Treatment of Knee Osteoarthritis: Wisdom of Isan Folk Massage

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Kanyarat Peng-ngummuang
Jintana Junlatat
Ganniga Pumthong
Sureerat Butprom


The purpose of this study was to explore the wisdom and to document the knowledge of massage for knee osteoarthritis (KOA) of Isan folk healers in Ubon Ratchathani and Si Sa Ket provinces, which have Thai-Lao and Khmer cultures, respectively. This qualitative research deployed in-depth interviews, observations, notes, and video/audio recording for collecting data from folk healers who had experiences in healing and were accepted by local residents. Content analyses were undertaken and then the data were returned to the folk healers for review and comments, based on which the data were revised as per folk healers’ wishes to disclose. The comparative data on anatomy positions were analyzed by an applied Thai traditional medicine practitioner and physical therapists. The results showed that, among 12 folk healers who treated KOA with massage, 6 were from Ubon Ratchathani and 6 were from Si Sa Ket – 9 male and 3 female, mostly elderly. The folk healers from both provinces revealed similar procedures for treating KOA, demonstrating a cultural mix that had slightly different combinations of treatment patterns, treatment methods, beliefs and pre-treatment rituals. The steps of KOA treatment consisted of (1) setting up a bowl of worship, (2) history taking, (3) physical examination, (4) massage, (5) post-massage assessment, and (6) advice on self-care. The folk healers emphasize holistic healing that includes the physical, mental, and spiritual aspects. Folk massage relaxes the ligaments and muscles involved in knee movement, improves blood circulation, increases joint flexibility, relieves pain, and improves the quality of life. This study also aimed to conserve folk wisdom and the information obtained can be used as a guide for the people or medical personnel to understand the folk medicine wisdom and apply it in providing integrated health care for KOA patients.


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Palazzo C., Nguyen C., Lefevre-Colau M.M., Rannou F., Poiraudeau S. Risk factors and burden of osteoarthritis. Ann Phys Rehabil Med. 2016;59(3):134–8.

Pereira D., Peleteiro B., Araújo J., Branco J., Santos R.A., Ramos E. The effect of osteoarthritis definition on prevalence and incidence estimates: A systematic review. Osteoarthr Cartil. 2011;19(11):1270–85.

Blagojevic M., Jinks C., Jeffery A., Jordan K.P. Risk factors for onset of osteoarthritis of the knee in older adults: A systematic review and meta-analysis. Osteoarthr Cartil. 2010;18(1):24–33.

Thai Rheumatism Association. Guideline for the treatment of osteoarthritis of knee. Bangkok: Thai Rheumatism Association; 2011. p. 9–20 (in Thai)

Thompho D., Sricha L., Chuchang S. The efficacy of Thai massage herbal compression and knee wraps in diabetic patients with knee osteoarthritis at Buayai Hospital, Buayai district, Nakhon Ratchasima province. Medical Journal of Srisaket Surin Buriram Hospitals. 2021;36(2):391-401. (in Thai)

Foundation for the Promotion of Thai Traditional Medicine. Court-type Thai traditional massage. 2nd ed. Bangkok: Usa Publishing; 2012. p. 123–5 (in Thai)

Sridharmma K., Tongharmmachat S., Kempila P. The research on the wisdom of local Isan medicine in Khamphi Bai-Lan (scripture written on palm-leaves). 2009;3:13–20. (in Thai)

Piwngern T., Thuma K. A comparative study on pain relief with herbal compress balls made from Zinggiber cassumunar and Derris scandens in knee osteoarthritis patients. J Thai Trad Alt Med. 2020;18(2):298-306. (in Thai)

Hanprasertpong N., Teekachunhatean S., Chiranthanut N. Thai massage, and Thai herbal compress versus oral Ibuprofen in symptomatic treatment of osteoarthritis of the knee: A randomized controlled trial. BioMed Research International. 2014:1-13.

Turajane T., Labpiboonpong V., Maungsiri S. Cost analysis of intra-articular sodium hyaluronate treatment in knee osteoarthritis patients who failed conservative treatment. J Med Assoc Thai. 2007;90(9):1839–44.

Ratubon K., Sokhor M. Narrative of the local history and community power creation of Bru people, Ta-Long and Vern-Bueg, Khong Jiam District, Ubonratchathani Province. Humanities and Social Sciences Journal, Ubon Ratchathani Rajabhat University. 2018;8(special issue):463-80. (in Thai)

Thitapanyo P., Nabundhit C., Nabundhit S. Improving the quality of life for the Kui, a multicultural group in South Isan, Thailand. Journal of Humanities and Social Sciences Mahasarakham University. 2019;38(5):1-11. (in Thai).

