Massage therapy is a very simple and side effects free methodology. In certain cases, it can be so extremely powerful that it has no substitute. The doctor’s story I am about to present could be considered as an example of the massive phenomena of mechanical pain and dysfunctions that to a large degree could only be successfully addressed by means of massage.
Approximately 3 years ago I had a client who was a dual board certified neurologist. The referring physician told me that I should have prepared myself for questioning because the person he referred to me was very knowledgeable in conventional medicine and yet was very open to other methods of treatment. During almost 12 years the client suffered from upper back middle thoracic pain with the significant limitation in range of motion in cervical spine.
According to his report, 12 years ago It started with the minor pain in between scapulas region. Little by little the pain increased until it came to the point when it was difficult to sleep, as well as caused a high-intensity pain during the day and a specially at attempts to move during the day.
When this doctor arrived, I was listening to him very carefully. He performed all the tests including EMG studies, MRI, all blood tests and they all came out perfectly good and yet he was suffering.
During my palpation examination, checking the tension in fascia and muscles, and the fact that all the tests didn’t support the presence of this pains and movement restrictions, considered history of this abnormality development, I came to the conclusion that the pain was caused by excessive tension in fascia and muscles and subsequent trigger points developments in these tissues, which, surely, are not detected by radiological means and other undertook examinations. To me it was classic severe case of myofascial pain, that can cripple person, at the time all possible tests will come out perfectly good.
After the first treatment, almost all the range of motion with in cervical spine, was restored and the pain sensation was reduced significantly. After this, striking (from the point of view of my client) experience my client wanted to invite me for lunch with the purpose of finding out details on what I did in order to achieve so significant outcome. I told him that the lunch arrangement was not necessary and that I was happy to explain him physiological effect of massage, including, details on connective tissue massage, muscular mobilization, trigger points therapy etc., without being sweetened.
I told him that the main problem that produced his difficult clinical picture was tension in fascia and muscles and subsequent trigger points development. What I practically did was I palpated various localization of pain, detected tensions in connective tissue, muscles, performed connective tissue massage to release the tension in fascia, mobilized muscles and brought them to relatively normal resting tone. Performed ischemic compression on trigger points etc.
When muscles are constricted there is a significant deprivation of blood supply, which in turn, and if sustained a prolonged time, caused low grade inflammatory condition. Due to metabolic disturbances, this condition caused accumulation of tension in fascia, adhesions, as well as triggering trigger points developments.
During the course of several procedures he was practically rid of pain. He was very thankful but also very curious and inquisitive about my methodology as if he couldn’t comprehend that such simple methods could produce such tangible results, as if he felt there was something else, something hidden from the naked eye that he overlooked in his understanding. He kept on going back to the history of his disorder and the history of attempted treatments, requesting an explanation of why exactly they didn’t work while massage did.
During those 12 years of suffering, numerous times he received corticosteroids trigger points injections, achieving temporary pain releases. And then the pain was coming back. On his question, why wouldn't sustain this reliefs I answered that he was suffering from the vicious cycle of abnormal developments within soft tissue. First painful muscles tension, then fascia tension, and then trigger points developments. Exercise just made it worse because they added additional tension to already exhausted and dysfunctional muscles, corticosteroids injections only inhibited trigger points with no positive effect on tension within fascia. This wasn't an adequate treatment, and therefore symptoms were coming back.
Massage therapy procedure, however seemingly simple, directly addresses all causes of these symptoms, and therefore produces good results. I also have explained him, that in order to sustain results, and make sure pains will not return and the normal range of motion will be sustained or even become much better, he must to continue to receive 12 to 15 treatments. This number of repeated treatments was necessary to reset and sustain the higher level of threshold of pain. Because he suffered prolonged time, repeated treatment also will help “cleaning up” phenomenon of pain sensitization.
To him my explanation sounded absolutely scientific and he felt that this course of actions had good potentials for sustained results. Being open minded scientist and clinician, he was amazed by simplicity of massage therapy, its absence of side effects, and clinically proven concept of its methodology.
Several times after that he returned to me with problems caused by sports related injuries, within different body parts. Interestingly enough, the original case, he came with, didn't trouble him during the last three years.
He also referred me many people with myofascial pains, sciatic nerve neuralgia and other neuralgias. Little by little he started trusting me. He is very responsible doctor and I really like how he establishes diagnosis. For example tension headache could be the result of a brain tumor, and other phenomena that produce symptoms that are very similar to tension headache symptoms. So first of all he excludes such possibilities.
I felt like at home with him, because as a professional, I grew up in the environment of the integrative approach to medicine . Diagnosis establishment by using differential diagnostic techniques, including different tests by MDs that exclude the possibility of the medical problem being not the cases for massage therapy, and then intensive massage therapy treatment.
Recently he called me about one a relatively healthy 72 year old man, who developed typical neuropathy such as the one accompanying diabetes, while as the patient couldn't even be diagnoses as being in pre-diabetic stage. So he contemplated on this case and couldn't come to the definite conclusion.
I will continue the discussion of this interesting case in my next blog…
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