Massage to treat pruritus in burn patients

Itchiness is a common and distressing problem among patients with burn wounds.

In a recent review, researchers from the UK listed massage as an effective treatment.

“Extreme pruritus is an all too frequent part of burn wound healing”, says Dr. Robert Sheridan from the Shriners Burns Hospital in Boston. “This typically begins shortly after the wound is healed, peaks in intensity 4 to 6 months after injury, and then gradually subsides in most patients.”

“It can be very troubling at night. In most patients, it is adequately managed with massage, moisturizers, and oral antihistamines at night. This difficult problem has numerous alternative approaches, though none works reliably for everyone.”

And that’s the problem that the Brits want to address through more research.

The best I could find was this study published more than 10 years ago by researchers at the University of Miami School of Medicine in Florida.

First, the details.

  • 28 adult patients with burns were randomly assigned before debridement (removal of dead skin) to massage therapy or standard medical care.
    • Massage therapy involved 30-minute sessions twice a week for 5 weeks, using cocoa butter as a lubricant.
    • Standard care included application of cocoa butter, without massage, to closed wounds.

And, the results.

  • Anxiety and cortisol levels (as a measure of stress) decreased.
  • Itch scores on a 10-point scale declined from 6 to 2 after the first session and from 3 to 1 after the last session.
    • Comparable scores for the control group were 6 to 5 and 7 to 6, respectively.
  • Activity, vocalizations, and anxiety improved after massage therapy sessions on the first and last days of treatment.

The bottom line?
Dr. Sheridan observes, “Historically, survival was the only gauge of success in managing those with serious burns. More recently, the overriding objective of all aspects of burn care has become reintegration of the patient into his or her home and community.”

When it comes to treating pruritus associated with burns, nothing works 100%, 100% of the time. But massage is an option that helps ease recovery and can be part of treatment that includes antihistamines, doxepin (Sinequan), and transcutaneous electrical nerve stimulation,

And, yes, more research is needed to determine it’s most appropriate application.

1/28/09 20:50 JR

Hi, I’m JR

John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at www.Vicus.com, a complementary and alternative medicine website.