Nursing How To’s: Providing Back Care and Massage

Nothing better than experiencing a soothing massage right after a long and toxic day, right? You could already sigh imagining the feel of all those sore muscles being loosened. But wait, it’s not only nurses who need this kind of soothing, right? Even patients need their own dose of relaxing back massage. But when and how should nurses perform this procedure?

Back Massage: A background

Back massage is usually given in conjunction with the activities of bathing the client. It can also be done on other occasions when a client seems to have a risk of developing skin irritation due to bed rest. The goal when performing this procedure is to enhance relaxation, reduce muscle tension and stimulate circulation.

However, performing a back massage is contraindicated in clients with vertebral fractures, rib fractures, burns, open wounds, bleeding, or heart attack.

After a back massage:

–          A client should feel refreshed and relaxed, as evidenced by verbal or non verbal response

–          The blood supply to the muscles and skin of the back is promoted, as evidenced by a change in skin color and warmth

–          The client should feel more comfortable, as evidenced by non-verbal and verbal response.

Steps in Performing Back Massage

  • Explain the procedure and offer back massage to the patient.

Back massage can facilitate circulation and promote relaxation.

  • Perform proper hand washing.

Hand washing deters the spread of microorganisms.

  • Provide privacy. Close curtain or door.

Privacy increases relaxation

  • Assist the patient to the prone position or side – lying position with the back exposed from the shoulders to the sacral area.

This position exposes an adequate area for massage with privacy and warmth maintained.

  • Use the bath blanket to drape the patient. Raise the bed to the high position and lower the side rail closest to you.

Having the bed in the high position reduces back strain for the nurse.

  • Warm the lubricant or lotion in the palm of your hand or place the container in warm water.

Cold lotion causes chilling and uncomfortable sensation.

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

Effleurage relaxes the patient and lessens tension.

  • 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.

Continuous contact is soothing and stimulates circulation and muscle relaxation.

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

A firmer stroke with continuous contact promotes relaxation.

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

Kneading increases blood circulation to areas.

  • Complete the massage with additional long stroking movements.

Long stroking motion is soothing and promotes relaxation.

  • During massage, observe the patient’s skin for reddened or open areas. Pay particular attention to the skin over bony prominences.

Pressure may interfere with circulation and lead to development of decubitus ulcers.Back rub stimulates circulation to these areas.

  • Use the towel to pat the patient dry and to remove excess lotion.Apply powder if the patient requests it.

This provides additional comfort for the patient

  • Perform hand washing.

To deter the spread of microorganisms.

  • Assess the patient’s response and record your observations on the patient’s chart.

This provides accurate documentation of the procedure and condition of the patient’s skin.



Liane Clores, RN MAN

Currently an Intensive Care Unit nurse, pursuing a degree in Master of Arts in Nursing Major in Nursing Service Administration. Has been a contributor of Student Nurses Quarterly, Vox Populi, The Hillside Echo and the Voice of Nightingale publications. Other experience include: Medical-Surgical, Pediatric, Obstetric, Emergency and Recovery Room Nursing.

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