Massage and manual therapies

Conflicting advice exists about the use of massage and manual treatments in clinical practice guidelines for people with knee osteoarthritis. Some recommend it and some recommend against it. The most important thing to take note of is that even the guidelines that recommend it only suggest its use as an adjunct (addition) to first-line treatments of education and self-management, exercise and physical activity, and weight management.


Let’s watch our video with Ali Gibbs, a specialist physiotherapist and knee osteoarthritis researcher, who will explain more about massage, manual therapies and knee osteoarthritis.

Frequently Asked Questions (FAQs)

Many people think that massage and manual therapies are the same thing, but although they have similar effects, they are slightly different.

Massage tends to be a more generic form of treatment. It usually involves touch and techniques applied to the whole leg with the aim of promoting relaxation and having an impact upon lymphatic drainage. The exact mechanisms of why people can feel better after massage are unclear, however a large proportion is likely due to to relaxation.

Manual therapies are broad and can contain an number of different options that are usually performed by healthcare professionals. Generally, manual therapies are more targeted approaches that are performed in an attempt to improve mobility or alter symptoms. Just like massage, the exact mechanisms of why people can feel better after manual therapies are unclear. A large proportion of the treatment effect is likely due to a change in how your body and mind react to movements or symptoms.

Unfortunately – both of these treatments have short-lasting effects. Therefore they are only considered for some people to compliment first-line treatments and should not be seen as a long term solution or something that can ‘fix’ osteoarthritis.

Yes, generally speaking massage and manual therapies are safe for people with knee osteoarthritis. However it is important to consider the effectiveness when making a decision about seeking these treatments.

As mentioned in our ‘treatments overview‘ page, there is no known ‘cure’ for knee osteoarthritis. People can make big claims about the impact that massage and manual therapies has on knee osteoarthritis, however unfortunately there is not the evidence to support this. As mentioned in the previous FAQ, massage and manual therapies are generally safe for people with knee osteoarthritis, therefore it is worthwhile trialing it if it is of interest to you. However symptom relief is short-term and it should not be received at the expense of first-line treatments.

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