Saint Louis University College Of Nursing Presented By: CERIACO, Chedan RAYRAY, Ciara Krisanthilae SORIANO, Miriem Paulle   BSN 3 - K1

Presented To: Ms. Lalaine Melissa Jimenez Level III Clinical Instructor    Clinical Setting:


Massage eases anxiety and muscle tension. Simple rubbing of a painful muscle or joint with an analgesic ointment or liniment containing menthol is a commonly used massage technique. Analgesic ointments containing menthol relieve pain, but the analgesic mechanism is unknown. These ointments produce immediate sensations of warmth that last for several hours, even longer if the body part is wrapped in plastic. They can be used to relieve joint or muscle pain. Moreover, menthol ointment rubbed into the neck, scalp, or forehead sometimes relieves tension headaches. Some cultures (eg, Filipino) use it on the abdomen to relieve gas pains or on the abdomen or lower back to relieve the pain of labor or delivery.

A variety of massage strokes or movements may be used singly or in combination, depending on the outcome desired. These include effleurage (stroking), friction, pressure, petrissage (kneading or making large, quick pinches of the skin, subcutaneous tissue, and muscle), vibration, and percussion. Historically, the back massage has been used by nurses to enhance or induce relaxation before sleep or to stimulate skin circulation in association with hygienic measures. Support persons, too, can provide the technique to loved ones.

The duration of a massage ranges from 5 to 20 minutes, in accordance with the client’s tolerance. Before offering a massage, the nurse must ensure that the environment is free of distractions and interruptions and that the room temperature is comfortable for the client with the back uncovered. The nurse must also feel relaxed and convey an attitude that the massage will alleviate pain, stress, and physical and mental tension. Because cultural and religious beliefs regarding personal touch may cause the client emotional discomfort during massage therapy, the nurse must, in addition, ensure that the client is receptive to the therapy.

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relieve muscle tension promote physical and mental relaxation improve muscle and skin functioning relieve insomnia provide relief from pain


Lotion or oil

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Effleurage: stroking the body; smooth, long strokes moving hands up and down the back Petrissage: kneading or making large quick pinches of the skin, subcutaneous tissue, and muscle Tapotement: sharp, backing movement of little finger side of each hand on the fleshy back, never on the spinal column; must not be too strong to cause discomfort or pain

1. Select an appropriate time free of interruptions and distractions. - Provide massage following the morning bath, before sleeping, and at other times as necessary to achieve relaxation and comfort for the client. - Assist the client to a prone position in bed. Remove the client’s gown, or open the back of the gown. 2. Warm the massage lotion or oil before use. - Warm the lotion or oil by pouring it into your hands before applying it to the client’s back. Cold lotion may startle the client and increase discomfort.

3. Effleurage the entire back. - Place your hands next to the lower spine. Using your palms and fingers, slowly massage upwards to the neck, gradually decreasing pressure as you get close to the neck. Circle your hands over the shoulder blades, and then slowly move them gently down the lateral surface of the back. Effleurage has a relaxing, sedative effect if slow movement and light pressure are used. 4. Apply friction strokes next to the spine. - Use your thumbs to apply friction strokes (strong circular motions). - Massage the back, moving from side to side in smooth, tiny circles, starting at the neck and ending at the waist.

5. Optional: Petrissage the back and shoulders of the client. - Petrissage first up the vertebral column and then over the entire back. Petrissage is stimulating, especially if done quickly and with firm pressure. - Observe the client carefully to ensure that petrissage does not cause pain or discomfort. If the client grimaces or withdraws from the touch, ease the kneading pressure. 6. Apply hand pressure movements up the back. - Using moderate pressure, walk your hands up the outer edges of the back from the hips to the neck. 7. Optional: Effleurage and petrissage the upper back and shoulders, using long soothing strokes. This area often experiences the most tension.

8. Apply pressure strokes along the spinal column. - Place one hand on top of the other, and move slowly from the lower spine to the top of the spine, using light to moderate pressure. - Observe the client carefully to ensure that the pressure strokes are not causing the client pain or discomfort. 9. Using gentle pressure, apply large circular movements to the back. - Start at the outer side of the back at the waistline. Move from the waistline to the lower hip, then across the hip and up the spine. 10. Complete the massage by using light effleurage to the entire back. - With each massage stroke, lessen the pressure. 11. Assist the client to a position of comfort.


Kozier, B., et. Al. (2004). Fundamentals of Nursing (5th ed.). Jurong, Singapore: Pearson Education South Asia PTE Ltd.

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