Chapter 6: Working With Clients with Health Problems 2 CE Hours
Learning objectives Describe the symptoms of osteoarthritis, lymphedema, fibromyalgia, and Parkinson’s disease. Identify the populations that are most likely to have each of these conditions. Course overview Individuals with chronic illnesses often seek massage therapy for the benefits it can offer in relaxation, stress reduction, and relief of muscular aches and tension. This educational module provides basic information about four chronic conditions that massage therapists may encounter in their clients – osteoarthritis, lymphedema, fibromyalgia, and Parkinson’s disease. Information is presented on the causes, physiology, and symptoms of each of these conditions, as well as the treatments and lifestyle
Describe the most common treatments and lifestyle adaptations used by clients for these conditions. Discuss the available research on the benefits of massage therapy for individuals with these conditions.
adaptations that clients may be using in managing their disease. Risk factors, preventive measures, and current research about the benefits of massage are also addressed. An understanding of the clients’ health problems, challenges they may be facing, and their involvement with other health professionals can assist the massage therapist in providing safe and beneficial massage therapy for clients with chronic conditions.
PART 1: OSTEOARTHRITIS
The term “arthritis,” which literally means “joint inflammation,” is an umbrella term used for more than 100 different medical conditions that are a portion of the larger category of rheumatic disease. The common thread among all of these conditions is that they affect the musculoskeletal system, especially the joints. One in five (21 percent) of US adults has some form of doctor- diagnosed arthritis, according to the Centers for Disease Control and Prevention (CDC). 1 But the total number of people with arthritis is actually much greater, because many individuals do not seek medical advice for their aches and pains, so their cases are not captured in the reports from physicians. The CDC’s national household survey puts the prevalence of arthritis at one in three adults (33 percent) 2 . Arthritis is currently the leading cause of disability in the United States. 3 Osteoarthritis is the most common type of arthritis, and because it is most common in people over age 60, we’ll see a huge increase in the numbers, with the Baby Boomers beginning to hit their 60s now. The number of people with doctor-diagnosed Anatomy and physiology Osteoarthritis occurs in the synovial joints, such as those in the knees, hips, and fingers, which allow for much more movement than do the cartilaginous joints. The cartilage covering bones and joints, called articular cartilage , promotes friction-free movement and helps absorb shock. Figure 1: Normal Joint
arthritis is projected to increase from 46 million in 2006 to 65 million in 2030. 1 Osteoarthritis is also referred to as degenerative, hypertrophic arthritis, or age-related arthritis. It is more common in males under age 45, but after age 45 affects more females. Many individuals seek massage therapy for relief from the body aches associated with arthritis. Most reports of massage providing relief are anecdotal, but scientific research is also now adding to the evidence of the benefits to be derived from massage. For example, recent scientific studies have shown benefits from massage for individuals with arthritis of the knee and hands. The massage therapist should be aware of the anatomy and physiology related to osteoarthritis and understand the limitations and lifestyle modifications associated with this chronic condition. The cartilage is one of the few tissues in the body that does not have its own blood supply. Instead, the health of the cartilage is maintained by the absorption of nutrients supplied by the synovial fluid, which is secreted by a membrane that lines the joints. In addition, some joints, such as those in the shoulder and the knee, are supplemented by bursa sacs that contain fluid to help cushion the joint and reduce friction. Osteoarthritis develops when cartilage deteriorates. The biologic factors leading to the deterioration of cartilage in osteoarthritis are not entirely understood. Genetic factors are thought to be involved in about half of osteoarthritis cases in the hands and hips and a somewhat lower percentage of cases in the knee. The deterioration of the cartilage usually occurs slowly over time. The cartilage begins to degenerate by flaking or forming tiny crevasses. In advanced cases, there is a total loss of the cartilage cushion between the bones of the joints. An injury to a joint or near a joint is often the starting point in the disease process. As the cartilage is worn away, the bone forms spurs (osteophytes) and fluid-filled pockets in the marrow known as subchondral cysts. As the disorder progresses, pain results from deformation of the bones and fluid accumulation in the joints. Also, bits of bone or cartilage can break off and float inside the joint space, causing more pain and damage.
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Book Code: MTX1323
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