Pneumothorax and...massage?

**Tait** · Oct 30, 2009 12:22 AM

I was helping a patient of another nurse this evening and she was complaining of right shoulder pain after a left AICD placement. She requested that I massage her shoulder, and I did, feeling a fairly large muscular "knot" there. (Along the edge of the scapula where I am sure many of us get them, I know I do)

Later on this evening we found out she has a small R pneumothorax and another nurse on the floor suggested I not massage her shoulder anymore to reduce the risk of increasing the pneumo.

Has anyone else run into this situation?

Thanks!

Tait

suanna · Oct 30, 2009, 01:33 AM

I can't imagine how massaging a patients shoulder would have an effect on thier pneumothorax one way or the other. Shoulder pain is common with a small pneumothorax. If you have time- sure- rub it. The pain will come back as soon as you stop- the air is still there, but the patient may appriciate the attention. Analygesics would be my first intervention. They last longer than a neck rub- but a nice neck/back rub is still nice while you are waiting for the meds to kick in.

**Tait** · Oct 30, 2009, 01:36 AM

Originally Posted by suanna

I can't imagine how massaging a patients shoulder would have an effect on thier pneumothorax one way or the other. Shoulder pain is common with a small pneumothorax. If you have time- sure- rub it. The pain will come back as soon as you stop- the air is still there, but the patient may appriciate the attention. Analygesics would be my first intervention. They last longer than a neck rub- but a nice neck/back rub is still nice while you are waiting for the meds to kick in.

She was an hour into Lortab, Dilaudid, Ativan, Xanax and Morphine. Nothing seemed to help at all except the massage.

Tait

suanna · Oct 31, 2009, 12:49 AM

Originally Posted by Tait

She was an hour into Lortab, Dilaudid, Ativan, Xanax and Morphine. Nothing seemed to help at all except the massage.

Tait

Yep - it's a tough pain to get under control. We have had some luck with ketrolac IV as well as ice or heat depending on the patients preference. Remarkably, repositioning seems to help as well- supine, side laying- anything but upright which tends to focus the air(and the pain) at the apex of the lung field. Of course, if the pneumo has impaired air exchange, the patient may need to be upright for optimal breaths in the unaffected side.

CASTLEGATES · Oct 31, 2009, 06:44 AM

I had pneumothorax. Massage was one thing I wouldn't do but if they want it and it helps...patient is always right.

Basically you're squishing air between the tissues. I had nice crepitus for a few days. It hurt when I smushed it around.

Pneumothorax and...massage?

Pneumothorax and...massage?

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