Massage Therapy Journal Summer 2026

42 • Massage Therapy Journal

AMTA Continuing Education

Biosimilars. A biosimilar is very similar to, but not an exact copy of, a biologic drug. A biosimilar drug can be recognized by a dash after the generic name, followed by four letters. Drug makers have to prove that biosimilars are just as safe and effective as the original and that they work the same way, meaning the patient gets the same dose the same way at the same strength. Biosimilars usually come with lower price tags. The hope is that this will help more people get the drugs they need. 38 The side effects pertinent for massage therapy for biosimilars are the same as with biologics. Corticosteroids. Sometimes called steroids or glucocorticoids, corticosteroids reduce inflammation by acting like the hormone cortisol, which regulates the body’s response to stressors. Because steroids work quickly and powerfully, they provide fast, short-term relief, but have more serious side effects when used long-term (for more than two weeks). 39 Possible side effects from corticosteroids pertinent to massage therapy include: 39 • Hyperglycemia (high blood glucose) • Osteoporosis, osteonecrosis (death of bone tissue) • Edema; thinning of the epidermis • Dizziness, headache; irregular heartbeat and pulse • Increased risk for infections and decreased ability to fight them Oral Medications for Chronic Pain Management Medications prescribed to reduce RA inflammation provide pain relief, but for some people with RA and at certain times for most people with RA (during an exacerbation, for example), their pain requires greater relief. Chronic pain that is ineffectively managed has physiological, psychological and emotional consequences. 40 Pain produces a physiological stress response—including increased heart and breathing rates—to facilitate the increasing demands of oxygen and other nutrients to vital organs. Failure to relieve pain produces a prolonged stress state, which can result in harmful multisystem effects. 41

People living with chronic pain are at heightened risk for mental health problems, including depression, anxiety and substance use disorders. Chronic pain can affect sleep, increase stress levels and contribute to depression. An estimated 35 percent to 45 percent of people with chronic pain experience depression. 40 Mental Health America used data from its online mental health screening program to analyze the intersection between mental health and chronic pain. Between 2015 and 2019, more than 160,000 individuals who used the Mental Health America screening program self-identified as living with arthritis or other chronic pain. People who reported having arthritis or chronic pain were more likely to have several mental health conditions, including severe anxiety, severe depression, bipolar and PTSD. 45 Classes of medications that treat chronic and episodes of acute pain for people with RA, including possible side effects pertinent to massage, include the following: 42 NSAIDs . Non-steroidal anti-inflammatory (NSAID) drugs are available in OTC (Aleve, Motrin, or Advil) and prescription strengths. NSAIDs relieve pain and inflammation by blocking the actions of prostaglandins, which are active at sites of infection. 43 Possible side effects from NSAIDs pertinent to massage therapy may include: 44 • Increased risk for hypertension, heart attack or stroke • Stomach pain, gas, diarrhea or constipation Opioid analgesic : Tramadol (Ultram) 45 Possible side effects pertinent to massage therapy may include: • Sleepiness, headache, dry mouth • Nervousness, uncontrollable shaking of a part of the body • Muscle tightness, changes in mood, heartburn or indigestion Non-opioid analgesic : Acetaminophen (Tylenol) 46 • Stomach ulcers, nausea and vomiting • Internal bleeding, poor blood clotting • Edema in the extremities, dizziness, poor concentration

Between 2015 and 2019, more than 160,000 individuals who used the Mental Health America screening program self identified as living with arthritis or other chronic pain.

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