Therapeutic massage for knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials

Objective To evaluate the effectiveness of therapeutic massage (tuina) for treating knee osteoarthritis (KOA). Methods Six English and Chinese databases, including Chinese National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full-text Database (Wanfang), Chongqing VIP Database (CQVIP), China Biology Medicine Disc (CBM), Cochrane Library and PubMed databases, were independently searched to identify appropriate randomized controlled trials (RCTs) studying therapeutic massage for KOA compared to oral non-steroidal anti-inflammatory drugs (NSAIDs) alone. The main outcome measures were total effectiveness and the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) score. Results A total of 8 RCTs were included and they were of average quality. The results showed that therapeutic massage was more effective than NSAIDs comparing total effectiveness [risk ratio (RR)=1.14, 95% confidence interval (Cl) (1.07, 1.21), P <0.0001]; compared with NSAIDs, therapeutic massage produced more significant improvements in pain [mean difference (MD)=−2.06, 95%Cl (−2.75, −1.36), P <0.00001], stiffness intensity [MD=−0.90, 95%Cl (−1.05, −0.75), P <0.00001] and joint function [MD=−12.48, 95%Cl (−13.91, −11.05), P <0.00001]. Conclusion Therapeutic massage was more effective than oral NSAIDs in treating KOA. In relieving pain and stiffness and improving the function of knee joint, therapeutic massage was superior to NSAIDs.