Massage & Bodywork

July | August 2014

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TABLE LESSONS Ms. K.'s expression changed as she processed the meaning of my words. "Maybe the X-ray looks worse than it actually is?" she wondered aloud. I had Ms. K. lie on her left side and we went through the same procedure with her right multifi di and erector spinae. The areas of tenderness were quite similar bilaterally. I then turned my attention to her hip, taking it gently through a range of motion in all planes. I was stunned at her movement capability—it was far better than I expected. My face must have looked perplexed. "Is everything OK?" Ms. K. asked. "Better than OK," I replied. "Your hip has much more movement than I expected, given your diagnosis." "That's nice to hear, but both doctors said the hip is very arthritic. I am afraid that I won't be able to sustain the active lifestyle that my husband and I have always enjoyed." "Wait, both doctors?" I asked. "Yes, a doctor at Mayo Clinic also said that I would likely be using a cane in less than fi ve years. It is quite depressing to have that to look forward to." "When was that?" I asked. "1999," she replied nonchalantly. I stared at her in disbelief. It took a moment for her to realize what she had just said. I had to respond. "Maybe the X-ray looks worse than it actually is?" she "I'd like to make three points, if I may. First, it would be extremely unusual for anyone over 70 to not show degenerative changes in the spine. Second, it isn't a given that arthritis is the cause of your back pain. Since your pain started exactly on December 20, what do you suppose your spine looked like on December 19? Third, the prediction that you would be using a cane in fi ve years was 15 years ago." Ms. K.'s expression changed as she processed the meaning of my words. "Maybe the X-ray looks worse than it actually is?" she wondered aloud. In Ms. K.'s case, and in many others, seeing was believing. Being told what to expect by two doctors and an X-ray had colored her interpretation of her aches, pains, and physical problems. Words and images have powerful effects, both positive (placebo) and negative (nocebo). X-rays don't always tell the whole story—there isn't always a direct relationship between what is seen and the pain a person is experiencing. Ms. K. improved greatly after two sessions, showing that degenerative changes could not account for all of her pain. Much of that improvement was probably due to a change in her perception of the meaning of her pain. Douglas Nelson is the founder and principal instructor for Precision Neuromuscular Therapy Seminars and president of the 16-therapist clinic BodyWork Associates in Champaign, Illinois. His clinic, seminars, and research endeavors explore the science behind this work. Visit www.nmtmidwest.com, or email him at doug@nmtmidwest.com.

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