Giving a Back Massage

Goal: The patient reports increased comfort and decreased pain and exhibits a relaxed state.

1. Perform hand hygiene and put on PPE, if indicated.

2. Identify the patient.

3. Offer a back massage to the patient and explain the procedure.

4. Put on gloves, if indicated.

5. Close room door and/or curtain.

6. Assess the patient’s pain, using an appropriate assessment tool and measurement scale. (See Fundamentals Review 10-1 through 10-6.)

7. Raise the bed to a comfortable working position, usually elbow height of the caregiver (VISN 8 Patient Safety Center, 2009), and lower the side rail.

8. Assist the patient to a comfortable position, preferably the prone or side-lying position. Remove the covers and move the patient’s gown just enough to expose the patient’s back from the shoulders to sacral area. Drape the patient, as needed, with the bath blanket.

9. Warm the lubricant or lotion in the palm of your hand, or place the container in small basin of warm water. During massage, observe the patient’s skin for reddened or open areas. Pay particular attention to the skin over bony prominences. (See Chapter 8, Skin Integrity and Wound Care, for detailed information regarding skin assessment.)

10. Using light, gliding strokes (effleurage), apply lotion to patient’s shoulders, back, and sacral area.

11. Place your hands beside each other at the base of the patient’s spine and stroke upward to the shoulders and back downward to the buttocks in slow, continuous strokes. Continue for several minutes.

12. Massage the patient’s shoulder, entire back, areas over iliac crests, and sacrum with circular stroking motions. Keep your hands in contact with the patient’s skin. Continue for several minutes, applying additional lotion, as necessary.

13. Knead the patient’s skin by gently alternating grasping and compression motions (pétrissage).

14. Complete the massage with additional long, stroking movements that eventually become lighter in pressure.

15. Use the towel to pat the patient dry and to remove excess lotion.

16. Remove gloves, if worn. Reposition patient’s gown and covers. Raise side rail and lower bed. Assist patient to a position of comfort.

17. Remove additional PPE, if used. Perform hand hygiene.

18. Evaluate the patient’s response to interventions. Reassess level of discomfort or pain using original assessment tools. Reassess and alter plan of care, as appropriate.