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by Tina Allen, LMT, CPMMT, CPMT, CIMT Updated July 2011
What is Spina Bifida?
Spina Bifida is a birth defect of the central nervous system, where the bones of the spine do not completely form, leaving part of the spinal cord exposed. When a child is born with spina bifida, they have an opening in the spine. A healthy spine is closed to protect the spinal cord (the bundle of nerves that sends messages back and forth between your brain and the rest of your body). Because of the opening in the spine, the nerves of the spinal cord may be damaged. A spinal cord that's damaged may not be able to fully and accurately send messages from the brain to other parts of the body.
Types of Spina Bifida
There is not only one type of spina bifida.
One kind of spina bifida can go unnoticed - spina bifida occulta. With this diagnosis, the opening in the person's back is covered by muscle and skin and the spinal cord is usually normal. There may be some problems with the spine, or there may be no apparent problems at all.
A second type of spina bifida is known as meningocele. This involves the meninges, the membranes that cover the brain and spinal cord. Meningocele is the diagnosis given when only the meninges, not the nerves, push through the opening in the vertebrae. The spinal cord can be normal and a person with a meningocele usually has no problems. A person with meningocele may need to have surgery to prevent further nerve damage later.
The most commonly known diagnosis under the Spina Bifida umbrella is myelomeningocele. In this diagnosis, the baby is born with a sac protruding from the opening in the spine. This sac contains nerves and part of the spinal cord. About 1 in 1,000 babies born in the United States have this type of spina bifida.
A child with myelomeningocele will have some paralysis as the spinal cord hasn't developed normally and some nerves may have been damaged. They will have loss of feeling in their lower extremities (legs). The severity of paralysis will vary, depending on where the opening is on the back. The lower down the back the opening is, the fewer nerves are affected and the less paralysis there is. Children will also have symptoms consisting of partial loss of feeling, sensitivity and muscular function in the lower extremities. Many times they become wheelchair bound due to their diagnosis.
Massage for Spina Bifida
When considering massage for spina bifida, it is important to provide massage therapy for the lower extremities. Children with Spina Bifida benefit from receiving tactile stimulation on their lower extremities, not only for the circulatory benefits, but also for the emotional benefits. With all children who may have decreased sensitivity or loss of feeling in an area, there is no reason to avoid such areas.
Pediatric massage therapy has also been shown to speed myelination which is important for proper nervous function. Massage can help alleviate pain and tension in muscle tissue. If the child is wheelchair bound, massage can help loosen muscles that can become rigid from staying in one position for long periods of time. Depending on the child’s symptoms and diagnosis of spina bifida, you may wish to avoid, or use great care, in the lumbosacral area.
Massage techniques that may be useful in providing therapeutic pediatric massage to children affected by spina bifida include gentle, nurturing touch (Swedish massage techniques) and placing warm hands and holding rather than stroking can also provide needed tactile stimulation and skin-to-skin contact. Through the use of pediatric massage therapy, children with spina bifida may experience improved physical and emotional health.
Massage may be a supportive therapy that can be readily applied, most effectively by specially trained massage therapists or by parents who have learned massage techniques from a skilled, educated massage therapist. Pediatric massage and nurturing touch are the most appropriate massage techniques to use in this population. When using massage therapy for children with cancer, your work does not need to be aggressive to achieve its maximum potential.
For more information visit Comprehensive Pediatric Massage Training Course (CPMT)
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