Massage and Acute Care
“Touch is often the most neglected or assaulted sense of the hospitalized patient”
~ Barb White, MS, LMT
Massage is making its way to prominence in the medical mainstream. As a touch modality, massage is no longer on the sidelines of healing. It is becoming the 21st century balance to the technology side of the health-care environment.
Its plays a vital, supportive role in the well-being of hospital patients in intensive care units, cancer wards, delivery rooms and psychiatric wards as well as in hospice settings.
Benefits of Massage in Hospital Settings:
- a decrease in pain
- less need for medication,
- lowered stress levels and increased emotional well-being
- greater mobility
- improved sleep
- faster recovery
- decreased anxiety and depression
- increased energy levels
Pain Management
When any trauma or injury of any magnitude occurs in the body, a network of nerve cells called nociceptors relays this information through the spinal cord to the brain. The cortex and limbic systems register the input and create the appropriate pain response in the body (increased heart rate, crying, discomfort, inflammation).
When pain is present, the necessary healing activities such as coughing, breathing deeply and mobility are inhibited. Pain can also intensify stress and anxiety, which further increases pain and develops a ‘pain/immobility/stress/pain’ closed loop cycle that requires intervention to promote recovery.
Massage has been effective in breaking that cycle because it produces serotonin, a natural anti-pain hormone and slows the activity of the inflammatory response in the same way that aspirin or nsaids do.
Studies conducted by NIH using 65 participants in a hospital setting revealed that pain levels of patients were reduced by almost 50% with the use of massage protocols. Numerous other studies, have echoed these findings globally.
Lower Blood Pressure
Pain, stress, noise, isolation, interrupted sleep and post surgical immobility can contribute to increased blood pressure in patients. A Mayo Clinic study of the pain/stress/blood pressure cycle on post cardiac surgery patients revealed that massage – 3 sessions of 20 minutes each – significantly altered blood pressure readings and was so impactful that Mayo Clinic immediately hired full-time massage therapists.
Cardiac surgeries or procedures are particularly fear and stress inducing. In a NIH study of 46 patients, it was found that a 20-minute back massage before heart catheterization significantly reduced blood pressure and decreased the need for sedative before and during the procedure.
Post Surgical Support
Painkillers are a necessity after surgeries but can prolong recovery and extend hospitalization. When massage therapy is incorporated as part of the postsurgical protocol, fewer medications were needed which contributed to faster recovery.
Mobility is enhanced by massage in post surgical situations. When a patient is able to move more easily, healing is more easily achieved.
Pain and discomfort in backs, shoulders, and necks are the most common areas affected by post op immobility and surgical procedures that necessitate the manipulation of the body. Massage helps relieve these effects.
Stress
The signature result of massage therapy is its ability to affect a physical and mental relaxation response. This quieted state of presence allows the patient to rest deeply and support essential healing. In addition, massage (especially back massage) is known to lower blood pressure, heart rate and decrease muscle tension by calming the production of stress hormones – cortisol and noradrenaline.
Emotional Well-Being
Perhaps the most difficult issue for patients to manage during the hospital experience is the emotional upset that results from anxiety, fear, disruption in normal routines, restlessness, lack of sleep, and sense of isolation. Massage is a welcome support system for many patients who consistently report improved state of mind, more relaxation for mind and body, increased coping skills and the ability to sleep deeply and rest.
This is especially true for oncology patients who suffer the effects of chemotherapy. Massage has been reported to help with side effects such as depression, nausea, fatigue, mental dysfunction and insomnia.
Massage Adapted for Hospital Patient Care
Massage interventions in a hospital setting differ from standard massage treatments. Usually gentler forms of Swedish, acupressure, craniosacral or cross fiber myotherapy and pressure points are used. The methods may be altered to accommodate any contraindications and are usually of shorter duration, given at bedside sometimes with patient on their side, focused on areas of need or concern and adjusted for time available and patient’s energy.
In all cases, massage offers patients a welcome interruption from the treatments, tests, medical assessments, relentless activities and invasive duties of staff and abnormal interactions with family that make up a day in hospital. Massage interjects time and attention on the patient that is uniquely personal and connecting thus helping them cope with their illness both physically and psychologically.