And how could massage help alleviate pain or tensi

how could massage help alleviate pain or tension? Doreen, like many elderly people, has a complex medical picture. She has lower back pain due to wear and tear on her dorsal intervertebral discs, which causes occasional sciatic pain, chronic asthma and a tendency to develop bronchitis in winter, hypertension, varicose veins, angina (one of three arteries to her heart are partially blocked), and there is oedema in both legs. She has right shoulder pain and restricted mobility, which has deteriorated over the last two years. Her thumb joints are arthritic, and she has an inoperable torn cruciate ligament. Pause for thought – how to

her safely without aggravating any of these conditions? And how could massage help alleviate pain or tension? Cardiovascular conditions indicate a letter to the doctor asking if she has any concerns about the advisability of massage. The cause of the oedema is unclear, so best to avoid draining strokes on the legs – but these would be contraindicated anyway by her varicose veins. High blood pressure indicates not too long lying on her front, no deep strokes, no percussion. ewrertie With her knee problem, she may need assistance getting on and off the table. Her thumbs could do with some gentle rotations to assist production of synovial fluid, and her shoulders and lower back could do with regular massage, since the muscles there are probably contracting around the pain. Her intercostals and breathing muscles are likely to be tight. But this is not all. Doreen also takes various forms of medication: bendrofluazide, enalapril, steroids, co-proxamol and doxazosin, a list as daunting as her medical conditions. However, a little internet searching informs me that the first is a diuretic, the second for hypertension (high blood pressure), the steroids relieve her shoulder pain, the next one is an analgesic (pain killer) prescribed for arthritic conditions and doxazosin is an alpha-adrenergic blocker, which means that it causes the blood vessels to relax. This is even more information to take into account when planning a treatment. Doreen may need to use the toilet before her massage, or even during, if she's taking a diuretic. The analgesic and the steroids both mask pain, so she may not be able to give accurate feedback if the pressure is too deep. The steroids will reduce inflammation in the shoulder area, but if the cause of the pain is underlying tissue damage, it's probably unwise to try stretches or rotations. The doxazosin may make bruising a possibility, yet another reason to avoid deep massage.