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A B M P m e m b e r s e a r n F R E E C E a t w w w. a b m p . c o m / c e b y r e a d i n g M a s s a g e & B o d y w o r k m a g a z i n e 31 TABLE LESSONS best practices Changing Direction Consider the Less Obvious By Douglas Nelson "Wait—how long?" I asked, thinking I misheard my client's answer to my question. "I've had a headache every day for at least eight years, but it might actually be ten," she replied. "I don't remember a day without a headache in all these years." Mrs. E. was my new client that day, and her facial expression revealed a resignation of her current circumstance. "I'm sure you must have tried various treatment strategies over the years. Can you share with me what treatments you have explored?" I could tell by the way Mrs. E. glanced to the floor before answering that she must have repeated this list of failed strategies to many other health-care providers. "I have done just about everything you could imagine. My regular doctor and I have used a litany of different medications. Each has some small benefit, which is outweighed by the side effects or the fact that they just don't seem to help very much. In addition, I have tried physical therapy, chiropractic, and acupuncture. The latest thing I have tried is Botox, and that has seemed to help a bit. But, in the end, I still have a headache each day." "Could you tell me about the chiropractic and physical therapies?" I asked. "What did they do, and where was it directed?" "I have lots of shoulder and neck discomfort," she replied. "I'm pretty sure they thought that if my shoulders and neck were better, it would solve the headaches. The chiropractor focused primarily on my neck using adjustments. I have seen three different physical therapists, and all of them directed treatment to this area," pointing to her upper trapezius. "What can you tell me about the quality of the headaches?" I asked.