Servet KALYONCUO
Journal of Experimental and Clinical Medicine - 2026;43(2):201-210
Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by persistent synovial inflammation, leading to pain, joint stiffness, and functional impairment. Despite advances in pharmacological treatments, including disease-modifying antirheumatic drugs (DMARDs) and biologic agents, many patients continue to experience residual symptoms that negatively affect quality of life. This review aims to evaluate the potential role of massage therapy as a complementary approach in the management of RA, with a focus on its clinical effects and proposed mechanisms. A structured literature search was conducted in Medline/PubMed, Scopus, and the Directory of Open Access Journals (DOAJ) for studies published up to March 1, 2025. Studies were considered if they included individuals diagnosed with RA, evaluated any form of massage therapy (e.g., Swedish massage, aromatherapy massage, reflexology), and reported clinical or patient-reported outcomes. Both randomized controlled trials and quasi-experimental studies were included, while studies involving non-RA populations or insufficient methodological detail were excluded. However, this review was not designed as a fully systematic review and may be subject to selection bias. The available evidence suggests that massage therapy may be associated with improvements in pain, joint mobility, and patient-reported outcomes in individuals with RA. However, the overall strength of evidence is limited by methodological concerns, including small sample sizes, heterogeneity in intervention protocols, and the frequent lack of appropriate control groups. While some studies report reductions in inflammatory biomarkers such as interleukin-6 (IL-6) and C-reactive protein (CRP), these findings are based on limited evidence and should be interpreted cautiously, particularly in studies where massage therapy is combined with other interventions. Massage therapy may also contribute to psychological well-being by reducing stress and improving overall mental health. Evidence derived from non-RA populations was considered only as supportive background and was not central to the conclusions of this review. Additionally, the potential for publication bias should be acknowledged, as studies with positive findings are more likely to be published. The integration of massage therapy into RA management may benefit from nurse-led approaches; however, variability in practitioner training and the lack of standardized intervention protocols remain important challenges. Future research should prioritize well-designed, adequately powered randomized controlled trials focusing specifically on RA populations, with standardized massage interventions and clearly defined outcome measures.
