Issue link: https://www.massageandbodyworkdigital.com/i/329694
I t p a y s t o b e A B M P C e r t i f i e d : w w w. a b m p . c o m / g o / c e r t i f i e d c e n t r a l 99 relaxation or has clinical goals. The questions can be incorporated into your first-session intake. Simply say something like, "May I ask about any medications you're taking regularly?" Be sure to document what the client reports. If your client doesn't know the name of the medication, ask what the medication is for. You might get a response like, "Oh, something for my blood pressure, something for my heart, and oh, yes, I had a small stroke last year so I take a pill for that." This brief exchange gives you a significant amount of relevant knowledge and can guide your session and inform any precautions you might take. KNOW HOW MEDICATION IS ADMINISTERED The method by which a medication is administered—whether injected, delivered by patch, or rubbed on the skin, for example—directly affects your massage. A corticosteroid injection in the elbow joint within the past 24 hours to reduce tennis elbow inflammation would be a local massage therapy contraindication. The medication's effectiveness is intended for a very localized effect and massaging the area might cleanse the joint of the much-needed medication. Similarly, a Betaserone injection into the belly fat of a multiple sclerosis (MS) patient must be left undisturbed because the injection site can be easily irritated and will be sore. Knowing about an adhesive patch containing pain-relieving medication is another example of the therapist's "need to know" stance regarding drug administration methods, as these patches are easily dislodged and touching them should be avoided. If you open the door to discussion by asking your clients about their medications, they will often offer drug administration information. For example, "My doctor injected my left knee with a steroid this morning. Can you still massage it?" Or, "I took my MS medication last night—just wanted you to know." Again, knowledge of the intended effects of the medication, as well as the method of administration, establishes a foundation for safe care. UNDERSTAND THE NAMES When you research your clients' medications, be aware that every drug has several different names: 1. The generic name is the scientific name assigned to a formula during its testing phase and throughout its final clinical trials. This name is generally not used by consumers. 2. A trade name (or brand name) is the name used to market the drug, and is assigned by the pharmaceutical company once the drug is approved for use. For example, the drug with the generic name naproxen is sold under the trade names of Aleve, Anaprox, and Naprosyn. 3. The class name is the name that categorizes the drug's actions. There are just a few dozen class names, each covering many medications. For example, the class of nonsteroidal anti- inflammatories includes Actron, Advil, Aleve, Anaprox, Motrin, Naprelan, and Orudis; the class of skeletal muscle relaxants includes Flexeril, Lioresal, and Valium; and the class of antiparkinsonian drugs includes Comtan, Eldepryl, Mirapex, and Requip. UNDERSTAND OFF-LABEL USE Some medications were designed, researched, and trialed for one purpose, and were later found to be effective for another purpose. Prescribing a medication for that other purpose is called off- label use, and is common and ethical. Discovering off-label uses for a drug is one of the benefits of long-term clinical trials. One example is Lyrica (pregabalin). This medication is clinically an anticonvulsant but also relieves multiple symptoms of fibromyalgia and neuropathy, so it is often prescribed off-label for those conditions. KEEP A REFERENCE CHART HANDY Once you do your research and practice long enough, you'll be very familiar with the most common medications your clients are taking. But we're all too busy to try to memorize this essential information. I've tried to make your life easier (and your practice safer) by creating the chart on the previous pages. It is by no means exhaustive, but it provides a listing of many of the drugs you'll run into as a massage therapist, and some quick guidance about precautions to take. There are some excellent reference books written specifically for massage therapists that can serve as quick guides as well. Please ask your clients about medications during your massage therapy intake. It shows a deeper level of care, raises your professionalism to a higher level of involvement, and can ultimately help keep you and your clients safe from harm. Charlotte Michael Versagi is a national presenter and author of Step-by-Step Massage Therapy Protocols for Common Conditions (Lippincott Williams & Wilkins, 2011). Contact her at charlotteversagi@gmail.com. MEDICATIONS MAT TER