Overview o Asthma is a condition that can effect anyone o It is a chronic disorder that obstructs the airway thus interfering with the breathing process. Asthma may be triggered by external factors (such as smoke) and is also linked to internal factors such as emotional state o Normal airways are wide enough to allow air to flow easily through the bronchioles, the tubes that connect the lungs to the outside environment, but when someone has asthma, these airways become smaller and more sensitive to debris which then become “triggers” for an attack. o Asthmatics are extremely sensitive to the same debris and are hyper-reactive when the body responds to the presence of the debris o Bronchioles always seem inflamed and when triggered, the bronchiole tubes swell and secrete extra mucus causing difficulties with breathing causing respiratory distress o Respiratory distress is when a person has extreme difficulty breathing especially with exhalation o Bronchospasms are also common with asthmatic. These create a difficulty getting air in and out of the lungs because the muscles in the bronchial tubes will tighten and relax spontaneously for an unknown amount of time. (1, 4, 5, 9, 10) Types o There are 4 types of asthma. o Bronchial asthma – The most typical from of asthma typically caused by excessive mucus production and wheezing leading to bronchospasms and attacks. o Exercise induced asthma – Typical among athletes, this form of asthma occurs with physical excretion, symptoms may be delayed for hours after exertion but will include extreme shortness of breath and bronchospasms. o Silent asthma – Silent asthma is a severe form as it has no symptoms warn to warn of an impending attack, but leaves the person suddenly dangerously short of breath o Cough variant asthma – coughing alone is the primary symptom of this form. The sufferer will find their symptom becomes worse in the middle of the night leaving them fatigued and short of breath after a long coughing session. (1, 4, 9, 10)
Classifications o Each type of asthma can then be classified as one of the following: o Mild-intermittent – attacks occur less than twice a week and have little to no impact on daily living o Mild persistent – attacks occur more than twice a week and up to once a day. Night time episodes happen once a month and the attacks may affect daily living o Moderate persistent – Attacks likely occur in episodes once a day and night time attacks once a week. This class likely affects daily living o Severe persistent – attacks occur most days and nights and severely affects daily living. (1, 4, 10)
Common Triggers for asthmatics include: o Smoke o Exercise o Dust mites o Cockroach waste o Pet-related allergens o Respiratory infections o Food intolerance o Medications (beta blockers, Aspirin, tetracycline) o Psychological factors such as stress and emotional responses o GERD (Gastroesophageal Reflux Disease) o Climatic factors (temperature changes, humidity, ect.) o Genetic predisposition (1, 4, 9, 10)
Signs and symptoms of asthma may include any of the following: o Shortness of breath (Dyspnea) o Wheezing o Coughing o Difficulty with air release (exhaling) o Panic feeling o Sweating o Anxiety (1, 4, 10) Treatment o Treatment for asthma contains a wide range of options. One of the best things to do is limiting exposure to triggers. This will help to limit the amount of attacks. Prescription medications can also help to manage signs and symptoms as well as treat the bronchioles as well. Most of the treatments are aimed to reduce the risk of attacks as asthma is not currently curable. (4, 10)
Medications o Medications for asthma are used to treat the causes of the attacks. Common medications include: o Bronchodilators - reduce airway resistance by widening the bronchiole tubes o Corticosteroids (oral or inhaled) – Used as a long term anti-inflammatory to reduce the swelling of the bronchioles o Antihistamines – used when allergens are a main trigger to help control the effects of the allergen on the airway. (4, 9, 10)
