MEDICAL MASSAGE vs. TEN YEARS OF PAIN

In every issue of our journal, you will find a Case of the Month, which we will select from among the submitted cases. Everyone who is using MEDICAL MASSAGE PROTOCOLS in their practice may submit their cases for review, and we will share with our readers the best one in every new issue.

If you would like to share with our readers your account of professional success and participate in the Case of the Month program, see Case of the Month Program.

I met Novella three years ago during our Medical Massage Seminar in North Carolina. From my experience as a teacher, I have noticed that what some practitioners need is just an initial push to achieve great professional success in the medical massage field because they are already ready to embrace it. After such initial motivation, these practitioners are able to absorb knowledge and practically apply it to form their own unique clinical experience.

This is the exact story of Novella’s transformation. Moving from the stress-reduction and therapeutic massage field, she developed a very successful medical massage practice, and despite the economic turmoil that affects many practitioners, she built up a thriving practice where she is able to help many patients who are in great need of her knowledge and expertise.

We see our goal in JMS as guiding practitioners like Novella onto the right path. Only an increased number of successful medical massage practitioners will give medical massage the chance to be incorporated into the field of traditional medicine, where it originated and where it belongs. Here is our Case of the Month:

MEDICAL MASSAGE vs. TEN YEARS OF PAIN

By Novella Kennedy, LMT

Female, 42 years old, married mother of three children. She is self-employed in farming.

Initial Complaints

The client looked desperate because of the intense pain in the neck, especially on the right side. She couldn’t even bend her neck forward far enough to fill out the paperwork. She had gone without sleep for days since the last flare-up of intense cervical pain. The client was unable to drive. She walked carefully and slowly with a lateral bend of the head toward the right side.

She moved her whole upper body when it was necessary to look sideways. She also suffered from severe headaches. Painkillers and narcotics did not touch the pain.

CASE HISTORY

Ten years ago, she fell backward onto a couch, with her head bent backward in a whiplash fashion over the back of the couch. According to the client, due to that injury, her neck swelled nearly even with the sides of her head. Chiropractic treatments caused even more intense pain. A neurologist prescribed narcotics for the pain, with instructions not to go to a chiropractor again because it “could kill her”. The fear of what might happen if she used her neck seemed to have frozen her ability to function normally since the accident.

To protect her neck, she had developed a routine in which she lifted her head with her hands while getting out of chairs or turning over in bed. There had been no neck or back interventions except narcotics for pain. There were no other contributing health issues.

The current acute attack was caused (as usual in harvest season) by driving the tractor and the repetitive motion of constantly looking back both ways. Her method of looking back involved movement of both shoulders held stiffly with a lateral spinal twist toward the back without any movement of the neck. She had used this method for every movement of the neck since the accident, for the past ten years! Nothing, including narcotics, heat, or ice, offered any relief for this flare-up.

Clinical Examination

The client was tearful and distraught. She had nearly gone to the emergency room because of her pain. That had been her pattern for ten years, and she wanted healing instead of narcotics. She was stressed from caring for a household and a job while being in pain. Lack of sleep and the pain had left her weak and tired. Learning of the possibility of less pain or of being pain-free gave her hope and ease.

My questions initially focused on gathering information on what exactly was happening and where. I asked her about the character, pattern, location, and radiation of pain. All answers pointed to Skeletal Muscle Pain. The type of pain, the time of pain and increased pain with movement also confirmed the conclusion of skeletal muscle pain.

Next, I examined her for specific pain locations. Pain caused total restriction in the ROM of the neck. Her examination revealed two main areas where pain was extremely intense: the trapezius muscle and the levator scapulae muscle. Considering this, I was determined to find out which MEDICAL MASSAGE PROTOCOL I should concentrate upon first.

There is a difference between Trapezius Muscle Syndrome and Levator Scapulae Muscle Syndrome. Her head rotation was greatly restricted, and she reported pain on both sides. When she tried to rotate her head, her neck pain increased on the opposite side. This indicated bilateral Trapezius Muscle Syndrome. The Shrug Test, Test to Examine Weakness of the Upper Portion of the Trapezius Muscle, and Trigger Point Test confirmed the initial examination and removed all guesswork.

MEDICAL MASSAGE PROTOCOL

First week: Sessions 1 & 2

I started with the MEDICAL MASSAGE PROTOCOL for Cervicocranialgia – Video Library Protocol. Since the client had a bilateral clinical picture, there was no unaffected side. Since the pain threshold had already dropped dramatically before she came in, I worked very slowly, steadily and specifically. Carefully, I worked through her pain, trying to elevate its threshold, and her facial expression started to relax, and she showed signs of relief. These sessions concentrated on reducing the hypertonicity of the trapezius muscle. After the first session, she went home and slept for twelve hours.

Second week: Sessions 3 & 4

I continued with the same protocol, but now added the protocol for Greater Occipital Nerve Neuralgia – Video Library Protocol due to reports of headache. Pain reduction allowed for some Trigger Point therapy on the trapezius muscle and passive stretching of the neck. Slight work on ROM was begun.

Third week: Sessions 5 & 6

She reported some pain in the paravertebral muscles of the upper back. I used electric vibration after the initial preparation of the muscles. I continued with the Trapezius Muscle Syndrome protocol while carefully intensifying stretching and increasing ROM in the neck. The client reported a significant increase in ROM and said that her neck felt weak from using it to look around so much. She was very excited and animated as she explained to me her newfound freedom in her neck and her life.

Fourth week: Session 7

At this point, the client was pain-free. She was in disbelief, since she had spent the past ten years in pain AND on narcotics. Upon examination, she showed normal ROM. She can use her neck in every way to support her head without assisting with her hands. Now she drives the tractor, easily looking wherever necessary. She cares for her home and children with renewed vigor and energy. Narcotics have not been required to control pain since Medical Massage entered her life. Her pain-free state is maintained through monthly monitoring, replacing a history of chronic misery with a returned quality of life.

ABOUT THE AUTHOR

Category: Case Studies

Tags: JMS 2010 Issue #5