Altman R.D., Marcussen K.C. Effects of a ginger extract on knee pain in patients with osteoarthritis. Arthritis Rheum. 2001;44(11):2531–8.

Kuptniratsaikul V., Dajpratham P., Taechaarpornkul W., Buntragulpoontawee M., Lukkanapichonchut P., Chootip C., Saengsuwan J., Tantayakom K., Laongpech S. Efficacy and safety of Curcuma domestica extracts compared with Ibuprofen in patients with knee osteoarthritis: A multicenter study. Clin Interv Aging. 2014;9:451–8.

Khonglormyati J., Khunpra R. Effectiveness of Derris Scandens (Roxb.) Benth. (Thaowan Priang) in elderly patients with knee osteoarthritis. J Prev Med Assoc Thail. 2019;9(3):304–12. (in Thai)

Rachawat P., Pinsornsak P., Kanokkangsadal P., Itharat A. Clinical efficacy and safety of Benjakul remedy extract for treating primary osteoarthritis of knee compared with Diclofenac: Double blind, randomized controlled trial. Evidence-based Complement Altern Med. 2017;2017.

Peungsuwan P., Sermcheep P., Harnmontree P., Eungpinichpong W., Puntumetakul R., Chatchawan U., Yamauchi J. The effectiveness of Thai exercise with traditional massage on the pain, walking ability and QOL of older people with knee osteoarthritis: A randomized controlled trial in the community. J Phys Ther Sci. 2014;26(1):139–44.

Biillee J. The effects of self knee pain relief program in elderly with osteoarthritis. Thai Journal of Public Health and Health Sciences. 2018;1(2):42-51. (in Thai)

Lekdee T., Phuetphol C. The effect of herbal poultice combines with educating program to relieve knee pain among osteoarthritis in diabetes mellitus patient at Kongnang District Health Promotion Hospital, Tha Bo District, Nong Khai Province. J Prapokklao Hosp Clin Med Educat Center. 2019;36(1):39-46.

Piyanuch Y., Supim W. A study of wisdom of folk doctor in Ampur Ounkharuk, Nakhornnayok Province. 2009;24. (in Thai)

Punthawongkoon C., Thuseewan M., Pumthong G., Nontapot S., Sooktho S., Junlathat J. Indigenous wisdom of folk medical doctors living in Ubonratchathani. Ubonratchathani: Withayakarnpim; 2015. (in Thai)

Board of Folk healers, Sisaket Province. Consideration for renewal of folk healer certificate, In: Report of the meeting of the committee of folk healers in Sisaket Province 1/2021; 4 March 2021; Health Promotion Building Sisaket Provincial Public Health Office: Sisaket. p. 1-8 (in Thai)

Juntaramano S., Swangareeruk J., Khunboonchan T. The wisdom of Thai indigenous massage: Case study of 5 indigenous healers. J Thai Trad Alt Med. 2019;17(1):26-41. (in Thai)

Plakornkul V., Vannabhum M., Viravud Y., Roongruangchai J., Mutirangura P., Akarasereenont P., Laohapand T. The effects of the court-type Thai traditional massage on anatomical relations, blood flow, and skin temperature of the neck, shoulder, and arm. BMC Complement Altern Med . 2016;16(1):363.

Klinhom U. Khid Sen Isan folk massage. Bangkok: Usa Printing; 2012. (in Thai)

Eungpinichpong W. Thai massage to relieve knee pain from osteoarthritis of knee. J Med Tech Phy Ther. 2006;18(2):38-41. (in Thai)

Sefton J.M., Yarar C., Berry J.W., Pascoe D.D. Therapeutic massage of the neck and shoulders produces changes in peripheral blood flow when assessed with dynamic infrared thermography. J Altern Complement Med. 2010;16(7):723–32.

Sukkum B. Thai blessing ceremony of Kui ethnic group in Sisaket Province, Thailand. Journal of Multidisciplinary in Humanities and Social Sciences. 2021;4(1):108-22. (in Thai)

Chantawang N., Homwutthiwong K., Mairuae N., Khongsri S., Raomad W., Lapyuneyong N. Anatomical locations in the lower limb that correlate with the basic massage lines and signaling points of court type Thai traditional massage. J Altern Complement Med. 2015;13(2):123–33.

Viriyabubpa C., Pumrin S., Kijjasawad N., Neamsuvan O. The study of the body of knowledge of herniated disc treatment of a folk healer. J Med Heal Sci. 2018;25(3):14–29. (in Thai)