Massage for client with arthritis around spine?

[Jewelz8705]

I have recently qualified as an ITEC Holisitic Masseur. My first potential client is somewhat unusual.

I am working in Afghanistan as a volunteer with a charity so I am unable to get reliable medical advice. The Director of my charity has had arthritis in his spine for several years. He was on medication before coming to Afghanistan but has not taken any for the last two years. His arthritis has led to a trapped nerve which causes him severe discomfort which causes him to Hunch up his shoulders. The pain and discomfort he feels is sometimes enough to keep him from work or force him to work reduced hours.

His Afghan doctor told me massage would be good for him. I am concerned at the involvement of his vertebrae though so I don't want to just plough in there on his shoulder and spinal muscles and aggravate his condition.

Can anyone advise me as to how to proceed? Is this just a case I should not touch?

 

[teqycafq]

If you massage the soft tissue and get it to stretch and relax, then you will take pressure from the vertebrae which will to some extent relieve a lot of his discomfort and give him a greater range of movement.

Just build the treatment up slowly and it will be fine

 

[Dova]

I would imagine, that if you kept the massage pressure light, then it would be of benefit - he will soon tell you if the pressure is too much.

 

[The Coast Guarder]

no problem with massage, as long as he can complete the treatment regime (which would have to include strengthening exercises too).

Bare in mind what's happening with arthritis (I'm using DJD).

DJD is your body's reaction to excessive movement in the joints at some stage, either habitually, or through a specific trauma, the body then tries to stabilise the joints, and grows butresses around them.
and Hence the muscle tightness/spasm in the region; if you relax the superficial muscles, but don't strengthen the deep ones, then you are increasing the amount of movement, and potentially aggravating the arthritis.
The appropriate course of treatment would include cervical mobilisation techniques, possibly including traction (you can get home units, probably difficult in Afganistan), followed by relaxing the (relatively) superficial musculature whilst strengthening the deep.

If you/he don't have accesss to mobilisation then it's not the end of the world, but the treatment will take longer, and he'll have to keep it mobile (ROM exercises, NOT head rolls). If you/he don't have access to the relevant rehab exercises, then don't do the relaxation - you may provide symptomatic relief, but you could easily aggravate the underlying problem.
If he's got a trapped nerve through IVF encroachment (sounds likely in this case) then spinal mobilisation becomes even more important - Find a physio would probably be the best advice I could give you/him.

PS - there's always the TENS option for (virtually) risk-free symptomattic relief, again though, may be difficult to get hold of over there, though I'm sure someone can post you one

 

[MikeSnake]

I have several clients with arthritis of neck vertebrae. I do deepish (lots of relaxing and warming strokes first) massage to relax and stretch the adjoining muscles - which they inform me, very much benefits them.
I would stress not to do any pressure or manipulation (inc. neck stretches) to the joints.
Ask him to guide you as to what feels good - we're never too experienced to gain from client feedback!!

 

[ijwmvsui]

Thanks so much for all the great advice! Its a bit lonely out here, very hard to find any Western-trained medics, so I really appreciate the input.

My main worry is either aggravating the arthritis or doing damage to the trapped nerve, but it sounds like I can proceed and it will be fine as long as I start slow and pay attention to the client.

We're off to find some almond oil form the bazaar this afternoon, so hopefully I can begin treating this evening or tomorrow.