The suitability of shiatsu in hospitals

1. Shiatsu massage as an adjunct to pharmacological management
of cancer pain: a pilot project.
Background
• Pain in cancer patients is a complex issue. Opioids are frequently used to manage
pain, but they come with many side effects.
• Non-pharmacological therapies are increasingly used as adjuvants to
pharmacological treatments. These include psychological interventions as well as
physical therapies such as acupuncture.
• Many NHS hospitals in the UK offer a complementary therapies service for cancer
& palliative care.
• Massage and reflexology are the two most common manual therapies offered.
Author: Fernando Cabo, honorary complementary therapist, St Bartholomew’s Hospital.
Director Professional Shiatsu School

2. • Very few NHS hospitals or health trusts seem to have carried out any service
evaluation of individual manual therapies. They tend to analyse the service as
one, and in most cases they have reported feedback from patients without any
kind of statistical analysis of symptom improvement.
• A literature search for research carried out in NHS hospitals returned one clinical
trial comparing aromatherapy massage and reflexology for the relief of symptoms
and two trials one for reflexology and another for aromatherapy for the
treatment of anxiety and depression.
• One service evaluation of shiatsu for symptom relief in outpatients was
commissioned by Bart’s Health Trust.
• To assess its effects, the researchers used the validated form MYCaW with a 7-
point Lickert-type scale to report changes in symptoms

3. Relieving pressure – An evaluation of shiatsu treatments
for cancer and palliative care patients in an NHS setting
• MYCaW asks patients to record their main concern. Their second concern may be
recorded but they need not have a second concern.
• Pain was the most common concern. The results of the evaluation can be seen on the
next slide. These results prompted the realisation of this pilot project.

5. INTERVENTION
Shiatsu is applied without using one’s strength but by using the weight of the body

6. Shiatsu is very versatile. It can be given on a massage table, a bed or a sofa.
Because it is done through clothing, it is ideal to be used in a hospital setting where
patients do not need to take clothes off or change their position

7. Treatment of a patient with COPD. Patient cannot lie flat.

8. What is shiatsu?
Shiatsu is a manual therapy applied by leaning forward in a
relaxed manner with the weight of one's body to an optimum
point, and the correct use of fingers, palms, etc., in order to apply
sustained, stationary pressure on different parts of the body.
It is a holistic therapy that aims to treat most of the body in each
session.

9. AIMS
• The main aim of the research is to assess the value of shiatsu as an adjuvant to
standard treatment for the management of pain in cancer inpatients.
• A secondary aim is to assess the feasibility of recruiting patients for a future clinical
trial.

10. • The shiatsu massage service was introduced in St Bartholomew’s Hospital in 2016
after a pilot trial in which patients reported their satisfaction with the service.
• The shiatsu massage service is offered one day a week to all inpatients who are
staying in one of the cancer wards and it lasts from 20 minutes to half an hour.
• Patients in the wards can stay for a short period of time or for several weeks if the
doctors consider it necessary.
• Patients who wish to receive a shiatsu treatment, and who experience any type of
pain or ache, are asked to evaluate the intensity of the pain before and after
treatment using a numerical rating scale from 0 to 5.
They are also asked to rate the relief the shiatsu treatment has provided from no
change (0) to completely relieved (5).
• For the purposes of this research, we are also noting down unrequested
comments offered by patients after receiving the shiatsu treatment to add a
qualitative approach to the research.
METHODS

11. • 32 patients have been treated for different types of pain.
• A mean improvement of 2 points on a 5 point scale has been reported by patients
• The mean result for the relief experienced is a score of three, where patients
reported that they were considerably relieved.
• Comments express the deep sense of relaxation and the soothing effects of the
shiatsu treatment.
RESULTS
CONCLUSION
I believe that shiatsu massage is a beneficial and appreciated intervention that can
be used in addition to conventional treatment and can help in relieving pain
symptoms in cancer patients.