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  • Karen Stoner, LMT

Massage Tips and Trivia: Pain in one spot, doesn't mean that spot's the problem

"Just because you have pain in one spot, doesn't necessarily mean that is the spot that needs massage help"

This is one of the weird issues that therapists and clients go back and forth on frequently. Many times, someone will come in saying "My ___ hurts" so they expect that that is where the Massage Therapist will work to relieve the pain. For example, if someone comes in and says "my neck hurts", the therapist will likely start with the neck, and if they find the issue, they can work on it to help relieve the pain. Unfortunately, sometimes it isn't this easy. There are some times when someone can come in and say "my neck hurts" but although they may be feeling the pain in their neck, the issue causing the pain may actually be in the shoulders, the skull, the pectorals, or the back.

We call this phenomenon 'Referred Pain'. It happens because the body is all connected, with nerves, muscles, and everything down to the circulation of blood and lymph all working together to move and work throughout the entire body. If one thing somewhere in the body gets disrupted, it can have an effect not only in that area, but also all along the pathway that is connected to that area. If something along that pathway is generally on the weaker side or is the site of a previous issue, the nerves in that area are more sensitive to the disruption, so may send out pain signals more quickly and easily, even though it is not the spot of the actual issue.

When a massage is happening, the therapist generally first addresses the area where the client says they feel pain or an issue, but they never usually only stop there. Many times the therapist will address not only the area with the issue, but will investigate and work on surrounding spots or parts that have a connection to the area with the issue to see if another spot is contributing in any way to the initial problem. Sometimes it makes sense how one thing can cause pain elsewhere, but sometimes it is more vague. A headache can be caused from anything in the neck, to the shoulders and traps, or elsewhere in the back. Low back pain can often be traced to tight gluteal muscles. Jaw pain can actually be connected to tight hips! So just because there is pain somewhere, doesn't mean that is where the problem is.

While this is handy for Massage therapists to solve the problem of the issue and get great results, it can also be a point of argument with the client. If the client comes in saying a spot in their left shoulder hurts, but there is a huge area of tightness in the low right back that is pulling on everything in the left shoulder, massage work should be done on the left shoulder, but to really fix the problem, work also needs to be done on the low right back. This can occasionally upset the client because if they came in with a sore left shoulder, the area that hurts isn't the spot being worked on. This is where good communication between therapist and client comes in handy. Therapists should be able to explain why they are doing what they are doing, and likewise, clients should be open and respectful for the therapist's training and expertise to attempt to fix the source of the problem, not just the symptoms. If the communication isn't two-way, this is where referred pain can become a real pain for both the client and the therapist.

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