Massage Therapy Journal Summer 2026

Summer 2026 • 39

RA) may increase the risk for complications and death. 22 There is still much that we don’t know or understand about the short- or long-term effects of COVID-19, and even less about the effects on health after COVID-19 for people with autoimmune conditions such as RA In a June 2021 article, Carolyn Tague and colleagues 23 prepared the following service delivery protocols (which are not specifically intended for people with any particular pre-existing health condition such as RA) for COVID-19 survivors, including the following adjustments: • Specific intake questions to assess for any long-term health consequences, including symptoms of coagulopathy (impairment in the blood’s ability to form clots). If coagulopathy is present, massage treatment should be postponed. • Adjust massage for pressure, positioning or site restrictions based on presenting conditions. • Increase follow-up assessments to build knowledge base of working with COVID-19 survivors. This could include adding a section to the electronic medical record or session notes both for provider use and to document for case series. COVID-19 Vaccine Protocol For most people with RA, getting the COVID-19 vaccine and its boosters offers the greatest chance of protection against severe illness, hospitalization and death from the infection. Yet people with autoimmune diseases such as RA and those taking disease-modifying anti-rheumatic drugs (DMARDs) have a lower response to the vaccine and an increased risk of breakthrough infections. To combat this, the American College of Rheumatology recommends adjusting the timing of receipt and possibly the dose of certain DMARDs, such as rituximab, medical methotrexate and abatacept, to help the immune system develop the best possible response to the vaccine while still controlling RA symptoms. 24

The RA Treatment Team

Rheumatologist

Orthopedic surgeon

Cardiologist

Ophthalmologist Pulmonologist

Nephrologist

Respiratory therapist

Physical therapist (PT)

Occupational therapist (OT)

Diagnosing and Testing for RA Patients: The RA Treatment Team Depending on the course of an individual’s RA, there may be multiple medical practitioners involved in planning and delivering care. The following practitioners are some of the most common RA patients might see: • Rheumatologist. An internist who has completed additional training in the diagnosis and treatment of diseases such as RA and fibromyalgia that affect body structures that produce movement, including muscles, musculoskeletal diseases and treats them using non-surgical methods. 24 RA patients benefit from the specific training and experience of a rheumatologist to design individual treatment plans that address their specific needs and preferences. • Orthopedic surgeon. A surgeon who performs surgery on muscles, bones, joints, ligaments and tendons. 25 An orthopedic surgeon may perform joint repair and replacement surgeries and other surgical procedures on patients with RA. • Cardiologist. A physician who specializes in treatment of the heart and blood vessels, including surgery, and educates patients about heart health, 26 and can treat RA patients with cardiovascular complications. bones, joints, ligaments and tendons. A rheumatologist diagnoses types of

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