Back Care

Back Care

Definition

Scientific form of massaging the back using different massaging strokes to provide cutaneous stimulation and thus promote comfort.

Purposes

·           To relieve muscle tension

·           To promote physical and mental relaxation.

·           To relieve insomnia

·           To stimulate blood circulation

·           To assess the condition of skin

·           To prevent bedsore

Contraindications

Patients with

·           Rib fracture

·           Burns

·           Immediate post operative period after coronary artery bypass graft

·           Spinal injuries

·           Surgeries on back

·           Lotion or oil

Articles Needed:-

·           Lotion or oil

·           Bath towel

·           Bath blanket

·           Soap

·           Wash cloth

·           Warm water in basin

·           Mackintosh and draw sheet

If patient requires hygienic care, it should be provided, followed by massage

Massage Techniques

Effleurage

They are long sweeping strokes that alternate between firm and light pressure and which can be performed using the palm of the hand or the fingertips. The knots and tension in the muscles tend to get broken with this massage technique.

Petrissage

This is the technique of kneading the muscles of the body to attain deeper massage penetration. The thumbs and the knuckles of the fingers are used to knead the muscles of the body and to squeeze them to prepare them for the other massage techniques that follow.

Tapotement or Rhythmic Tapping

As the name suggests, it consists of rhythmic tapping that uses the fists of the cupped hands. This helps to loosen and relax the muscles being manipulated and also helps to energize them.

Friction

This move seeks to create heat to bring about relaxation of the muscles. The palms of the hand are rubbed together vigorously with each other, or they are rubbed onto the skin of the person being massaged in order to produce heat by friction. This technique can be used as a warm up for the muscles of the body to be treated for deeper massage.

Vibration or Shaking

This helps to loosen up the muscles by using a back and forth action of the fingertips or the heel of the hand over the skin. The muscles of the body are litreally shaken up to loosen and relax the muscles.

Procedure

·           Explain the procedure and the position to the patient.

·           Adjust bed to comfortable height.

·           Adjust light, temperature and sound within room.

·           Close curtains around bed. Lower the side rails and help patient assume prone or side lying position (sim’s position)

·           Expose patient’s back, shoulders, upper arms, and buttocks. Cover remainder of body.

·           Wash your hands with warm water.

·           Inform patient that lotion will feel cool and wet

·           Apply hands first to sacral area massaging in circular motion, stroke upwards from buttocks to shoulders

·           Continue in one smooth stroke from upper  back  to  arm  and  laterally alongside of back, down to iliac crest.

·           Do not take hands off from patient’s back till the end of the procedure.

·           Continue massage pattern effleurage for at least 3 minutes.

·           Perform petrissage along upward along one side of spine from buttock to shoulders.

·           Perform tapotement for 2 minutes.

·           Apply other remaining massaging techniques for at least 2 minutes.

·           Apply oil or lubricants to back as required.

·           Wipe excess lubricant from patients back with bath towel/ tissue.

·           Retie gown or assist pajamas.

·           Help patient to comfortable position. Raise side rails as needed

·           Disposed of soiled towel and wash hands.

·           Record response to back massage and condition of skin.

Special Consideration

·           For patients with history of hypertension and dysarrhythmia asses pulse and blood pressure.

·           Consider cultural preferences.

·           Do not give massage if any discoloration of skin present.

·           A back massage should take about five to ten minutes and can be given with the patient’s bath, before bedtime, or at any other time during the day.

·           Determine if any allergies or skin sensitivities exist before applying lotion to the patient’s skin.

·           The greatest relaxation effect of a massage occurs when the rhythm of the massage is coordinated with the patient’s breathing.