Business Week, December 17, 2007, 16:00 EST
It's now standard post-surgical practice at some U.S. hospitals
MONDAY, Dec. 17 (HealthDay News) -- A 20-minute evening back massage can help relieve the pain and anxiety that often follows major surgery, new research shows.
"In patients getting massage, the acute response was equivalent to a [dose] of morphine, which was pretty remarkable," said study senior author Dr. Daniel B. Hinshaw, professor of surgery and a member of the palliative care team at the VA Ann Arbor Healthcare System in Michigan.
According to Hinshaw, the idea for the study originated years ago, when he would ask nurses to give elderly patients a massage to augment pain relief medication. "Over the years, I have been concerned about the kind of pain and suffering that surgeons produce," he said. "How could we improve pain relief and reduce suffering?"
The massage trial included 605 veterans undergoing chest or abdominal surgery, randomly assigned to one of three groups. One group of 203 veterans received standard care, while another 200 got a daily 20-minute back massage. A third group of 202 got 20 minutes of individual attention but no massage. They were asked to quantify their feelings of pain and anxiety on a scale of 1 to 10.
"It's normal for a patient to have peak pain in the first day, which then declines," Hinshaw noted.
But, according to the study, "The rate of decline was faster by about a day for patients in the massage group," he said. Patients also experienced short-term declines in anxiety following massage, the team found.
Reporting in the December issue of the journal Archives of Surgery, Hinshaw's team found no differences in longer-term patient anxiety, length of hospital stay or the amount of pain-relieving medication used among the three groups.
Massage will now become part of the post-surgical routine at the Ann Arbor facility and related VA facilities in the region, Hinshaw said. His group is exploring its use to reduce the incidence and length of delirium experienced after surgery. Delirium, which is difficult to treat, can often lengthen the time spent in the hospital after surgery, he said.
A similar program of post-surgical massage has been in place at the Mayo Clinic in Rochester, Minn., for the past few years, said Susanne Cutshall, a clinical nurse specialist there.
"Ours is for cardiac surgery," Cutshall said. "We have a full-time therapist available. If there is a suggestion of back, shoulder or neck pain, the therapist can come and see them. Patients get a brochure about it before they come here, so they can ask for it."
The Mayo massage program "started about five years ago, when we were looking at pain medication," Cutshall said. "We stopped to listen to what the patients were saying about back, neck and shoulder pain. It seems to be muscular in origin."
A massage session at the Mayo can last from 20 minutes to 40 minutes, depending on what the patient might need, Cutshall said.
"Most people, it helps," she said. "It may make the pain a little better, they might sleep better, they might be less anxious."
There's more on post-surgical pain treatment at the U.S. National Library of Medicine.
SOURCES: Daniel B. Hinshaw, M.D., professor, surgery, University of Michigan, Ann Arbor; Susanne Cutshall, R.N., clinical nurse specialist, Mayo Clinic, Rochester, Minn; December 2007, Archives of Surgery
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