Back Care

Regular bathing & massage of the neck,

back, buttocks, & upper arms promotes
patient relaxation & allows assessment
of skin condition. Particularly
important for bedridden patient,
massage causes cutaneous
vasodilatation, helping to prevent
pressure ulcers caused by prolonged
pressure bony prominences or by
perspiration.
Therapeutic Massage
Therapeutic massage is the
application of pressure & motion
by the hands with the intent of
recipient’s well – being. It
involves kneading, rubbing &
using friction.
For the past 30 years, many touch
therapies have been assimilated
into mainstream nursing practice.
Massage therapy is now recognized
as a highly beneficial modality & is
prescribed by a number of
physicians. In addition, many states
now have licensing requirements
for massage practitioners.
Traditionally, back rubs have been
administered by nurses to provide
comfort to hospitalized clients.
Today, they are considered
standard practice. Massage
techniques can be used with all age
groups & are especially beneficial to
those who are immobilized.
A back rub or massage can achieve
many results, including relaxation,
increased circulation of the blood and
lymph, & are relief from
musculoskeletal stiffness, pain, &
spasm. Research suggests that
individuals with chronic obstructive
lung disease benefit from massage
therapy.
 The subjects in this study
experienced positive changes in
in heart rate, O2 saturation, and
blood pressure as a result of
massage.
Nursing Alert
Massage should be used with
caution for people with heart
disease, diabetes, hypertension, or
kidney disease because increased
circulation in this conditions may be
harmful
Massage should never be attempted
in areas of circulatory abnormalities
such as aneurysm, varicose veins,
necrosis, phlebitis, or thrombus or
in areas of soft – tissue injury, open
wounds, inflammation, joint or
bone injury, dermatitis, recent
surgery, or sciatica.
Three strokes commonly used during
back massage are effleurage,
friction, and petrissage. Start with
effleurage, and then go on to
petrissage & friction. Perform each
stroke at least six (6) times before
moving on to the next, & then
repeat the whole series if desired.
When performing effleurage and
friction, keep your hands parallel to
the vertebrae to avoid tickling the
patient. For all three strokes,
maintain a regular rhythm and
steady contract with the patient’s
back to help him relax.
 Effleurage
Using your palm, stroke from the
buttocks up to the shoulders,
over the upper arms, and back to
the buttocks. Use slightly less
pressure on the downward
strokes.
The whole hand is used.
Gliding & long rhythmic strokes
are used.
Firm, even – pressured strokes
are directed toward the heart to
assist blood return.
Lighter pressure is used when
moving away from the heart.
Effleurage
 Friction

Use circular thumb strokes to

move from buttocks to
shoulders;
then, using a smooth stroke,
return to the buttocks.
Thumb pads, heel of hand, or
fingertips are used.
Focused, deep, circular motion
are used.
Penetrates deeper muscle layers.
Is done after effleurage &
petrissage.
Friction
 Petrissage
Using your thumb to oppose your
fingers, knead & stroke half the
back & upper arms, starting at the
buttocks & moving toward the
shoulder. Then knead & stroke the
other half of the back, rhythmically
Alternating your hands.
Pressing, squeezing, kneading, &
rolling movements by both hands
(use entire hands) are used.
Deep circulation is enhanced.
C – shaped motions stimulate the
muscle body.
Promotes muscle relaxation.
Petrissage
 Tapotement
 Palms, fingertips, & knuckles are
used.
 Brisk, vigorous, rhythmic,
percussive movements are used.
 Hands alternately tap, cup, slap, &
pummel muscles.
 Invigorates and stimulates tired
muscles.
 Vibrations
 Very fine, rapid, shaking
movements, administered by
the entire hand.
 Stimulates or relaxes muscles.