Can Massage Therapy Help with Werner’s Syndrome

Werner syndrome, also known as adult progeria, is a rare autosomal recessive disorder characterized by premature aging, with patients often presenting with various aging phenotypes from a young age. In their thirties, people with Werner syndrome often experience graying hair or hair loss. In their forties, they may develop bilateral cataracts and diabetes, malignant neoplasms, and atherosclerotic diseases in their fifties. [1] Additionally, a high percentage of people with Werner syndrome experience intractable skin ulcers, a type of non-healing sores that can significantly reduce quality of life. [2] Additional abnormalities include loss of the layer of fat beneath the skin (subcutaneous adipose tissue); severe wasting (atrophy) of muscle tissue in certain areas of the body; and degenerative skin changes, particularly in the facial area, the upper arms and hands and the lower legs and feet (distal extremities). [4] Additional common symptoms include diabetes mellitus, hypogonadism, osteoporosis, osteosclerosis of the digits, soft tissue calcification, premature atherosclerosis, rare or multiple neoplasms, malformed teeth, and flat feet. [5]

This article explores how massage therapy could positively influence the quality of life for those with Werner syndrome. Approaching threatment for Werner syndrome addresses the various contraindications and cautions associated with its pathologies and symptoms. As a result, because there is a lack of research on Werner Syndrome and massage, treatment is performed based on the safest possible approach to maximize quality of life.

In essence, massage therapists must educate themselves on atherosclerotic diseases, cancer, osteoporosis, diabetes, and the various skin considerations often experienced due to Werner Syndrome.

Key Points

• Research suggests massage therapy may help manage symptoms of Werner syndrome, like pain and stiffness, though direct studies are limited.
• Based on research on similar conditions, it seems likely that benefits include improved circulation, reduced stress, and improved quality of life.
• The evidence leans toward massage being a safe complementary therapy, but patients should consult healthcare providers due to the condition’s rarity.

Atherosclerotic Diseases

Research suggests people with Werner syndrome tend to experience coronary artery atherosclerosis [3], peripheral artery disease, and cerebrovascular disease, which are common due to premature aging and atherosclerosis. Atherosclerosis is a long-lasting condition where arteries get inflamed and clogged. It happens when cholesterol builds up into plaques inside the arteries, making them narrow (stenosis) or blocking them with blood clots (thrombosis) if the plaques break apart.

Massage Considerations: Because atherosclerosis is most often related to other diseases, read recommendations for specific diseases such as angina pectoris and peripheral arterial disease. Caution is advised in the anterior throat area because the carotid arteries may contain undiagnosed fibrous plaque. This caution is increased with older clients because the likelihood increases with age. Massage is contraindicated in this area because pressure may dislodge clots; therefore, the carotids should be avoided when massaging the muscle. [8]

• Angina Pectoris: Massage should only be applied in stable cases of angina. In this instance, massage may help by reducing stress and by decreasing the effects of the sympathetic nervous system, which is responsible for coronary artery vasoconstriction. Sudden exposure to extreme cold can bring on an attack. Therefore, the therapist needs to avoid the use of cold therapy and provide the client with a blanket and table warmer. Additionally, clients must have their necessary medication (e.g., nitroglycerin) when they receive treatment. [8]
• Peripheral Arterial Disease: The affected area is a local contraindication (usually lower extremities) due to the possibility of clot formation. If a stent has been inserted in the leg, adapt the massage according to the restrictions decided by the surgeon. [8] 

Malignancy

The spectrum of cancers in individuals with Werner syndrome is unusual in that it includes a large number of sarcomas and very rare cancer types in typical locations. The most common cancers are soft-tissue sarcomas, osteosarcomas, melanomas, and thyroid carcinomas. Acral lentiginous melanomas (most often observed on the feet and nasal mucosa) are particularly prevalent compared to levels observed in the general population. Common types of carcinomas have also been observed. [3]

Osteoporosis

The osteoporosis of individuals with Werner syndrome is unusual in that it especially affects the long bones. In contrast, osteoporosis during normative aging preferentially involves the vertebral bodies, particularly in women. Characteristic osteolytic lesions of the distal joints of the fingers are observed on radiograph. [3]

Massage Considerations: Diagnosis of osteoporosis is often made after significant bone loss, so the use of lighter pressure in massage is indicated. The client should be positioned for comfort, especially in cases of spinal abnormalities such as severe kyphosis. Joint movements and compression should be avoided or carefully administered without twisting or torquing. If the client feels unstable when getting on or off the table, be ready to assist them. [8]

Skin

Deep, chronic ulcers around the ankles (Achilles tendon, medial malleolus, lateral malleolus) are highly characteristic. [3]

Diabetes Mellitus

The study by Stenbäck et al. (2024) found that a single session of Swedish massage increases levels of IL-6, a protein that can help reduce inflammation and improve how your body handles sugar and fat. This could be beneficial for people with Werner Syndrome who have type 2 diabetes, as it might help manage their blood sugar levels better. [7] Other studies suggest that regular massage, especially over longer periods like three months, can lower blood glucose in diabetes, which could help improve quality of life by reducing diabetes-related complications. [6]

It is important to keep in mind that the evidence is not completely clear, especially for type 2 diabetes, with some studies showing no significant benefits after short periods. More research is needed, particularly for people with Werner Syndrome, as no specific studies exist. Still, the potential for better diabetes management and general relaxation from massage could make a big difference in quality of life.

Massage Considerations: Suggest the client eat a meal within 2 to 3 hours or have a good snack no more than 1 hour before the massage . Ask if the client carries a glucose meter or glucose tablets or gel and, if so, where they are in case the ther apist has to get to them quickly if the client has a hypoglycemic episode during the massage.

• If the client has neuropathy, use firm yet gentle pressure with an open palm.
• Continuously check in with the client about pressure, sensory experience, and comfort.
• If the client has vision problems, provide unobstructed passage to and from the massage table.
• Avoid and inform the client of any bruises or breaks in the skin, especially on the feet.
• Do not use lubricant between the toes because this may lead to infection.

Complications of diabetes may include

• Neuropathy
• Ulcers

Other Complications may include:

• Atherosclerosis
• Peripheral arterial (vascular) disease
• Gangrene
• Hypertension
• Diabetic retinopathy and cataracts
• Periodontal disease
• Kidney and heart disease
• Fungal infections such as thrush, jock itch, vaginal yeast infections and athlete’s foot

Potential Benefits

Massage therapy might help people with Werner syndrome by easing pain and stiffness, which are common due to premature aging. It could also improve blood flow, help with skin ulcers, reduce stress, and make daily life more comfortable. While there is no specific research on Werner syndrome, studies on aging-related issues suggest these benefits could apply.

Supporting Research

Since Werner syndrome is rare, there aren’t direct studies, but research on massage for pain relief and skin health in older adults shows promise. For example, a study found massage reduces pain in osteoarthritis, which could help with Werner syndrome’s musculoskeletal issues. Another study showed it improves wound healing, potentially aiding skin ulcers. Therefore, the analysis extrapolated benefits from research on massage therapy for aging populations and conditions with overlapping symptoms, such as osteoarthritis, fibromyalgia, and wound healing in older adults.

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