Back Care

Regular bathing & massage of the neck, back, buttocks, & upper arms promotes patient relaxation & allows assessment of skin condition. Particularly important for bedridden patient, massage causes cutaneous vasodilatation, helping to prevent pressure ulcers caused by prolonged pressure bony prominences or by perspiration.

Therapeutic Massage

Therapeutic massage is the application of pressure & motion by the hands with the intent of recipient’s well – being. It involves kneading, rubbing & using friction.

For the past 30 years, many touch therapies have been assimilated into mainstream nursing practice. Massage therapy is now recognized as a highly beneficial modality & is prescribed by a number of physicians. In addition, many states now have licensing requirements for massage practitioners.

Traditionally, back rubs have been administered by nurses to provide comfort to hospitalized clients. Today, they are considered standard practice. Massage techniques can be used with all age groups & are especially beneficial to those who are immobilized.

A back rub or massage can achieve many results, including relaxation, increased circulation of the blood and lymph, & are relief from musculoskeletal stiffness, pain, & spasm. Research suggests that individuals with chronic obstructive lung disease benefit from massage therapy.

The subjects in this study experienced positive changes in in heart rate, O2 saturation, and blood pressure as a result of massage.

Nursing Alert

Massage should be used with caution for people with heart disease, diabetes, hypertension, or kidney disease because increased circulation in this conditions may be harmful

Massage should never be attempted in areas of circulatory abnormalities such as aneurysm, varicose veins, necrosis, phlebitis, or thrombus or in areas of soft – tissue injury, open wounds, inflammation, joint or bone injury, dermatitis, recent surgery, or sciatica.

Three strokes commonly used during back massage are effleurage, friction, and petrissage. Start with effleurage, and then go on to petrissage & friction. Perform each stroke at least six (6) times before moving on to the next, & then repeat the whole series if desired.

When performing effleurage and friction, keep your hands parallel to the vertebrae to avoid tickling the patient. For all three strokes, maintain a regular rhythm and steady contract with the patient’s back to help him relax.

Effleurage Using your palm, stroke from the buttocks up to the shoulders, over the upper arms, and back to the buttocks. Use slightly less pressure on the downward strokes.

The whole hand is used. Gliding & long rhythmic strokes are used. Firm, even – pressured strokes are directed toward the heart to assist blood return. Lighter pressure is used when moving away from the heart.



Use circular thumb strokes to move from buttocks to shoulders; then, using a smooth stroke, return to the buttocks.

Thumb pads, heel of hand, or fingertips are used. Focused, deep, circular motion are used. Penetrates deeper muscle layers. Is done after effleurage & petrissage.


Using your thumb to oppose your fingers, knead & stroke half the back & upper arms, starting at the buttocks & moving toward the shoulder. Then knead & stroke the other half of the back, rhythmically Alternating your hands.

Pressing, squeezing, kneading, & rolling movements by both hands (use entire hands) are used. Deep circulation is enhanced. C – shaped motions stimulate the muscle body. Promotes muscle relaxation.


Palms, fingertips, & knuckles are used.  Brisk, vigorous, rhythmic, percussive movements are used.  Hands alternately tap, cup, slap, & pummel muscles.  Invigorates and stimulates tired muscles.

Vibrations Very fine, rapid, shaking movements, administered by the entire hand.  Stimulates or relaxes muscles.

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