Reduction of Knee Pain from Osteoarthritis with Thai Massage and Thai Herbal Poultice in Government Hospitals, Thailand

Objectives: This randomized controlled trial (RCT) aimed to assess the efficacy of Thai massage combined with a Thai herbal knee poultice in alleviating knee pain associated with osteoarthritis. Methods: A total of 308 adults aged 44 years and older with clinically diagnosed knee osteoarthritis were recruited from 27 primary care clinics across four public health sectors in Thailand. In this two-arm, parallel-group randomized controlled trial, participants were randomly assigned to one of two groups: (1) a control group receiving Thai massage alone, or (2) an intervention group receiving Thai massage combined with a Thai herbal knee poultice applied every other day for five sessions, followed by five weekly maintenance sessions. Outcome measures were assessed at baseline and at week 5 using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) to evaluate pain, joint stiffness, and physical function. Knee radiographs were also obtained to support clinical assessment. Results: At week 5 the intervention group experienced significantly greater reductions in resting pain (p = 0.023). Stiffness improved markedly—both on first arising and later in the day (p = 0.001). Physical function gains were superior in the intervention group, including the ability to stand (p = 0.001), rise from a chair (p = 0.001), walk on level ground (p = 0.002), get in and out of a car (p = 0.001), shop, and put on trousers or a sarong (both p = 0.001). No radiographic progression was detected in either group. Conclusion: A five week regimen of Thai massage augmented with a Thai herbal knee poultice produced clinically and statistically significant improvements in pain, stiffness and physical function compared with massage alone. These findings warrant confirmation in a larger, longer term clinical trial.