Back massage or back care involves cleaning and massaging an individual's back for therapeutic and comfort purposes. It increases elimination through the skin, induces sleep, provides comfort, regulates body temperature, and aids in patient observation. Contraindications include burns, rib fractures, spinal injuries, and back surgeries. Back massage techniques include effleurage, petrissage, friction, hand over hand strokes, brush strokes, kneading, and tapping motions. Proper back care involves assessing the skin, washing with soap and water, applying lotion or oil, massaging for 3-5 minutes, redressing the patient, and documenting the procedure.

1. Back massage or
Back care

2. Back massage or back
care
• Definition
Back care means,
“cleaning and massaging an
individual’s back as a
therapeutic and comfort
measure.”

3. Purposes

4. • Increases elimination through the skin
• Induces sleep
• Provides comfort to the patient
• Regulates body temperature
• Aids in observation of patient

5. Contraindications
• Burns
• Rib fracture
• Spinal injuries
• Surgeries on back

6. Basic principles of back massage
• Agents used for back massage:
a) Lotions or emollients:
lotions and emollients reduce friction and lubricate the skin
They are appropriate for most patients, especially those with
a tendency towards dry skin; that are, elderly patients.
b) Rubbing alcohol:
Alcohol evaporates quickly, so it has a cooling but very drying
effect.
A certain amount of alcohol is absorbed by the skin so it should
not be used on infants, elderly patients or patients with liver
diseases

7. c) Powder
Powder reduces friction but also has a drying
effect on the skin
It may be appropriate for those patients who
perspire freely and/or are confined to bed.
3. General guidelines:
a. A back massage should take about five to ten minutes
and can be given with the patient’s bath, before
bedtime or at any other time during the day
b. Determine if any patient allergies or skin sensitivities
exit before applying lotion to the patient’s skin

8. c. The greatest relaxation effect of a massage occurs
when the rhythm of the massage is coordinated with
the patient’s breathing
d. Give special attention to bony prominences
e. Avoid using powder and lotion together because this
may lead to skin maceration
f. Develop a turning schedule and give back care at each
position change

9. Articles
required
A tray containing
Basin -1 with warm water
Sponge cloth – 1
Small bowl – 1
Soap with soap dish
Towel – 1
A kidney tray with paper bag
Spirit
Talcum powder/lotion/oil
Mackintosh with cover
A set of patient’s clothes

10. PROCEDURE
Nursing action
Check the client’s identification and
condition
Explain to the client about the
purpose and procedures
Put all required equipments to the
bedside and set up.
Close all windows and doors and put
the screen or/and utilize the curtain
Rationals
• To assess the client
• Helps in promoting
relaxation and cooperation
• Make the time of the
procedure minimum and
effective
• To ensure that the room is
warm and maintain the
privacy

11. Nursing action
 Perform hand hygiene with
warm water.
 Placing the appropriate
position:
 Move the client near towards
you.
 Turn the client to her/his side
and put the mackintosh
covered by big towel under
the client’s body.
Rationale
• Cold water causes muscle
tension
• To make him/her more
comfortable and provide
the care easily. Mackintosh
prevents the linens from
soiling.

12. • Expose the client’s back fully
and observe it whether if
there is any abnormality.
• To find any abnormality to
prevent further complications
and to provide proper
medication as soon as
possible.
• If you find out some redness,
heat or sores, you cannot give
any massage to that place.
• If the client has already some
red sore or broken down area,
you need to report to the
senior staff or doctor

13. • Wipe back with wet wash
cloth. Lather soap on hands.
Apply soap from down to
upward direction in circular
motion giving special
attention to the pressure
areas and rinse with plain
warm water. Dry the area
thoroughly.
• To clean the back before we
give massage with
oil/lotion/powder

14. • Put some lotion or oil into your
palm. Apply the oil or the lotion
and massage at least 3-5
minutes by placing the palms:
a) From sacral region to neck, use
firm, smooth strokes to massage
over scapulae.
b) From upper shoulder to the
lowest parts of buttocks gently
but firmly knead skin by grasping
area between thumb and fingers.
Work across each shoulder and
around nape of neck. Continue
downwards along each side to
sacrum.
• Oil or lotion keeps the skin dry by
absorbing the moisture and
protects the skin from friction.

15. Steps for back massage - Effleurage
• Using your palm, stroke
from the buttocks upto the
shoulders, over the upper
arms and back to the
buttocks. Use slightly less
pressure on the downward
strokes

16. Petrissage
• Using your thumb to
oppose your fingers, knead
and stroke half the back and
upper arms, starting at the
buttocks and moving
toward the shoulder. The
knead and stroke the other
half of the back,
rhythmically alternating
your hands.

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

18. Hand over hand
• Massage the back with
short quick strokes using
alternate hands

19. Brush strokes
• Lightly stroke the back with
finger tips while massaging

20. Kneading
• Stroke the back with both
hands together

21. Tapping
• Tap the back with both
hands

22. • Help the client to put on the
clothes and return the client
to comfortable position
• Replace all equipments in
proper place.
• Perform hand hygiene
• Document on the chart with
your signature, including
date, time and the skin
condition. Report the
findings.
• To provide warmth and
comfort
• To prepare for the next
procedure
• To prevent spread of
infection
• Documentation provides
coordination of care.