backcare and back massage

1. Back care and back
massage:
Pratiksha Ghimire
LMC

2. Back care:
Back care means cleaning and massaging back, paying
special attention to pressure points. Back massage include
rhythmic stroking, rubbing and squeezing of the tissues of
back.
It is a scientific form of massaging the back using different
massaging strokes to provide cutaneous stimulation and
thus promote comfort.

3. Purpose:
To promote blood circulation.
To maintain cleanliness and prevent skin breakdown.
To prevent infection.
To inspect skin condition.
To promote rest and sleep.
To reduce tension associated with anxiety and stress.
The upward strokes pressure should be more than down
ward strokes.
Do not massage if skin turns red.

4. Indication:
• Unconscious patient
• Prolong bed ridden patient.
• Patient with restricted movement.
• Malnourished patient
• Edematous patient
• Patient with poor personal hygiene.
• Patient suffering from chronic back pain.

5. Contraindication:
Surgeries in back
Burn injury in back.
Spinal injury
Restricted movement after surgery.
Patient suffering from clotting disorders

6. General principles:
Hand washing before and after procedure.
Back care can be done with bed bath for the maintenance
of personal hygiene.
Maintain proper privacy of the patient.
Special care should be taken of pressure points along with
two hourly position changing.
If the skin is moist or in summer season use powder and
incase of dry skin or in winter oil can be used.

7. General principles:
Water temperature should be 105 to 110°F.
Keep the patient in proper position.
Consider cultural preferences of the patient.

8. Articles required:
Tray
Rubber sheet
Medium towel
Medium steel bowl – 2
Sponge towel-2
Oil/powder
Soap in a dish
Warm water

9. Preparation of articles:
Screen and top sheets – to maintain privacy
Two big steel trays – to keep all articles
A big basin – to hold water according to season
Mackintosh with draw sheet – to protect bed from soiling .
Soap with soap case – to clean and remove dirt from back.

10. Preparation of articles:
A big towel - to wipe the back
Oil/talcum – to prevent skin friction
Bucket – to collect waste water
Gloves – if patients is infected
Kidney tray – to collect wet waste.

11. Required position:

12. Preparation of environment
Put the screen around the bed.
Close windows and doors as well.
Switch on the light and switch off the fan or increase the
temperature of AC switch off AC.
Adjust the bed in required height.
Lowered the side rail of the care giver side.

13. Special precautions:
Use gloves if the patient is suffering from any
communicable diseases or according to the hospital
protocol.
Never use too much oil or powder, it may create irritation.
Provide massage using proper technique otherwise
sometimes it may create subcutaneous tissue
degeneration specifically in elderly.
Direct pressure against pressure points in back should be
avoided.

14. Special precautions:
Rub your hands before touching to avoid unnecessary
chilling.
Lotion or oil also can be preheated to avoid unnecessary
chilling.
Ideal duration of back care should be 5-20 minutes not
more than that minimum 3-5 minutes for each step.

15. Massage techniques:
Effleurage:
They are long sweeping strokes that
alternate between firm and light
pressure and which can be
performed using the palm of the
hand or the fingertips. The knots and
tension in the muscles tend to get
broken with this massage technique.
It is way of oil distribution.

16. Massage techniques:
Petrissage:
This is the technique of
kneading the muscles of the
body to attain deeper
massage penetration. The
thumbs and the knuckles of
the fingers are used to knead
the muscles of the body and
to squeeze them to prepare
them for the other massage
techniques that follow.

17. Massage techniques:
Tapotement:
tapping or pounding of the skin.
Variation:
Hacking
Cupping
Tapping
Performed with a light fast tempo
Promotes muscular and systemic
relaxation and desensitization of
irritated nerve endings.

18. Massage techniques:
Friction:
This move seeks to create heat to
bring about relaxation of the
muscles. The palms of the hand are
rubbed together vigorously with each
other, or they are rubbed onto the
skin of the person being massaged in
order to produce heat by friction.
This technique can be used as a
warm up for the muscles of the body
to be treated for deeper massage.

19. Massage techniques:
Vibration:
This helps to loosen up the
muscles by using a back and
forth action of the fingertips
or the heel of the hand over
the skin. The muscles of the
body are shaken up to
loosen and relax the
muscles.

20. After care:
Remove extra oil or powder.
Ask or help the patient to wear cloth.
Provide comfortable position.
Terminate all articles.
Handwashing .

21. Record and reporting:
After procedure need documentation.
Document if any abnormalities (i.e. redness) found during
inspection.
Document the date and time of position changing and care
given.
Put signature against documentation of back care given.
Document if pain or discomfort is present or not