Ep 605 – PAD and COPD: “I Have a Client Who . . .” Pathology Conversations with Ruth Werner

A hospice client with advanced COPD and peripheral artery disease presents a complicated case involving the heart, lungs, and cardiovascular system. In this episode, Ruth Werner explores how endothelial damage, oxidative stress, and systemic inflammation contribute to chronic illness. But the more pressing question is: Can massage be safely provided to a client with these conditions who is nearing the end of her life?

Resources:

Association, A.H. (2024) Early diagnosis, treatment of peripheral artery disease essential to improve outcomes, reduce amputation risk, Medical Xpress. Available at: https://medicalxpress.com/news/2024-05-early-diagnosis-treatment-peripheral-artery.html (Accessed: November 2, 2026).

Masked Peripheral Arterial Disease: Definition, risk groups and detection (no date) MESI Medical. Available at: https://mesimedical.com/insights/masked-peripheral-arterial-disease-definition-risk-groups-and-detection (Accessed: November 2, 2026).

Massage Therapy Pressure Scale from Medical Conditions and Massage Therapy: a Decision Tree Approach by Tracy Walton. Available at: https://www.tracywalton.com/wp-content/uploads/2015/04/Walton-Massage-Therapy-Pressure-Scale-for-WEBSITE.pdf. (Accessed: November 3, 2026).

Most Common Symptoms of Peripheral Artery Disease (no date). Available at: https://copd.net/clinical/peripheral-artery-disease-symptoms (Accessed: November 2, 2026).

Papaporfyriou, A. et al. (2023) “Cardiovascular Diseases in COPD: From Diagnosis and Prevalence to Therapy,” Life, 13(6), p. 1299. Available at: https://doi.org/10.3390/life13061299.

Pizarro, C. et al. (2016) “Lower extremity and carotid artery disease in COPD,” ERJ Open Research, 2(4), pp. 00037–02016. Available at: https://doi.org/10.1183/23120541.00037-2016.

Polverino, F., Celli, B.R. and Owen, C.A. (2018) “COPD as an endothelial disorder: endothelial injury linking lesions in the lungs and other organs? (2017 Grover Conference Series),” Pulmonary Circulation, 8(1), p. 2045894018758528. Available at: https://doi.org/10.1177/2045894018758528.

Tschopp, J., Dumont, P. and Hayoz, D. (2017) “True prevalence of COPD and its association with peripheral arterial disease in the internal medicine ward of a tertiary care hospital,” Swiss Medical Weekly, 147(2728), p. w14460. Available at: https://doi.org/10.4414/smw.2017.14460.

Episode Hosts

Meet our hosts

  • Ruth Werner Photo

    Ruth Werner

    Ruth Werner is a former massage therapist, a writer, and an NCBTMB-approved continuing education provider. She wrote A Massage Therapist's Guide to Pathology (available at booksofdiscovery.com), now in its seventh edition, which is used in massage schools worldwide. Werner is available at ruthwerner.com or [email protected].