Massage Therapy Journal Summer 2026

Summer 2026 • 41

antinuclear antibodies may indicate an autoimmune response. 34

Medications prescribed to treat symptoms of RA typically work by suppressing inflammation, in one manner or another. While OTC anti inflammatory drugs and topical medications can work well for osteoarthritis, the systemic inflammation characteristic of RA requires a different, more powerful, approach. NOTE: Drug side effects can be minimal to life threatening, and unpredictable. When referring to the following content, keep in mind that an individual may experience all or none of the side effects listed here, or others not listed here. An allergic response may occur and can be serious. Classes of medications that treat RA symptoms and slow down the disease progression, including possible side effects pertinent to massage, include: DMARDs. Decrease inflammation, temporarily ease pain and can slow the progression of RA. Not all DMARDs work in the same way. Conventional DMARDs broadly restrict immune system functioning, while targeted DMARDs block precise pathways inside immune cells. 37 Possible side effects from DMARDs pertinent to massage therapy include: 37 • Injection site reactions • Headache, nausea • Increased risk for infections and decreased ability to fight them Biologics. These are a subset of DMARDs, and while both help protect against the effects of inflammation, biologic drugs inhibit specific immune system tools such as tumor necrosis factor and B cells. Biologics are more difficult to make (they are typically made from living materials such as animal, human and bacteria cells), and are far more expensive than conventional drugs, sometimes requiring thousands of dollars out-of-pocket every month, even with insurance. 38 Possible side effects from biologics pertinent to massage therapy include: 38 • Injection site reactions • Headache, nausea • Flu-like illness, fever and chills • Increased risk for infections and decreased ability to fight them

7. Imaging studies: These are not only used during the diagnosis process (sometimes to eliminate other causes for reported symptoms) but are also to gauge RA progression and to assess joint damage or deterioration when deciding whether or not surgery may be needed. 8. Standard X-rays: Can show joint damage, for example, but are unreliable in diagnosing early-stage RA, when joint damage is less apparent. 35 Other image scanning procedures may produce better results. 9. Ultrasound: Sound waves introduced into the body are reflected differently depending on the tissue under examination. Such differences are detected by the ultrasound machine and turned into an image. 10. Magnetic resonance imaging (MRI): Strong magnets and radio waves affect atoms in the water molecules in body tissues. When the radio waves are turned off, the atoms release energy that’s detected by the MRI machine to create images. 11. Computed tomography: Rotating X-ray beams create a 3-D image of body structures. strength) by passing a high and a low x-ray beam through the body, usually in the hip and the spine. 36 Oral and Topical Medications for RA Patients Prescribed oral medications . A client diagnosed with RA is likely taking multiple prescribed and over-the-counter (OTC) medications every day. These drugs can be classified by their intent, which may be to treat: • RA symptoms and slow down disease progression by reducing causative inflammation • Chronic pain of RA and post-surgical acute pain 12. Dual-energy X-ray absorptiometry: Measures bone density (thickness and

• Complications of RA • Comorbidities of RA • Side effects of medications

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