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I had a new client the other day for an 80 minute massage. I asked him if there is anything that he wanted me to know. He told me that he suffers from a herniated disc that he has had for a few years. He has constant low back and right hip pain that at times radiates down the back of his leg to his knee. He told me that he has had two injections in his low back and has to stay on anit- inflamtory medication. Anything to avoid surgery. The pain is always there. I asked him if he ever saw a chiropractor for his pain. He said yes. But the adjustments hurt his hip so bad that he could not continiue. So here is a guy that thinks he is on the verge of surgery. I knew that there was a very strong probubllity that was not the case. The vast majority of pain people experience is nocioceptive pain( soft tissue- muscle, tendon, ligament, facia). MDs and Chiropractors see pain as neuropathic pain( nerve pain). With that asumption they give the wrong treatments and therapies. Now there is no denying that at times injections and surgery is needed. Not denying that. But most of the time - NOT. 70% to 85% of all pain comes directly from trigger points. Anyway I showed my client a testimonial from a client that I was able to help out of a very painful condition that she had delt with for a couple of years. I showed him that testimonial because all pain has a psychological eliment too it. I wanted him to start thinking maybe he is not on the edge of surgery. I palpated his entire back upper torso, both hips, and right leg. I found a very painful spot on his right L5 erectors. Another very painful spot on his right greater trochantor. A painful spot in the middle part of his lower right hamstrings. And also a tender spot on the right spinous of L3. I knew that if Iwas able to eliminate all those painful palaptory spots that I would most likely eliminate his pain problem. Because a healthy body had no painful spots even with deep massage. Ive been hunting and eliminateing trigger points for thirty years now. He walked out of the massage room pain free. He was pain free for the first time in years. All those other professional people misdiagnosed him because they assume neuropathic pain over nocioceptive pain. I assume the other way around. I'm a Massage Therapist.
even an occasional success is great benefit to the victims of long-term chronic pain. MTs in spa environments know to be very careful touching "forbidden" areas of the body. The highly skilled do work-arounds to find the source(s) of pain that seem to arise in genital-anal areas-- like the testicular pain. Most LMTs wouldn't have considered that the intense pain centered in this man's testicles could have a myofascial origin-- and would have referred him away to an MD. For 13 years everyone had failed him. He finally by trial and error over a decade came to the right place. Expert medical doctors and expert massage therapist working as a true team to benefit those in severe pain.
Hey Gordon! Just because there aren't a lot of clinical trials doesn't mean the work isn't effective. However, the placebo effect is really important. It is NOT and I repeat NOT about people fooling themselves into feeling better. Anything we can do to engage people's innate healing abilities (possibly a much more accurate description of the placebo effect) is tremendously worthwhile. Trust in the practitioner has a lot to do with that.
What she says about clinical trials and follow ups is valid. However, in manual therapy it's difficult to do sham treatments which is what is required to do random, controlled studies. They are starting to be conducted, though, with favorable results for skilled manual therapy.
Remember that for some people there will never be enough scientific evidence to change their minds. We aren't dealing with science versus "quackery". We are dealing with belief systems. And changing people's beliefs is damned near impossible, unless they are willing to be wrong. That goes for us too, BTW. We have to be willing to understand that maybe what we are doing has more to do with placebo effect than us actually changing tissues. The people on the table can change their tissues, though. It's a powerful thing, to be a catalyst for someone's change like that.
Gordon J. Wallis said:
This is interesting, I think? More then once, I've been accused by many to be a lier, a con man, or a nut case, and so on by many. Including medical doctors, physical therapists, lay people, and even other massage therapists.
I knew what the answer would be, but I sent a video of me working on a patient to this website that's run by a medical doctor, and asked her what she thought. http://www.skepdoc.info/
Here is the video I sent her. https://www.youtube.com/watch?v=rWDML1jqGo8&sns=em
In the attachment below is her answer. Now in all fairness, ten years ago if I saw one of my videos, I'd think it was a bunch of bull myself. Other professional massage therapists have accused me of being one of those that's responsible of giving massage therapists a flakey reputation to the medical community, as well as negatively influencing young massage therapists. So what do you guys think? In the attachment is her letter.
Trigger points are real; they restrict ROM, cause very real pain. The release of a trigger point by a skilled, highly trained manual therapist is not a placebo effect-- the therapist feels the knot melt, the client experiences immediate pain relief.
But, yes, placebo effect does play a part in any kind of medical intervention. If they want to get better, and believe in their caregivers, they probably will feel better, temporarily...even when treated with "flaky" treatment protocols. On the flip side of that coin, however, we've all had clients who seem to cling to their disability, who emotionally, for whatever personal reason, just cannot let go of their pain.
I will ALWAYS be skeptical of CST. Gordon, what you did by very briefly touching her skull was not CST-- you weren't moving bones of the skull, you were contacting a surface nerve that has Lovett Brothers Relationship with the coccyx...to release a trigger point at the coccyx. CST claims to manipulate sutures that weld permanently together in adulthood.
In my opinion (I assume I am allowed one), Cranial Sacral Therapy is entirely placebo effect, since (and science confirms this) the sutured plates of the skull cannot be manipulated. Scientific instruments are fabulous today, which have not been employed to prove that cranial bones can be moved even one micrometer
But, hey, placebo is a very real effect, and undoubtedly plays a part in all medical treatments (incl trigger point therapy). Testimonial evidence abounds that strong faith (placebo) has contributed to miraculous reversals of terminal illnesses.
Gordon J. Wallis said:
Gary, you saw that video. You in the past you have been skeptical of Cranial Sacral Therapy. What you see in that video is not classical Cranial Sacral Therapy. But I did touch her cranium and the Coccyx pain vanished. Is that placebo or? That question goes for anybody, not just Gary.