This is a progressive disease, characterised by death of nerve cells in a specific area of the brain called the basal ganglia. Parkinson patients lack the neurotransmitter dopamine and have symptoms such as tremors, speech impediments, movement difficulties and often dementia later in the course of the disease.
Motor neurone disease This is a chronic, slowly progressive disease of motor nerves, causing muscle wasting, weakness and paralysis.
Paralysis of the facial nerve (the fifth cranial nerve), usually affecting muscles on one side of the face. It can occur as a consequence of MS, a viral infection, or other infections. It has an acute onset and can be transient or permanent, although most cases make a complete recovery. Facial massage and facial exercises help muscles regain their tone.
Inflamed, trapped or pinched nerve Avoid massage over the area as it may worsen the inflammation and cause pain. Refer to medical practitioner if the condition is undiagnosed or severe. Loss of sensation due to a trapped nerve may inhibit or distort client’s response to pressure, discomfort and pain. However, release of tension in muscles through massage may reduce pressure on trapped or pinched nerves.
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Medication may distort a client’s feedback regarding pressure, discomfort and pain.
Depending on the medication and its effects, medical clearance may be necessary before treatment where clients are taking the following drugs:
Anticoagulants, such as Warfarin and Heparin, prescribed to thin the blood (deep massage could cause bruising or internal bleeding)
Steroids long term (can cause thinning of the skin, osteoporosis and capillary damage)
Cytoxic drugs (for treatment of cancer), which cause a reduction of blood-clotting ‘platelets’ (subsequently, heavy massage may cause bleeding under the skin).
Extra caution may be required when treating clients with the following conditions.
Elderly, very young or very nervous clients
A shorter treatment may be more appropriate. You should explain the procedure fully and check that they are not having treatment because someone else thinks it a good idea. Ensure that they are warm and comfortable throughout the treatment.
Myalgic encephalomyelitis (ME)
Clients with ME (also known as chronic fatigue syndrome) can benefit from Indian Head Massage, which may reduce anxiety about their condition. It is advisable to avoid deep pressure on tender areas. A shorter and more relaxing treatment is recommended, as ME sufferers often find a full or stimulating treatment exhausting.
James talks here about an experience as a practitioner:
‘I am qualified in Indian Head Massage and had been practising for two years, mainly in offices. I went on a meditation weekend and one of the other participants, John, aged 29, had ME.
When he heard I was a massage therapist he requested a treatment. I had not worked on anyone with ME before. John was thin, pale and low in energy. I was aware of the advice to work lightly on those with ME but I thought it was over-cautious, and felt sure my regular massage would energise him, as it did my other clients. I did my normal massage on him at 7.30 in the evening. By 8 he was in bed and was not seen again until 9 the next morning. I was very alarmed by this. His body could not take the stimulating treatment and it had exhausted him. It really taught me a lesson and I now adhere to advice on contraindications and precautions, and have since worked successfully on clients with ME.’
Postural defects include kyphosis, scoliosis and lordosis. Ensure that the client is comfortable during treatment: extra support may be needed for neck or lower back. Shorter treatments may be necessary.
Very large or very small-framed clients, disabled clients
Ensure that the chair is comfortable and check that the pressure applied is appropriate. Indian Head Massage can easily be carried out on someone who is in a wheelchair. As always, approach each case individually.
Patch tests may be required if using oils on sensitive individuals.