Assessing individuals using topical anti-inflammatories or analgesics may be difficult in that these body tissues may appear healthier and more resilient than they are. Practitioners who are unaware of the medication may be more aggressive than is appropriate or required, with greater risk of bruising. Be aware that any complaint of gastrointestinal pain and discomfort among individuals using NSAIDS is significant, as these medications can cause ulcers and bleeding of the gastrointestinal tract, both of which can become life-threatening if not addressed. If the patient as been diagnosed and is being treated for these side effects, abdominal massage and hydrotherapy are contraindicated until the condition has resolved. population was shown to treat their symptoms with both prescription and nonprescription pain medications. As a manual therapist, you are already probably familiar with the more common pain conditions that you see in your practice and no doubt in your education received training how to treat back, neck, and knee pain. Knowing the pathology of your patient, the medication they are taking, and how to integrate your manual treatment with other therapies they may be implementing, whether that be stretching or exercise, cryotherapy, or another modality, will be what sets your treatment apart in the category of pain management. and function. People with RA also may have systemic symptoms, such as fatigue, fever, weight loss, eye inflammation, anemia, subcutaneous nodules (bumps under the skin), or pleurisy (a lung inflammation). Most people with arthritis will use pain management strategies at some time. Regardless of the cause, pain management strategies are similar for people with osteoarthritis and rheumatoid arthritis. Some individuals with these conditions may have a different experience or may require a different medical approach to manage their disorder(s). For mild to moderate pain, your client may use nonopioid (nonnarcotic) drugs like acetaminophen and NSAIDs, such as aspirin and ibuprofen, which can be purchased over the counter (without a prescription). Moderate to severe pain may require opioids (also known as narcotics ) such as morphine, fentanyl, hydromorphone, oxycodone, and codeine, which require a prescription. Physicians sometimes prescribe nonopioids along with opioids for moderate to severe pain (Dey & Vrooman, 2023). Many anti-inflammatory medications are nonopioid analgesics, like aspirin, available without a prescription, and doctors find them appropriate for the treatment of acute and chronic effects. People with inflammation should be treated for both relief from pain and to slow or limit damage to the tissues that is the underlying cause. NSAIDs can reduce inflammation for varying lengths of time (Dey & Vrooman, 2023). already experience back pain, depression, IBS, arthritis, or lupus. There is no difference based on race with regard to fibromyalgia (NIAMS, 2021). Doctors are still unsure about exactly what causes fibromyalgia, but research shows that people suffering have altered neural pathways with brain scans. Additionally, they have a heightened sensitivity to pain. Pain in the legs, arms, head, chest, and back are particularly amplified for the
Healthcare Consideration: Drugs that alter blood- clotting mechanisms predispose users to bruising, so extra care should be used with individuals taking anticoagulants, platelet inhibitors, aspirin, and other NSAIDs. Petrissage, for example, may cause bruising in an individual taking any of these medications. Manual techniques like deep kneading, ischemic compressions, and cross fiber frictions may need to be modified or avoided. While these techniques do not damage normal tissue, they can be too aggressive for individuals on these medications. Pain and inflammatory conditions How do we define pain and inflammation conditions? There are many illnesses and pathologies that produce pain as a biproduct as the underlying problem. The easiest way to identify a sole pain condition is an abnormal persistent pain that doesn’t go away after a long period of time. This pain is most commonly caused by inflammatory conditions, stress, and orthopedic injuries. In 2021, over 20% of Americans identify as sufferers of chronic pain, with orthopedic pain (back, neck, knee) in particular, being at the top of the list as specified pain (CDC, 2023). This population was most likely to treat pain with physical therapy and/or manual therapy. This is an encouraging statistic as in the past the same Arthritis Arthritis is a general term for conditions that affect the joints and surrounding tissues. Joints are places in the body where bones come together, such as the knees, wrists, fingers, toes, and hips. The two most common types of arthritis are osteoarthritis and rheumatoid arthritis. Osteoarthritis (OA) is a painful, degenerative joint disease that often involves the hips, knees, neck, lower back, or the small joints of the hands. OA usually develops in joints that are injured by repeated overuse from performing a particular task or playing a favorite sport, or from carrying around excess body weight. Eventually this injury or repeated impact thins or wears away the cartilage that cushions the ends of the bones in the joint. As a result, the bones rub together, causing a grating sensation. Joint flexibility is reduced, bony spurs develop, and the joint swells. Usually, the first symptom of OA is pain that worsens following exercise or immobility. Treatment usually includes analgesics, topical creams, or NSAIDs; appropriate exercises or physical therapy; joint splinting; or joint replacement surgery for seriously damaged larger joints, such as the knee or hip (Mohammed et al., 2020). Rheumatoid arthritis (RA) is an autoimmune inflammatory disease that usually involves various joints in the fingers, thumbs, wrists, elbows, shoulders, knees, feet, and ankles. An autoimmune disease is one in which the body releases enzymes that attack its own healthy tissues. In RA, these enzymes destroy the linings of joints. This causes pain, swelling, stiffness, malformation, and reduced movement Fibromyalgia Fibromyalgia is a chronic condition that is characterized by widespread pain and tenderness throughout the body. Fatigue, insomnia, anxiety, and depression are accompanying symptoms that someone with fibromyalgia may experience but the predominant characteristic of this disorder is pain. Anyone can suffer from fibromyalgia, but the main population that is diagnosed with fibromyalgia is women who are middle aged or older. Individuals are more likely to be diagnosed with fibromyalgia if they
Page 89
Book Code: MTX1325
EliteLearning.com/ Massage-Therapy
Powered by FlippingBook