Introduction and Objective: Knee osteoarthritis (KOA) is one of the most common health problems in the elderly. It is referred to in Thai traditional medicine as “Lom Jab Pong Khao”, consisting of two types: Lom Jab Pong Nam Khao and Lom Jab Pong Haeng Khao. This randomized controlled trial aimed to explore the efficacy of knee massage and herbal poultice by comparing clinical symptoms and safety. The research was approved by the Human Research Review Board, Department of Thai Traditional and Alternative Medicine, Ministry of Public
Health (No. 10/2020).
Methods: The study was conducted from January to February 2021 in nine healthcare facilities across Thailand, involving 300 KOA volunteers divided equally into two groups: the intervention group and the control group. The intervention group received massage followed by herbal poultice, while the control group received only massage. Both groups received the treatments five times two days apart (five times in two weeks). The outcomes were evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and a safety
evaluation form. Data were statistically analyzed using t-test and repeated measures ANOVA.
Results: The majority of the volunteers were women, aged 60–69 years, with KOA stage 2 or 3. Both treatments were effective in reducing the pain and stiffness and improving knee function. In the intervention (massage and poultice) group, compared with the control (massage) group, significantly better improvements or relief were noted for clinical symptoms, knee pain relief and function (from the first to the fifth treatment), and knee stiffness (from the fourth to the fifth treatment) (p < 0.05). There were no adverse reactions or side effects in either group.
Discussion: The combination treatment of massage and herbal poultice can reduce all three clinical KOA symptoms. Massage helps relax tendons and muscles and improve blood circulation, resulting in reducing muscle pain, stiffness, and chronic inflammation of the knee joints. Additionally, the herbal poultice contains phlai (Zingibermontanum (J. Koenig) Link ex A. Dietr.) as the main ingredient that has been scientifically proved for effective pain relief. As the herbal poultice ingredients are absorbed through the skin, they can reduce pain and inflammation
of surrounding tissues of the knee. Various inner tissues also receive medicine from the herbal ingredients that penetrate the skin, thus reducing pain and inflammation when treated continuously for up to five times. Therefore, the treatment helps reduce such symptoms.
Conclusion and recommendation: The KOA treatment with massage and herbal poultice is an alternative way for relieving such symptoms such as pain and inflammation, and improving knee functional ability. It can also enhance palliative care for such an illness and improve the patient’s activities of daily living.