Massage Therapy Journal Summer 2026

50 • Massage Therapy Journal

AMTA Continuing Education

Supplementary therapies include physical and occupational therapy, exercise and strength training; various forms of integrative medicine; nutritional and dietary supplements and vitamin regimens, as well as types of talk therapy such as cognitive behavioral therapy (CBT). Physical therapy. A variety of PT techniques may ease RA symptoms, using both passive and active treatments: 66 Passive treatments : • Help to preserve the fluidity of the joints and ligaments • Performed on the patient by trained physical therapists or PT assistants • Tend to be more relaxing than active treatments Active treatments such as exercises that strengthen your body and prevent further RA pain :

meta-analysis suggests regular exercise can boost both quality of life and physical function in people with RA and other forms of inflammatory arthritis. Another study suggests even high intensity exercise is safe and effective for preventing or reversing the muscle wasting that often accompanies RA. 66 Active treatments include: 66 Muscle flexibility and strengthening. Using customized stretching and strengthening exercises, the PT will help lengthen and strengthen muscles and improve joint movement. Aerobic exercise. Aerobic exercises, such as walking and biking, are ideal for people with RA because they help to strengthen the spine without putting unnecessary stress on inflamed joints. Aerobic exercises also contribute to weight loss (excess body weight places stress on damaged joints). Hydrotherapy. As a passive treatment, hydrotherapy may simply involve sitting in a whirlpool bath to relieve pain and relax muscles without adding unnecessary stress on tired joints. As an active treatment, hydrotherapy takes advantage of buoyancy and reduced strain on weight-bearing joints. One review of studies found that almost all trials involving hydrotherapy and RA found benefit of hydrotherapy over no treatment. Benefits included reduced joint pain and better physical function. 66 Passive treatments include: 66 Cold therapy (cryotherapy). Cryotherapy eases painful RA exacerbations and slows circulation, which reduces swelling. In local cryotherapy—putting cold directly on a painful joint—the therapist may place a cold compress on the target area, use direct ice massage or even apply a spray known as fluoromethane to cool inflamed tissues. By contrast, global cryotherapy could involve immersion in an ice bath or a cryotherapy chamber. Heat therapy. Heat triggers the body’s natural healing process by speeding up blood flow to the painful area. Extra blood delivers extra oxygen and nutrients. Counter to intuition, the extra blood flow from heat

Physical Therapy Treatments Associated with RA

Muscle flexibility and strengthening

Aerobic exercise

Hydrotherapy

Cold therapy (cryotherapy)

Heat therapy

TENS therapy

Ultrasound therapy

• Usually follow completion of the course of passive treatments • Help address flexibility, strength and joint movement Active treatments. Active treatments not only curb recurrent pain but will also improve overall health and help you lose weight, if necessary, for RA patients—especially important because they are at higher risk of heart disease. You should strongly consider anything that can cut that risk. One recent systematic review and

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