Massage & Bodywork

MAY | JUNE 2020

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In these tables, I included studies that are in English, and those for which I had access to the whole article. I excluded studies that are published in other languages and those I could not gain access to beyond the abstract. I also excluded any studies that referred to cardiac massage, or CPR, and those in which the term manual therapy described care other than massage therapy. Bone Injuries What happened? Structure injured Who did the massage? Comments A 66-year-old man with osteoporosis had chronic low-back pain along with pain and numbness radiating down his legs. His doctors recommended surgery, but he preferred conservative treatment with massage 2–3 times per week. After a massage "was performed more violently than usual by a young masseur," the patient went to the emergency department. He had a new pedicle fracture, along with preexisting spondylolisthesis and several other structural problems. (Guo, Zhiping et al. 2012) Vertebra Massage therapist The authors theorize that this unusual injury was at least partly related to inappropriate pressure to the spine while the lumbar area was in hyperextension. The patient underwent spinal surgery. He fully recovered without any pain or numbness in his back or legs. A 48-year-old man was diagnosed with a C6–C7 fracture and dislocation caused by excessive hyperextension of the neck during a massage. (Abilash, Kak et al. 2017) Vertebrae "Traditional masseuse" who had frequently seen this client for back pain This client had undiagnosed ankylosing spondylitis when he received massage. At the time of his X-rays, he had damage throughout his spine. This massage session induced permanent tetraplegia. Blood Vessels, Then Other Organs What happened? Structure injured Who did the massage? Comments A 38-year-old woman had a sudden onset of stroke symptoms after receiving a 20-minute neck massage with a handheld electric massager. (Grant and Wang 2004) Artery, then brain Not clear; possibly the patient The patient had an acute infarction in the right middle cerebral artery and dissection of the right internal carotid artery. While the cause of this injury appears to be an electric device, it shows that damage to the carotid artery is possible with pressure at the anterior or lateral neck. A 20-year-old man received traditional Thai massage from a friend. Three days later, he went to the emergency department with bilateral leg numbness and weakness. (Vanichkulbodee, Issaragrisil, and Inboriboon 2019) Artery, then spinal cord Layperson An MRI found spinal cord compression from C6–T2 due to a spinal epidural hematoma. It was surgically corrected. At the time of writing, the patient was in an inpatient rehabilitation program to help manage his lower extremity motor deficits. A 59-year-old man with a history of aortic bypass surgery hurt his back while moving a refrigerator. His wife tried to relieve his pain by walking on his back. Later that day he had severe left loin pain radiating to the groin. At the hospital he was diagnosed with an embolus to the left kidney. (Mikhail et al. 1997) Artery, then kidney Spouse The patient was prescribed anticoagulants and later underwent corrective surgery. He had a full recovery. The authors believe that occlusions had been building in the aorta over a long period of time, but that the massage precipitated dislodgement. A 53-year-old woman received a "vigorous" calf massage from her pedicurist. It was so painful she asked them to stop. Soreness persisted on the left side for two weeks, followed by a sudden onset of shortness of breath. She was diagnosed with extensive acute pulmonary emboli. (Jabr 2007) Vein, then lung Pedicurist This case demonstrates a possibility that massage didn't just loosen a preexisting clot, but did enough damage to cause a new clot to form. From the author: "In summary, massage of the lower extremities done by nonprofessional persons . . . is not free from risks." Watch "Endangerment Sites: A Conversation with Whitney Lowe" N e w ! A B M P P o c k e t P a t h o l o g y a t w w w. a b m p . c o m / a b m p - p o c k e t - p a t h o l o g y - a p p . 31

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