Massage Therapy Journal Summer 2026

44 • Massage Therapy Journal

AMTA Continuing Education

Salicylates. Creams and ointments containing the pain-relieving substance found in aspirin. Examples include Aspercreme and Bengay. Counterirritants. Substances such as menthol and camphor produce a sensation of hot or cold that may temporarily override the ability to feel localized pain. Examples include Icy Hot and Biofreeze. Local anesthetics. Topical anesthetics such as lidocaine produce a numb sensation to reduce pain. Lidocaine is available in the form of a cream, gel, spray or patch. Examples include LidoPatch and Topicaine. Topical pain-relieving preparations requiring prescription include: 53 Diclofenac sodium (Voltaren 0.5 percent) Diclofenac sodium topical solution (Pennsaid 2 percent) These topical NSAIDs are FDA-approved to treat joint pain. Their side-effects are similar to oral NSAIDs, but because only a small amount is absorbed into the body when used topically, they are considered safer. Voltaren is also available OTC, in 1 percent strength. Additional Medications That Aid RA Patients Drugs used to treat RA complications can vary widely, since each individual’s health history is unique, and not every RA complication is treated using prescribed medications. Some of the drugs described above are also used to treat certain RA complications. For osteoporosis: Oral or injected anti-osteoporosis drugs Possible side effects pertinent to massage therapy may include: 54 • Oral anti-osteoporosis drugs such as alendronate or risedronate can cause nausea, heartburn, stomach pain • Injected anti-osteoporosis drugs such as ibandronate or zoledonic acid can cause fever, headache, muscle aches for up to three days following injection • Long term use (3-5 years) of anti osteoporosis drugs has risks, including

femur fracture, and death of bone tissue (osteonecrosis) in the jaw For infections: Antibiotics, for bacterial infections Possible side effects pertinent to massage therapy may include: 55 • Nausea, vomiting, stomach cramps, diarrhea • Rash, dizziness, yeast infections • Photosensitivity For serious viral infections—antivirals Possible side effects pertinent to massage therapy may include: 56 • Nausea, vomiting, dizziness, diarrhea • Anemia, impaired immune functioning, hair loss For heart disease: A range of medications may be prescribed, each with side effects pertinent when planning massage therapy. The most common include the following: 57 Anti-arrhythmics • Chest pain, dizziness/fainting; coughing, shortness of breath • Diarrhea or constipation, lower extremity edema • Worsening of arrhythmia symptoms Anticoagulants • Bruising, easy bleeding, rash • Nausea, vomiting, diarrhea; headache, fever Anti-hypertensives • Bruising, rash, lower body edema; dizziness, fatigue • Cold hands/feet; headache, insomnia; arrhythmia, chest pain, hypotension • Aspirin-induced asthma; shortness of breath • Easy bleeding or hemorrhage; bruising, nose bleeds, heartburn Diuretics • Increased urination frequency, volume • Tinnitus Not every comorbid condition that accompanies RA is treated using prescribed medications. Drugs used to treat comorbid conditions can vary widely, since each individual’s case is unique. • Heartburn, vomiting, diarrhea or constipation; shortness of breath Anti-platelets

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