Surgery o Bronchial Thermoplasty (2) o A bronchoscope tube is worked down the bronchioles into the alveoli. As the bronchoscope tube is retracted, it heats up causing the muscles of the bronchioles to shrink for up to 5 years which relieves the symptoms of asthma for 5 years. o This surgery is still new to the medical community and can only be performed by pulmonologists who are certified with bronchial thermoplasty. o Bronchial thermoplasty is typically only used for people who are not seeing an improvement in their symptoms while on the maximal doses of medications and are suffering from a severe form of asthma that greatly impacts their daily life. o For more information about bronchial thermoplasty, visit: http://www.btforasthma.com/
Alternatives (7) o Acupuncture o Acupuncture can help aid people suffering from asthma by using needle insertion into different points in the body to reduce the symptoms of asthma. More studies are needed in order to define just how useful acupuncture is in treating asthma o Vitamins o Three vitamin supplements that are shown to help with asthma are Antioxidents, Omega-3 fatty acids and Vitamin D. o Antioxidants – Those with severe asthma are typically known to have a decreased level of protective nutrients found in fruits and vegetables. Antioxidants such as magnesium, vitamin C and vitamin E are said to have some effect on asthma, but more study is needed to come to a conclusion about this. o Omega-3 fatty acids - Omega-3s are believed to reduce the inflammation that leads to asthma symptoms. It isn't clear whether omega-3s from vegetable sources, such as flaxseed and canola oil, have the same beneficial effects as omega-3s found in fish. o Vitamin D – It is shown that some people with severe asthma also have a vitamin D deficiency. Researchers are currently studying the effects of vitamin D with asthma and are finding results leading to the idea that vitamin D may help to reduce asthma symptoms.
Massage – Massage has been shown to help reduce the amount of attacks by aiding in the relaxation of the body. Benefits and risks of massage are as follows. (4, 8, 9) o Benefits o Can release tight muscles that aid in breathing o Aid in relaxation of bronchioles o Aid in total body relaxation to help regulate intrinsic trigger factors o Risks o During an attack, massage is a bad idea as it can be dangerous while the client is having difficulty breathing o Avoid scents, candles and essential oils as many of these are triggers for attacks o Use hypoallergenic oils in case of allergies o Make sure they have their inhaler in case an attack begins. o Do not over exhaust the client as it can trigger an attack o Warn your massage therapist before the massage of any triggers you know of to help them eliminate the triggers and keep you safe.
For more information please visit these references:
1. Asthma Society of Canada. (2014, November). About Asthma. Retrieved from Asthma Society of Canada: http://www.asthma.ca/adults/about/whatIsAsthma.php 2. Boston Scientific. (2014). Bronchial Thermoplasty. Retrieved from Bronchial Thermoplasty for Asthma: http://www.btforasthma.com/ 3. Daily Health Tips 24. (2014, November 21). Asthma. Retrieved from Daily Health Tips 24: http://www.dailyhealthtips24.com/asthma/ 4. Hannon, R. A., Pooler, C., & Porth, C. M. (2010). Porth Pathophysiology. Philadelphia, PA: Wolters Kluwer, Lippincott Williams & Wilkins. 5.Healthy Times Blog. (n.d.). Asthma Triggers Infographic. Retrieved from Healthy Times Blog: http://www.healthytimesblog.com/2010/12/asthma-triggers-infographic/ 6. Mayoclinic. (2014, August 19). Asthma. Retrieved from MayoClinic: http://www.mayoclinic.org/diseases-conditions/asthma/in-depth/asthma-treatment/art-20044554 7. Nature's Sunshine. (2014, February 26). How To Build A Herbal Medacine Cabinet. Retrieved from Nature's Sunshine: http://www.naturessunshine.com/blog/category/respiratory-health.aspx 8. NIH Medline Plus. (2011). Turning Discovery Into Health - Asthma. Retrieved from NIH Medline Plus: http://www.nlm.nih.gov/medlineplus/magazine/issues/fall11/articles/fall11pg4.html 9. Rattray, F., & Ludwig, L. (2000). Clinical Massage Therapy: Understanding Assessing and Treating Over 70 Conditions. Talus. 10. Werner, R. (2013). A massage therapist's guide to pathology. Philidelphia, PA, USA: Wolters Kluwer Health/Lippincott Williams & Wilkins.