Pathology D for Massage Therapists

Deep Vein Thrombosis (DVT)

Definition: Blood clot in deep veins ( responsible for 90% of blood flow to the heart from the legs) usually in the legs such as posterior tibial vein, anterior tibial vein, popliteal vein, femoral vein;  May lead to pulmonary embolism in which the thrombus dislodges and moves to pulmonary artery or postphlebitic syndrome which consists of edema, pain and skin changes due to the destruction of the venous valves.

Causes: unknown: May be due to injury, tears in the vessel lining, abnormal clotting tendencies, poor circulation, varicose veins, local infections, surgery, hormonal factors such as high estrogen birth control pills, nutritional deficiencies that weaken blood vessels:  Factors that increase the risk include childbirth, surgery trauma, birth control pills, aging

Signs/Symptoms: pain, swelling, bluish discoloration of the skin, warmth, fever, chills, itchiness: occurs more frequently in women than in men; occur mainly in calves, thigh and pelvis.  Difficult to diagnose – may be confused with phlebitis or muscular injury.

Indications: Do not massage until physician checks condition:  Warm moist compresses.

Contraindications: Do not apply massage directly to area as it may dislodge thrombus: May be on blood thinner medications such as heparin, coumadin or aspirin -use caution. Refer to appropriate health care practitioner.

Depression

Definition: whole body illness affecting the body, mind, spirit. Unipolar disorders – depressive episodes that reoccur several times.  Bipolar disorders usually begin as depression and progress  to mania.  Seasonal affective disorder – become more depressed during winter months with reduction of daylight.

Causes:  tension, stress, chemical imbalances in the brain, heavy metal toxicity, nutritional deficiencies, thyroid disorders, sugar related problems, poor diet, allergies to foods or chemicals, dysfunction in neurotransmitters (dopamine, serotonin, norepinephrine) caused by inadequate diet.

Signs/Symptoms: withdrawal, chronic fatigue, sleep problems, headaches, physical pain, digestive disorders, suicidal tendencies, irritability, anxiety, weight gain,

Indications: Massage for stress reduction, reduce muscle pain and fatigue, restore sense of self worth through touch

Contraindications: Caution: watch for side effects of drugs such as dizziness, irregular heartbeat, constipation, insomnia.  Some common drugs include Prozac, Zoloft, Asendin, Wellbutrin, steroids.
Refer to appropriate health care practitioner for care. Bach Flower Remedies.

Dementia

The Hidden Patient Polarity Therapy for Dementia Caregivers By Shirley Vanderbilt :Massage and Bodywork Magazine

Rewarding Work Massaging Clients with Dementia By Cynthia Bologna Massage and Bodywork Magazine

Diabetes Mellitus

Definition: defective insulin production in the body.  Type I- insulin dependent.  Type II – non-insulin dependent

Causes: hereditary, improper carbohydrate metabolism, hypothyroidism, obesity, high fat intake, hyperglycemia

Signs/Symptoms: blurred vision, itching, unusual thirst, fatigue, skin infections, tingling or numbness in the feet, flulike symptoms, loss of hair on the legs, increased facial hair, small yellow bumps on body, frequent urination

Indications: Massage to increase circulation, stress reduction.

Contraindications: Work with appropriate health care practitioner with diet and lifestyle changes.  Caution with diabetic neuropathy and other complications such as cardiovascular disease, ulcers, kidney disease, amputations, impaired vision.

Diabetic Retinopathy

Definition: Capillaries that nourish the retina leak fluid or blood that can damage the rod and cone cells
Causes: diabetes

Signs/Symptoms: vision disturbances, loss of vision:  may have no symptoms until relatively advanced

Indications: Massage ok

Contraindications: Work with physician for diabetic condition

Diarrhea

Definition: frequent and loose watery stools

Causes: bacterial, viral, food poisoning, parasites, caffeine, ulcerative colitis, Crohn’s disease, incomplete digestion, stress

Indications: Massage for stress reduction:  May occur after massage due to release of toxins and increase in circulation

Contraindications: Dehydration may be present:  Refer to Naturopath, Acupuncturist for treatment.  Physician may be needed if problems result.

Disc problems: (deterioration, protrusion, herniation, rupture)

Definition: general category of problems that occur with the discs in the spinal column

Deterioration: disc degenerates over time until the disc loses integrity and presses on surrounding structures (protrusion). Herniation or rupture ( leakage of nucleus) may also result

Causes: injury, trauma, nutritional deficiencies, allergies, stress, poor posture, weak ligaments.

