How Might Massage Help HIV Patients?
Musculoskeletal involvement in human immunodeficiency virus infected patients are important disease manifestations, responsible for increased morbidity and also decreased quality of life (Kole et al. 2013).
The effects of massage on HIV / AIDS musculoskeletal soft tissues include pain relief, decreased levels of depression, improved immune function, improved blood flow and blood composition, reduced edema, and increased mobility of connective tissue, muscle and the nervous system . Massage is therefore potentially effective in improving the quality of life in patients suffering from chronic disorders (Hillier et al. 2010).
Furthermore, an increase in immune function following massage where the proposed mechanisms for this effect occurs via alterations in bio-chemistry, such as reduced levels of cortisol and increased levels of serotonin and dopamine. Though what mediates these biochemical effects is not known but presumed to occur through stress reduction (Hillier et al. 2010).
Effectiveness of Massage for HIV Musculoskeletal Pain
In a Cochrane review by Hillier et al. (2010), they found that individual domains of quality of life, there were findings in favour of massage therapy in combination with other modalities,such as meditation and stress reduction, being superior to massage therapy alone or to the other modalities alone.
The Suitability of Massage for Musculoskeletal Pain in HIV Patients?
Osteopaths have had success at managing musculoskeletal complaints in HIV patients at the Blanchard Clinic (affiliated with the University College of Osteopathy, London). There is even research to suggest massage treatment might be effective for managing the musculoskeletal pain associated with HIV.
Though bear in mind, the osteopath will decide whether massage isa suitable and safe treatment option for managing musculoskeletal pain associated with HIV by completing an appropriate case history and examination or decide to refer you to the most appropriate medical practitioner.
The Challenge of Managing HIV Patients in Musculoskeletal Practice
The major challenges for the osteopath includes not only recognizing HIV infection associated rheumatic disorders but also distinguishing them from classic rheumatic diseases like rheumatoid arthritis, SLE, spondyloarthropathy, and vasculitis. So an aggressive multidisciplinary approach to early detection and timely intervention of these disorders, sometimes in consultation with a rheumatologist are all essential for effective management and to improve the quality of life (Kole et al. 2013). The other consideration is infection control during treatment.
HIV Infection Control During Treatment
As a blood-borne pathogen HIV is controllable in healthcare environments using the same guidelines and universal precautions which prevent all blood-borne infections including infectious hepatitis. The routine practice of osteopathy involves non-invasive manual contact only, therefore precautions are minimal. On the occasions that digital work within body cavities does take place (i.e. intraoral, peranal) the practitioners hand should be suitably gloved (Blanchard, 2009).
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Blanchard PD (2009). Masterclass: HIV-infection and osteopathy. International Journal of Osteopathic Medicine 12: 115–120
Hillier SL, Louw Q, Morris L, Uwimana J, Statham S (2010). Massage Therapy for People with HIV/AIDS. Cochrane Database Syst Rev. Jan 20;(1):CD007502
Kole AK, Roy R, Kole DC (2013). Musculoskeletal and rheumatological disorders in HIV infection: Experience in a tertiary referral center. Indian J Sex Transm Dis. 2013 Jul;34(2):107-12.