Issue link: https://www.massageandbodyworkdigital.com/i/588318
Also, be aware there may be times when how you present your findings and opinion to a client could affect her coping response. For example, Lucy came to me for neck pain and was actively coping. She was referred to me by a chiropractor who had told her that the chronicity of her neck condition was due to Lyme disease. When I palpated her neck, I found extreme tightness in the C2–C3 paraspinal muscles. My palpation findings, coupled with her intake history, led me to conclude that her neck pain hadn't changed since she had contracted Lyme disease. It was always there and at the same intensity. Who was right? In terms of the self-efficacy model, it didn't matter. Lucy's neck pain was not a broken arm where causality was easy to determine (she fell down), and there was a sure- fix to apply (cast the arm). The cause of her chronic pain was unknown at that point. The most important thing was that she was actively coping in the midst of unknown causality. I simply stated my palpation findings and my massage approach without expounding on the differences between her chiropractor's opinion and mine. It was up to Lucy to decide how she incorporated the different information to actively cope. 5. STRESS-DIATHESIS MODEL There is evidence to suggest a person who is highly stressed, anxious, and/or depressed may be more limited and emotionally distressed by pain than a person who is not stressed, anxious, and/or depressed. These highly stressed people are more likely to move from acute pain to chronic pain to disability. It is also true that depression can be brought about by persistent pain. 12 It is beyond our scope of practice to determine which came first— the depression or the chronic pain. Our job is to guide the person to proper counseling if we suspect a person is anxious, depressed, or highly stressed. I learned this the hard way. At one time, I was working for a massage spa. Bonnie, a chronic-pain sufferer, was sent to a few therapists, including myself, who specialized in chronic-pain treatment. Bonnie was very bright, but there were obvious signs she was troubled. For instance, she pulled a suitcase behind her everywhere she went, even though she wasn't homeless, and during her intake she spent a significant amount of time ranting about her mother. 94 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 5