Massage Therapy Journal Summer 2026

32 • Massage Therapy Journal

AMTA Continuing Education

A Review of Joint Structure and the Autoimmune Response In order to understand how RA affects the body, reviewing joint structure and function is helpful, as well as the associated connective tissue structures that facilitate and support joint movements. 2 • Synarthrotic joints have no synovial cavity, and are described by most sources as allowing little-to-no movement. The sutures of the skull are classified as synarthrotic joints (although craniosacral therapists disagree firmly with that characterization). • Amphiarthrotic joints also have no synovial cavity, but allow a degree of movement, such as at the joints between the vertebrae (intervertebral joints) and between the ribs, where they articulate with the spine and the sternum. • Diarthrotic (synovial) joints allow the full range of movement, and have a synovial cavity. Synovial joints move the skeleton and are found at the shoulder and hip, the elbows and knees, the ankles and wrists, and within the hands and feet. RA primarily affects synovial joints, as this is the prime location of inflammation. 2 However, RA can affect all joints. Synovial joints are characterized by structures that allow and protect the degree of movement allowed. 2 • Bursae (-a) are synovial fluid-filled sacs that reduce friction and cushion joint parts. Tendon sheaths are tube-like bursae that wrap around tendons traveling through areas of great friction, as at the wrist and ankle. RA is an autoimmune condition, so massage therapists need to be well versed in some fundamentals of the autoimmune response. The autoimmune response is initiated when the immune system mistakenly attacks and destroys healthy tissue, 3 representing a failure to distinguish self from non-self. Once initiated, the autoimmune response persists; pathogen-fighting immune cells continue to incorrectly identify the body’s own cells as invading pathogens, resulting in a wide variety of irreversible health conditions.

Davidson also offers this valuable insight to any practitioner that works with clients managing RA: “RA patients are not walking around with tell-tale glowing red dots of where our joints or organs are affected by RA inflammation. You can’t see the dark cloud of fatigue glooming over us, unless you notice its subtle signs. Many of us are suffering in silence and invisibly. We can take years to get a diagnosis because of the misconceptions surrounding arthritis—for example, the myth that arthritis does not affect young people—and because chronic pain is often not taken seriously. It can take multiple doctors to sift through our symptoms, lab tests and imaging scans to figure out what the heck is going on.” 1 As an autoimmune and inflammatory disease, RA is a complex one. Learn more about RA, what symptoms clients with RA may experience and how massage therapy can help.

Types of Joints

Joint Motion

Synovial Joints

Ball and socket joint

Shoulder

Saddle joint

Thumb/finger

Hinge joint

Elbow

Pivot joint

Spinal

Wrist

Ellipsoid/candyloid joint

Plane/gliding joint

Feet

Luminexa3D / mentalmind / Nandalal Sarkar / Shutterstock.com

amtamassage.org/mtj