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Saint Louis University
College Of Nursing

 Presented By:
BSN 3 - K1

 Presented To:
Ms. Lalaine Melissa
Level III Clinical
 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.
 To relieve muscle tension
 To promote physical and mental relaxation
 To improve muscle and skin functioning
 To relieve insomnia
 To provide relief from pain
 Lotion or oil
 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
- 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
- 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
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.
 Reference:

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