Massage & Bodywork

NOVEMBER | DECEMBER 2015

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F r e e S O A P n o t e s w i t h M a s s a g e B o o k f o r A B M P m e m b e r s : a b m p . u s / M a s s a g e b o o k 95 When I worked on her the first time, I didn't find any significant areas of pain. In fact, she fell asleep. To my surprise, soon after, Bonnie scheduled to see me and the other therapists twice a week for a month, claiming her pain was severely reduced. Bonnie now had a rather unhealthy dependence on massage and believed it was the only thing that could help her. It took many weeks before Bonnie's situation was resolved and she was back on track to getting proper psychological help, all because I had failed to communicate my concerns to her after the first session. Pain Models & Your Practice Pain models explain how chronic-pain sufferers respond to chronic pain. When a massage therapist can recognize pain-model responses, she can then adjust her treatment plans and help clients improve their quality of life. For instance, a problem-solver on steroids (misdirected problem solving) worries about all the negative outcomes that can be connected with her pain. You can potentially reduce that worry by redirecting her focus to a practical goal you can support with massage. For those clients who are doing the right thing by actively coping (self-efficacy), you can bolster their efforts with recommendations that empower them to cope with their pain, such as self-massage options and safe lifting techniques for heavy or awkward items. Not recognizing a pain-model response and your connection to it can potentially make a client's quality of life worse. For example, fueling a client who is fixated on a cure (acceptance and commitment) by posing as the cure, or encouraging him in a misguided search for a cure, can lead to more stress and anxiety for your client. Lastly, if your client is anxious and/or depressed (stress-diathesis), or if his activity world is shrinking (fear-avoidance), these are signs that your client needs help outside your scope of practice. Be honest with your client about your concerns and encourage him to seek appropriate assistance. Someone trained to help your client with his issues can shorten his path to self-efficacy, thus shortening his overall suffering. The body of research on chronic pain is growing. As it does, so will our understanding of chronic-pain responses and how we can further assist clients with chronic pain to improve their quality of life. Notes 1. Institute of Medicine, "Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research," June 29, 2011, accessed October 2015, http://iom.nationalacademies. org/reports/2011/relieving-pain-in-america-a-blueprint-for- transforming-prevention-care-education-research.aspx. 2. Daniel C. Cherkin et al., "A Comparison of the Effects of 2 Types of Massage and Usual Care on Chronic Low Back Pain: A Randomized, Controlled Trial," Annals of Internal Medicine 155, no. 1 (2011): 1–9. 3. M.S. Shutty, D. E. DeGood, and D. H. Tuttle, "Chronic Pain Patients' Beliefs About Their Pain and Treatment Outcomes," Archives of Physical Medicine and Rehabilitation 71, no. 2 (1990): 128–32. 4. NIH MedlinePlus, "Chronic Pain: Symptoms, Diagnosis, & Treatment," Spring 2011, accessed October 2015, www.nlm.nih.gov/medlineplus/magazine/ issues/spring11/articles/spring11pg5-6.html. 5. Cleveland Clinic, "Acute vs. Chronic Pain," accessed October 2015, http://my.clevelandclinic.org/services/anesthesiology/pain- management/diseases-conditions/hic-acute-vs-chronic-pain. 6. Neil Pearson, "Acute versus Chronic Pain: Understanding the Difference and Choosing Appropriate Treatment," Orion Health, 2012, accessed October 2015, www. orionhealth.net/2012/01/acute-and-chronic-pain/. 7. Steven J. Linton and William S. Shaw, "Impact of Psychological Factors in the Experience of Pain," Physical Therapy 91, no. 5 (May 2011): 700–711. 8. Ibid. 9. Rob Dunn, "The Top Ten Deadliest Animals of Our Evolutionary Past," Smithsonian.com, June 20, 2011, accessed October 2015, www.smithsonianmag.com/science-nature/the-top-ten- deadliest-animals-of-our-evolutionary-past-18257965/?no-ist. 10. Steven J. Linton and William S. Shaw, "Impact of Psychological Factors in the Experience of Pain." 11. Albert Bandura, Self Efficacy: The Exercise of Control (New York: W. H. Freeman, 1997). 12. Steven J. Linton and William S. Shaw, "Impact of Psychological Factors in the Experience of Pain." Mark Liskey relies on his 23 years of massage experience to write on topics ranging from client care to best business practices. Check out his latest article at www.markliskeymassage.com. THE PAINFUL TRUTH

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