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 . 43
TREATMENT OPTIONS
People who are susceptible to Raynaud's
know to take special care of their
temperature zones—they are advised to
be well prepared with gloves or mittens
and good socks, and to wear hats and
wrap their trunk and neck well in cold
temperatures. Many patients keep gloves
next to the freezer for when they have to
retrieve a bag of frozen peas or a package
of hamburger to defrost for dinner. And
if they are smokers, they are advised to
quit or cut down as much as possible.
If these self-care options are insufficient,
and if a move to a warmer climate is not
realistic, then a person with Raynaud's
phenomenon may have to consider
pharmacological intervention. This could
include some vasodilators like calcium
channel blockers or alpha blockers,
or it could mean using prescription
skin cream with counterirritants that
promote vasodilation on the surface. In
the most extreme cases, doctors may try
to block the motor nerves that control
vasoconstriction in the affected area.
This can be helpful, but it is typically a
temporary solution that may need to be
repeated as the damaged nerves recover.
All of these options have implications
for massage therapy, so it is important to
be aware of how a person with Raynaud's
syndrome manages their condition.
IMPLICATIONS FOR MASSAGE
Both forms of Raynaud's syndrome involve
vasospasm in response to cold or stress.
As long as the skin is healthy and intact,
massage for this condition is not only safe,
it is probably a really good idea—both for
stress reduction and for localized blood flow.
To my knowledge, no research about
massage for Raynaud's syndrome has been
published, but scads of anecdotes support
this idea, including what massage therapist
Choice Kitchen does for his own hands:
"My best treatment for the hands, when
they're cold or when they're throbbing or
achy (most all the time) or after a hard day,
is my hot water treatment. I turn on the
kitchen faucet water to pretty warm. When
my hands are acclimated, I turn the water a
little hotter. Usually by the third increase, I
start wringing my hands like a cloth, paying
particular attention to the fingers, wringing,
massaging, and stretching each one. When
it gets too hot, I quit. By then, my hands are
usually pink, and they feel oh-so-good."
Another helpful suggestion comes from a
practitioner from South Carolina: "One of my
clients with Raynaud's syndrome was a smoker.
She got some cramping during her massage,
so we agreed that she would not smoke for a
few hours before her appointment to limit the
vasoconstrictor properties of nicotine."
He adds that it is important to make sure
the client doesn't have to go through any
sudden decreases in heat: keeping a warm
room and a warm massage table and preparing
a gentle transition back to the outside world
are all important.
Ultimately, the choices about massage
therapy for a person with either type of
Raynaud's syndrome boil down to this: What
are the risks? What are the benefits? Can I
design a session that eradicates the risks while
maximizing the benefits?
PATHOLOGY PERSPECTIVES
Resources
American College of Rheumatology. "Raynaud's Phenomenon." Last modified
May 2015. Accessed January 2017. www.rheumatology.org/I-Am-A/Patient-
Caregiver/Diseases-Conditions/Raynauds-Phenomenon.
Brody, J. The New York Times. "Cold Hands May Signal Raynaud's Phenomenon."
December 5, 2016. Accessed January 2017. www.nytimes.com/2016/12/05/
well/live/cold-hands-may-signal-raynauds-phenomenon.html?_r=1.
Hansen-Dispenza, H. WebMD. "Raynaud Phenomenon." Last modified
November 14, 2016. Accessed January 2017. http://emedicine.medscape.com/
article/331197-overview.
NIH: National Heart, Lung, and Blood Institute. "What is Raynaud's?" Last
modified March 21, 2014. Accessed January 2017. www.nhlbi.nih.gov/health/
health-topics/topics/raynaud.
Raynaud's Association. "Frequently Asked Questions." Accessed January 2017.
www.raynauds.org/frequently-asked-questions/#FAQ25.
The risks include the possibility of
weakened or damaged skin with Raynaud's
phenomenon, plus making appropriate
accommodations for underlying factors and
medication. We also need to be mindful of
not asking our clients to make adjustments
to sudden drops in temperature.
The benefits of massage include being
able to help reduce stress and improve local
circulation, especially if we include extra
elements like hot stones or a paraffin bath.
As long as the skin is intact and healthy,
massage therapy looks like a terrific option
for a person with Raynaud's syndrome to
consider. But it would be great if a massage
therapist could gather some data to share on
whether bodywork had any impact on the
duration, frequency, or severity of Raynaud's
syndrome episodes—and then share it with
the rest of us. Maybe that will be you!
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.
