Massage & Bodywork

NOVEMBER | DECEMBER 2017

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84 m a s s a g e & b o d y w o r k n o v e m b e r / d e c e m b e r 2 0 1 7 technique SCIENCE OF NERVES Signs of Change Understanding Clients' Pain By Whitney Lowe This is an exciting time to be in the massage profession, thanks to research that is shedding new light on various facets of our work. In this column, I'll explore a fascinating shift in our understanding of our clients' pain complaints. Pain is the most common reason people seek the care of a massage therapist, and the more we understand pain, the better we can participate in a comprehensive solution to address it. Many in the health-care professions today were taught a relatively simple, and decidedly mechanistic, physiological explanation for how pain is perceived and transmitted in the body. This model actually goes back to the time of the philosopher Rene Descartes in the 17th century. Descartes's philosophy has carried through to form the philosophical foundation of our perspective of the body. When you hear the term Cartesian in relation to mathematical or scientific ideas, that means to some extent it follows Descartes's influence. Our understanding of pain transmission has, of course, evolved since the time of Descartes, but there is a great deal of similarity between his original ideas and those of our recent training. Yet, much of the "body as a machine" philosophy (i.e., the mechanistic view of the body) continues. Descartes suggested that when there is a noxious stimulus, like getting too close to a fire, a pain stimulus traveled from the contact point along a pathway of pain fibers to the brain (Image 1). Based on this idea, the predominant methods of pain management involved trying to block pain fibers before they got to the brain. This idea has continued to influence modern pain management to a significant degree. 1 This image from Descartes shows the pathways for pain signals.

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