Issue link: https://www.massageandbodyworkdigital.com/i/766890
Resources Andary, M. T. Medscape. "Guillain-Barré Syndrome." Accessed November 2016. http://emedicine.medscape.com/article/315632-overview. Cunningham, B. "Guillain-Barré Syndrome: Is There a Role for Massage Therapy? Part 1." Massage Therapy Canada (October 2010). Accessed November 2016. www.massagetherapycanada.com/operations/guillain-barre-syndrome-1759. Cunningham, B. "Guillain-Barré Syndrome: Is There a Role for Massage Therapy? Part 2." Massage Therapy Canada (January 2011). Accessed November 2016. www.massagetherapycanada.com/technique/guillain-barre-syndrome-1802. National Institute of Neurological Disorders and Stroke. "Guillain-Barré Syndrome Fact Sheet." Accessed November 2016. www.ninds.nih.gov/disorders/gbs/detail_gbs.htm. World Health Organization. "Guillain-Barré Fact Sheet." Accessed November 2016. www.who.int/mediacentre/factsheets/guillain-barre-syndrome/en/. C h e c k o u t A B M P 's l a t e s t n e w s a n d b l o g p o s t s . Av a i l a b l e a t w w w. a b m p . c o m . 41 The treatment challenge is that the nervous system is compromised and to suppress it further with narcotic painkillers is risky. These drugs also suppress the respiratory drive: a serious concern for GBS patients. Consequently, finding nonopioid options for pain management is an important part of the treatment strategy for people with GBS, and this is where massage therapy might be most helpful. As with every other question about massage therapy and pathology, working with a client who has GBS boils down to three questions: What are the risks? What are the benefits? How can I design a session or a series of sessions that eliminates the risks while maximizing the benefits? The Risks Overwhelm. A person who is still in the acute phase of this condition—that is, getting worse instead of better—is probably better off with gentle touch that supports, comforts, and soothes rather than challenges any processes in the body. This person's immune system is confused and overactive; they don't need more overwhelming stimulus. Numbness. Furthermore, many people with GBS experience some sensory paralysis. This is a caution for massage, because they can't give accurate feedback about pressure or comfort. Communication. A final caution concerns the most severe cases where a person might have some facial paralysis and/or spend some time on a ventilator to assist with respiration. Not only does this mean they are at great risk for secondary infection, it also means their ability to communicate is limited and any bodywork must be tuned to nonverbal signals about comfort. That said, acute GBS can be both frightening and painful. Any noninvasive comfort that massage can offer—as long as all the involved health-care providers are in the loop and the massage therapist is qualified to work in a hospital setting— can make this time a little easier. The Benefits A person who is being successfully treated for GBS, or who is in the long-term recovery period, may enjoy the more typical benefits of massage therapy, including boosting local circulation; stretching and manipulating disused muscles; and reducing pain, anxiety, and fatigue. One important benefit that massage can offer people with GBS is a nonpharmacological way to help manage pain. This disease is both acutely painful and involves a compromised nervous system and a weak respiratory drive. This means the most powerful analgesics are avoided if at all possible, because depressing the nervous system with opioids can open the door to other complications. Massage therapy has a good evidence base for pain PATHOLOGY PERSPECTIVES reduction, and while it may not be the only intervention that a person uses, it seems safe to suggest that massage might reduce the amount of overall painkiller medication a patient needs. This is a substantial benefit, especially in a situation where the side effects of medication are so potentially dangerous. A person who had GBS in the past and who has achieved full or nearly full recovery is a good candidate for any massage they enjoy. The only caveat is for people who experience permanent weakness or numbness; the affected areas must be treated with extra care. Ruth Werner, BCTMB, is a former massage therapist, a writer, and an NCBTMB- approved provider of continuing education. She wrote A Massage Therapist's Guide to Pathology (Lippincott Williams & Wilkins, 2016), now in its sixth edition, which is used in massage schools worldwide. Werner is available at www.ruthwerner.com.