Clinical Trial

  • Adam PerlmanEmail author
  • Susan Gould Fogerite
  • Oliver Glass
  • Elizabeth Bechard
  • Ather Ali
  • Valentine Y. Njike
  • Carl Pieper
  • Natalia O. Dmitrieva
  • Alison Luciano
  • Lisa Rosenberger
  • Teresa Keever
  • Carl Milak
  • Eric A. Finkelstein
  • Gwendolyn Mahon
  • Giovanni Campanile
  • Ann Cotter
  • David L. Katz
Original Research



Current treatment options for knee osteoarthritis have limited effectiveness and potentially adverse side effects. Massage may offer a safe and effective complement to the management of knee osteoarthritis.


Examine effects of whole-body massage on knee osteoarthritis, compared to active control (light-touch) and usual care.


Multisite RCT assessing the efficacy of massage compared to light-touch and usual care in adults with knee osteoarthritis, with assessments at baseline and weeks 8, 16, 24, 36, and 52. Subjects in massage or light-touch groups received eight weekly treatments, then were randomized to biweekly intervention or usual care to week 52. The original usual care group continued to week 24. Analysis was performed on an intention-to-treat basis.


Five hundred fifty-one screened for eligibility, 222 adults with knee osteoarthritis enrolled, 200 completed 8-week assessments, and 175 completed 52-week assessments.


Sixty minutes of protocolized full-body massage or light-touch.

Main Measures

Primary: Western Ontario and McMaster Universities Arthritis Index. Secondary: visual analog pain scale, PROMIS Pain Interference, knee range of motion, and timed 50-ft walk.

Key Results

At 8 weeks, massage significantly improved WOMAC Global scores compared to light-touch (− 8.16, 95% CI = − 13.50 to − 2.81) and usual care (− 9.55, 95% CI = − 14.66 to − 4.45). Additionally, massage improved pain, stiffness, and physical function WOMAC subscale scores compared to light-touch (p < 0.001; p = 0.04; p = 0.02, respectively) and usual care (p < 0.001; p = 0.002; p = 0.002; respectively). At 52 weeks, the omnibus test of any group difference in the change in WOMAC Global from baseline to 52 weeks was not significant (p = 0.707, df = 3), indicating no significant difference in change across groups. Adverse events were minimal.


Efficacy of symptom relief and safety of weekly massage make it an attractive short-term treatment option for knee osteoarthritis. Longer-term biweekly dose maintained improvement, but did not provide additional benefit beyond usual care post 8-week treatment.

Trial Registration NCT01537484


massage osteoarthritis arthritis knee pain musculoskeletal pain 



The team acknowledges the positive impacts and contributions of Ather Ali, ND, MPH, MHS, to their lives, with deep gratitude, love, and respect. We also thank Mary Carola (Rutgers), Michelle Pinto-Evans (Yale), and Gina Smith, MA (Yale), for coordinating study participants and entering data; Kim Turk, Kelly Cross, and Myra Blackwell (Duke); Lee Stang, Carol Nakagawara, Paula Jelly, and Susan Kmon (Yale); and Denise Ostopo-Gliozzi, Mariella Silva, and J. J. Long (Rutgers) for providing massage and light-touch interventions; Michael Patterson, PhD, DO, for developing the LT bodywork intervention; and the study subjects for their participation.

Funding Source

This study and publication were made possible by grant number R01AT004623 from the National Center for Complementary and Integrative Health (NCCIH) at the National Institutes of Health.

Compliance with Ethical Standards

All study materials were approved by the Institutional Review Boards of participating sites.

Conflict of Interest

The authors declare that they do not have a conflict of interest.


Its contents are solely the responsibility of the authors and do not necessarily represent the official views of NCCIH.

Supplementary material

11606_2018_4763_MOESM1_ESM.docx (48 kb)
ESM 1 (DOCX 48 kb)


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Copyright information

© Society of General Internal Medicine 2018

Authors and Affiliations

  • Adam Perlman
    • 1
    Email author
  • Susan Gould Fogerite
    • 2
  • Oliver Glass
    • 1
  • Elizabeth Bechard
    • 1
  • Ather Ali
    • 3
  • Valentine Y. Njike
    • 4
  • Carl Pieper
    • 1
  • Natalia O. Dmitrieva
    • 5
  • Alison Luciano
    • 1
  • Lisa Rosenberger
    • 4
  • Teresa Keever
    • 1
  • Carl Milak
    • 2
  • Eric A. Finkelstein
    • 6
  • Gwendolyn Mahon
    • 2
  • Giovanni Campanile
    • 7
  • Ann Cotter
    • 8
  • David L. Katz
    • 4
  1. 1.Duke Integrative MedicineDurhamUSA
  2. 2.Rutgers School of Health ProfessionsInstitute for Complementary and Alternative MedicineNewarkUSA
  3. 3.Yale School of MedicineNew HavenUSA
  4. 4.Yale-Griffin Prevention Research Center, Griffin HospitalYale University School of Public HealthDerbyUSA
  5. 5.Department of Psychological SciencesNorthern Arizona UniversityFlagstaffUSA
  6. 6.Duke-NUS Medical SchoolSingaporeSingapore
  7. 7.Atlantic Integrative Medical AssociatesChambers Center for Well BeingMorristownUSA
  8. 8.Veterans Administration New Jersey Health Care CenterEast OrangeUSA

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