Massage Therapy Journal Summer 2026

Summer 2026 • 33

Normal Synovial Joint

Synovial Joint With RA

Cartilage wears away

Joint capsule

Bone erosion

Swollen, inflamed synovial membrane Reduced joint space

Cartilage

Exposed bone

Meniscus

Bone

Exactly how the autoimmune response initiates RA in certain people is not understood, but it is suspected that a preexisting genetic predisposition (autoimmune diseases tend to run in families) combined with an infection, perhaps a virus, triggers the incorrect immune response. 8 Most autoimmune diseases share common characteristics that are: 3 • Chronic, incurable and sometimes progressive • Often marked by chronic inflammation • Usually characterized by periods of remissions, also called sub-acute phases, and recurrences, also called exacerbations, acute phases or flares. Conditions That Mimic RA It can sometimes be confusing for people who have been told that they have arthritis to distinguish between osteoarthritis (OA) and RA, or other arthritic conditions, and many health history forms compound the confusion by simply listing “arthritis” as a condition, without specification. While RA is different from other types of arthritis, it shares certain characteristics with others, such as OA, Still’s disease and reactive arthritis, which particularly mimic the symptoms of RA. Osteoarthritis. Because OA and RA affect the body in very different ways, and create quite different levels of risk to health, it is vital that massage therapists understand and can

As an autoimmune and inflammatory disease, RA is a complex one.

Tendon sheath

To date, 80 autoimmune diseases have been identified. 4 The six most common autoimmune diseases, besides RA, are Type I diabetes, psoriasis/psoriatic arthritis, multiple sclerosis, systemic lupus erythematosus (SLE), and inflammatory bowel diseases (Crohn’s disease, ulcerative colitis). 5 In RA, the autoimmune response attacks the synovium, the connective tissue membrane that lines the inner surfaces of synovial joint capsules, creating inflammation that thickens the tissue, causing chronic pain, swelling and stiffness at the affected joints. 3 Eventually, the affected joints deteriorate and become misshapen, affecting balance and stability. 6 Bilateral joints in the hands, knees and ankles are most often affected. 7

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