Signs/Symptoms: reduction of lordosis, pain, referred pain down leg (usually along dermatome), numbness, shooting pain, tingling, muscle weakness.

Indications: Massage to reduce inter-disc pressure; psoas, adductors, erectors spinae; realignment therapy; Movement re-education; Hot, moist peat packs.  Correct posture and body mechanics.

Contraindications: Refer to appropriate health care practitioner for accurate diagnosis;  Osteopaths and Chiropractors that deal with disc problems. Acupuncturists/Naturopaths to address lifestyle changes. Physical therapist for strengthening.

Healing Back Pain : The Mind-Body Connection (Paperback) – by John E. Sarno “I have never seen a patient with pain in the neck, shoulders, back or buttocks who didn’t believe that the pain was due to an..

Basic Clinical Massage Therapy: Integrating Anatomy and Treatment (Lww Massage Therapy & Bodywork Series) (Hardcover) – by James H. Clay, David M. Pounds

Clinical Massage Therapy: Understanding, Assessing and Treating Over 70 Conditions (Paperback)
by Fiona Rattray (Author), Linda Ludwig (Author)

Travell & Simons’ Myofascial Pain and Dysfunction: The Trigger Point Manual (2-Volume Set) (Hardcover) – by David G. Simons, Janet G. Travell, Lois S. Simons, Barbara D. Cummings

Dislocations

Definition: displacement of a bone from a joint with tearing of ligaments, tendons and articular capsules

Causes: trauma, injury; trauma usually from a pulling out of the joint; increased risk of dislocation after first time

Signs/Symptoms: pain, swelling, inflammation, hypermobililty in joint or lack of mobility, muscular contraction holding joint in place

Indications: Treatment after initial injury is realignment from a MD, ND, DC or other professional.  Massage to reduce inflammation, reduce pain, realign structure, restore ROM, reduce scar tissue formation and muscle spasm.

Contraindications: Caution advised. Have injury assessed by appropriate health care practitioner

Diverticulitis/Diverticulosis

Definition: Inflammation of mucous membranes of the lining of the colon forming diverticuli ( sac like outpouchings of the wall of the colon when the muscles become weak); particles get caught in diverticuli and become infected or inflamed

Causes: lack of sufficient bulk in the colon during segmentation (movement of the small intestine), food allergies, low-fiber diet, hereditary, obesity, coronary artery disease

Signs/Symptoms: gas, bloating, diarrhea, pain, stress, cramping, nausea, constant need to eliminate, tenderness on left side of abdomen, constipation

Indications: Massage for stress reduction, increase peristalsis, reduce pain; Visceral manipulation

Contraindications: Refer to Naturopath or Acupuncturist for diet modification and treatment. Inflammation may cause obstruction in colon or abscesses.

Dizziness

Definition: light headed feeling or feeling of imbalance

Causes: Dehydration, inner ear problems, vertebral misalignment, Trigger points in Sternocleidomastoid, premenstrual symptom, pre-menopausal symptom, stress induced, anxiety, virus, brain tumor, cerebral circulation blockage, thyroid, imbalance, fibromyalgia.

Indications:  Massage for stress reduction, muscle trigger point release;  SCM’s, Longus coli, Occipital ridge, trapezius; balance alignment.

Contraindications:  May be worse from turning head certain way, or getting up quickly:  Refer to appropriate health care practitioner for therapy:  Refer to Physician if condition worsens.  Chiropractic may help with vertebral alignment.

Dry Skin

Definition: imbalance of oils and moisture in the skin

Causes: hereditary, poor diet, environmental factors such as wind and cold, cosmetics, nutritional deficiencies, constant hand washing

Signs/Symptoms: dull looking skin, readily wrinkles, chapping, cracking

Indications: Use Aloe Vera, Vitamin E based oils and lotion

Contraindications: Severely cracked and bleeding skin should be avoided; Refer to appropriate health care provider

Duodenal Ulcer

Definition: crater like lesion in the first part of the duodenum

Causes: hypersecretion of acidic gastric juice: may be caused by stress, emotions, food reaction or drug reaction, over stimulation of the vagus nerve

Signs/Symptoms: burning pain that feels better after eating

Indications: Massage to reduce stress

Contraindications: Work with guidance of Naturopath, Acupuncturist, Physician.  Diet modification and lifestyle changes needed.

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