One
possible explanation for the positive effects following shorter and
less frequent massages in our study (20 min weekly massage
sessions for 4 weeks) is our use of moderate pressure massage [5],
although it is not clear what pressure was used in their study [4].
However, the use of self-report pain scales in their study [4] and
the more direct measure of pain responses to ROM measures in
our study makes cross-study comparisons difficult. Nonetheless,
the paradigm of combining therapist-delivered massage with
daily self-massages has been effective now in at least three
studies and suggests that this may be a more cost-effective therapy
for individuals with arthritis pain and one that may have
more sustainability [6e8]. The data of our study also highlight the
importance of designing massage therapy protocols that target
muscle groups affected by the joint movements and then
assessing those specific range of motion measures and the associated
pain.