The nurse aide SHOULD understand that a back massage:

A back massage is indeed beneficial because it promotes circulation. This increased circulation can help enhance blood flow, which is vital for delivering oxygen and nutrients to the muscles and tissues while also aiding in the removal of waste products. This physiological response not only contributes to the health of the tissues but can also lead to a decrease in muscle tension and promote overall relaxation.

The option that discusses relaxation is also accurate, as back massages can lead to a relaxation response in the body, but the focus here is on the specific physiological benefit of promoting circulation. By enhancing blood flow, a back massage aids in maintaining the health of the skin and underlying tissues, which is particularly beneficial for clients who may struggle with circulation issues due to immobility or other medical conditions.

Addressing the other options, while reducing pain can be a secondary benefit of a back massage, it is not the primary purpose of this practice. Additionally, stating that a back massage is only necessary for bedridden clients overlooks the fact that anyone, regardless of their mobility status, can benefit from improved circulation and relaxation through regular massage.