Massage & Bodywork

JULY | AUGUST 2021

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L i s te n to T h e A B M P Po d c a s t a t a b m p.co m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 35 PATHOLOGY PERSPECTIVES would normally disable neurotransmitters left in synaptic gaps in the brain. Replication. Antibiotics prevent or inhibit replication of the targeted bacteria, and some kinds of chemotherapy and other cancer drugs interfere with the cell replication cycle. SIDE EFFECTS AND HOW TO MITIGATE THEM A drug side effect is an unintended and often disagreeable effect of a medication. While often mild, temporary, and annoying, side effects can sometimes be severe. Very serious consequences of medication use are called adverse drug events, and they include things like allergic reactions, accidental overdoses, and dangerous drug interactions. Massage therapy is most likely to have a direct interface with the medications our clients use in the context of side effects. Some side effects are just accepted as part of medication use, but some might prompt people to make an appointment for massage. Atorvastatin (Lipitor) is associated with muscle pain, for instance (a subject I covered in "Statin Use and Massage Therapy" in the January/February 2018 issue of Massage & Bodywork, page 40). Some drugs used for symptoms of perimenopause or birth control can cause headaches. And sometimes drugs simply cause a feeling of fatigue or low stamina—antihypertensives are especially likely to do this. It can be appropriate to work with a client who wants relief from drug side effects, but it is important that we know what drugs they're using, and why. And if the side effects have a profound, more-than- occasionally-annoying effect on a person's quality of life, then it is appropriate to refer them back to their prescribing physician, who may be able to make some adjustments for a better result. Medications Possible Side Effects Mitigation & Adjustments for Underlying Conditions Antihypertensives, some anticonvulsants, antidepressants, tranquilizers Vasodilation/parasympathetic response, hypotension, dizziness, lethargy More time to transition at the end of the session, attendance during sitting up, conclude the session with active strokes Nonsteroidal anti- infl ammatory drugs, steroidal anti- infl ammatories, opioid analgesics Analgesia, anti-infl ammation Work conservatively to avoid overtreatment (normal signals about pain tolerance will be impaired) Glucose management (metformin, various forms of insulin) Sudden drop in blood sugar Monitor carefully; adjust schedule, if necessary, to work while blood sugar levels are steady; keep sugar sources available Anticoagulants, antiplatelet drugs Blood clotting inhibition Work conservatively to avoid bruising Oral or topical steroids Thinned skin, thinned bones, connective tissue weakness; immune system compromise Modify pressure to meet client fragility; attention to hygienic precautions and personal health Shown above is a table of side effects related to some commonly used medications, and how massage therapy might be adjusted to mitigate them, bearing in mind that further accommodations may be needed, depending on the underlying conditions. This table is by no means comprehensive, and your clients' medications, side effects, and necessary accommodations may be quite different from what you fi nd here. This basic introduction to pharmacology is meant to provide enough guidance to make safe choices in the short run and to get more information in the longer run. It is not enough to ask, "What medications do you use?" We must follow that up with questions about why they use those medications, and what side effects are present—because those are the answers that will inform clinical decisions. Ruth Werner is a former massage therapist, a writer, and an NCBTMB- approved continuing education provider. She wrote A Massage Therapist's Guide to Pathology (available at booksofdiscovery. com), now in its seventh edition, which is used in massage schools worldwide. Werner is also the host of the podcast I Have a Client Who . . . on The ABMP Podcast Network. Werner is available at ruthwerner.com or wernerworkshops@ruthwerner.com. SCAN AND WATCH "Reading a Drug Guide" 1. Open your camera 2. Scan the code 3. Tap on notification 4. Watch!

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