Issue link: https://www.massageandbodyworkdigital.com/i/77424
JOIn ruTh werner, JAmeS wASLASkI, And LyndA SOLIen-wOLFe FOr The SemInAr AT SeA, JAnuAry 23–30, 2011, And eArn CeuS. FOr mOre InFOrmATIOn, vISIT www.OrThOmASSAGe.neT. during healing. Very severe cases may indicate surgery for correction and stabilization, but this option is obviously highly invasive and risky. MASSAGE FOR SPONDY CONDITIONS All three of the conditions in this article feature low-back pain as a significant symptom, when symptoms are present at all. But because they all involve bony changes, manual therapies can't have significant or direct impact on the damaged structures. This by no means rules out massage as a treatment strategy. Indeed, the postural adaptations that accompany chronic low-back pain (hyperlordosis, tight psoas and hamstrings, weak abdominals, distortions at the hips and knees, ad infinitum) can contribute to secondary pain that far outpaces the initial irritation. Exercise protocols, myofascial release, and other soft-tissue modalities are often recommended, along with mild painkillers as a first recourse in these situations, because the only other options are highly invasive and risky surgeries that are appropriate only when the client's quality of life can't be improved in any other way. If a client reports areas of sharp shooting electrical pain that radiates into the buttock or leg, reduced sensation, diminished reflexes, or numbness—especially if this is a new pattern—it is important to consult with the primary care provider or neurologist. These suggest nerve or spinal cord impingement that must be evaluated before bodywork is a safe choice. Clients who have spondylosis, spondylolysis, or spondylolisthesis may have some limitations in what kinds of work they can receive. It is vital to avoid hyperextension of the low back, as this can exacerbate symptoms: this can be done with body cushions or a bolster under the abdomen when the client is prone november 2010. http://emedicine.medscape.com/article/310235-overview. heary, r. 2002. "Spondylolisthesis: Introduction and Illustrative Cases." American Association of neurological Surgeons. Accessed november 2010. www.medscape.com/viewarticle/439164. herkowitz, h., Abraham, d., Fischgrund, J. 1998. "diagnosis and Accessed november 2010. www.emedicine.com/neuro/topic564.htm. Froese, b. "Lumbar Spondylolysis and Spondylolisthesis." medscape. Accessed Resources baron, e.m. "Cervical Spondylosis: diagnosis and management." webmd. management of degenerative Lumbar Spondylolisthesis." General Medicine 1 (1). Accessed november 2010. www.medscape.com/viewarticle/722299. Litao, A. "Lumbosacral Spondylolisthesis." medscape. Accessed november 2010. http://emedicine.medscape.com/article/95691-overview. Pearson, A. et al. "degenerative Spondylolisthesis versus Spinal Stenosis." november 2010. www.emedicine.com/med/topic2901.htm. Zubin, I. "Spondylolisthesis." medscape. Accessed november 2010. http://emedicine.medscape.com/article/396016-overview musculoskeletal Imaging." uw radiology. Accessed november 2010. www.rad.washington.edu/mskbook/axialarthritis.html. rothschild, b.m. "Lumbar Spondylosis." medscape. Accessed and a bolster under the knees when he or she is supine. Another problem that many people with this spectrum of back disorders report is that being still for a prolonged period leads to stiffness and acute pain when movement begins again. In a massage setting, this means that turning over on the table after 30 minutes in one position can be difficult and painful. And getting off the table and dressed quickly is a daunting task. One way to mitigate this is to intersperse and conclude the session with gentle movement: rock the spine until it is loose if the client is prone, or for a supine client, gently stretch the low-back paraspinals by passively flexing the thighs and knees and then rotating the spine. For many people with low-back pain, massage is a long-term coping strategy that can make the difference between living with chronic pain medscape. Accessed november 2010. www.medscape.com/viewarticle/716556. richardson, m.L. "Approaches To differential diagnosis In or without it. As therapists, our understanding of the structures involved and the ways they affect the rest of how we move and relate to gravity can only increase our sensitivity in helping clients to find ways to live without pain. What a great opportunity! Therapy Foundation. She is a writer and NCBTMB-approved provider of continuing education. She wrote A Massage Therapist's Guide to Pathology (Lippincott Williams & Wilkins, 2009), now in its fourth edition, which is used in massage schools worldwide. Her latest book, Disease Handbook for Massage Therapists (Lippincott Williams & Wilkins, 2009), is also available at www.lww.com. Werner can be reached at www.rutherwerner. com or wernerworkshops@ruthwerner.com. Ruth Werner is president of the Massage earn CE hours at your convenience: abmp's online education center, www.abmp.com 103