Bodyworkers and the Urinary System
One effect of massage is the potential increase of urine production. Massage aids the movement of fluid from the interstitial compartment into the systemic circulation. The resultant increase in blood volume is counteracted by an increase in urine volume. Such effects are more significant in those persons with edema. The increase may be as high as three to four times the normal rate of urine formation. With the increase in urinary volume, an increase in excre-tion of the products accumulated in the edema fluid can be expected. Massage promotes excretion of ni-trogenous wastes and other ions, as evidenced by an increase in urinary levels after treatment.1,2
By stimulating large nerve fibers (gate control the-ory), massage can reduce pain originating from the urinary tract by reducing reflexive muscle spasm and inhibiting pain perception. It has the potential to re-duce pain by local reflex mechanisms as well.
It is important for the therapist to elicit a complete history related to the urinary system during the visit. Clients with pain in the low back region associated with fever; those with a history of change in color, fre-quency, or volume of urine; and those with pain on passing urine should be referred to a physician.3 His-tory of sudden increase in weight could be a result of fluid retention resulting from kidney malfunction. Be-cause edema can be an early sign of kidney problems, it must be ensured that edema is not caused by kidney disease. Kidney infections often present as tenderness, pain, or swelling in the back, just below the costal mar-gin and adjacent to the vertebrae. Problems with the organs of the urinary system may present as pain that is referred to other areas of the body .
Polycystic kidney is one condition in which the kidney is enlarged, with or without functional prob-lems. Abdominal massage is contraindicated in this condition.
Floating and movable kidneys are relatively com-mon. Care should be taken when the abdomen is massaged. (It is beyond the scope of this book to give details of the various kidney disorders, and the stu-dent is encouraged to refer to pathology textbooks.)
Individuals on dialysis, or those who have had kid-ney transplants, are usually prescribed antibiotics and drugs that suppress immunity. Care should be taken to prevent these clients from being exposed to any form of infection.