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