Back to basics: The truth about back pain.
Low back pain is the most prevalent cause of disability in people under age 45. In fact, at least four out of five adults, up to 85 percent of people over 50, will experience lower back pain at some point in their lives. *
Doesn't it make sense to learn how to treat it?
In a room full of 50 massage therapists, we asked the question: Do you, or do you know someone who suffers with back pain? The whole room was up in arms, literally.
When asked who did you/ or your family/friends go see to sort it out? The room resounded with; osteopaths, chiropractors and physiotherapists- most with dissatisfying results. Only 3 people in the room said they had seen massage therapists to treat their pain. Why is that?
Without a doubt massage therapists, can and should be our first point of call for the treatment of all types of pain including low back pain. Advanced massage is the least invasive and most effective treatment for pain. Unfortunately. it is common practice for new therapists to be told to stay away from any one with real pain, including those suffering from chronic low back pain, sciatica, slipped disc syndrome, spondyololysis, and the like. With knowledge and the right tools you can easily be the expert in treating low back pain.
Causes of low back pain
According to the most recent research on the cause of back pain by BUPA's research team, 95% of back pain is causes by soft tissue damage. The massage therapist's domain. The muscles, ligaments and fascia can be strained by a number of scenarios .
- Sudden injury or trauma to the tissues, such as lifting a heavy object. The muscles may over stretch, causing a sprain, strain or spasm in the muscles or ligaments.
- Chronic repetitive misuse use of the muscular structure such as poor posture and unhealthy work environments. This can result in long standing and persistent pain.
- Often an individual who suffers with low back pain experiences both theses scenarios. Having once suffered an injury, the injury does not heal 100% before becoming re-injured. Causing a cycle of acute and chronic pain.
- Trigger points may form in the tissue distant from the area that may fire off causing intense back pain.
- Scar tissue may form after an injury making the joint less flexible and causing restriction and a chronic pain condition
In far less cases, low back pain may indicate a more serious medical problem.
- If the spine becomes overly strained or compressed, a disc may rupture or bulge outward . This may in turn put pressure on a nerve and cause excruciating pain.
- In other cases degenerative conditions such as arthritis and osteoporosis may be the root of the problem
Telling the difference.
Although, soft tissue work, the work of qualified massage therapists can bring about pain relief in the majority of cases. The most important thing to know as a professional is your boundaries. It is not our job, nor we have the ability to diagnose a problem for our clients. If in doubt you should always refer your clients to an MD for a proper diagnosis. However, this does not mean that we can not treat our clients in 100% of cases. It is the job of the serious massage therapist to develop a set of advanced tools so that she/he may be able to bring some sense of comfort and relief to our clients that are in pain. It is the true beauty of our profession that we can be so versatile in our knowledge that we can help those in need. On our advanced massage courses we teach you a range of techniques so that you are never lost for something to relieve your clients.
Pathologies Associated with Low Back Pain
There exists a boundless list of pathologies associated with low back pain. Some of the most common are:
Sciatica- Sciatica is in fact just a symptom not a diagnosis. It merely means pain radiating down the leg. This may in fact be due to the sciatic nerve being impinged by a disc protraction. However, much more often it is the result of the piriformis muscle being in spasm, constricting the nerve which mimics protracted disc pain. This is known as "piriformis syndrome". Trigger points in the piriformis may also create sciatic pain. Both of which can be relived quite easily using advanced massage techniques such as those described below.
Scoliosis, Lordosis, Kyphosis-All spinal structural deviations. Yet it is the soft tissue around the spine that is in contraction and pain can be lessened by massage. In some cases the intensity of the condition can be reversed as it is the muscles in contraction that are pulling the spine into an unhealthy position.
Disc Pathologies- including disc degeneration leading to herniation, "slipped disc", spongdylolysis and spondylolisthesis. All of these conditions can be very serious and need attention from the medical community. In addition, they can all be eased by advanced massage. If the disc has come out of alignment or has degenerated in some way, it is often the soft tissue around the area that consequently goes into spasm, which causes pain. Advanced Massage is the perfect treatment for cases such as these, especially if they are long standing and have been causing chronic pain for a number of years.
How to Treat Low Back Pain
In designing our Jing Advanced Massage Holistic Medical Massage courses, we have developed a proven protocol for the treatment of pain.
Acute and chronic pain and the appropriate use of hot and cold.
The use of hot and cold as described in our last article for Today's Therapist on hydrotherapy is a vital tool in the treatment of pain. It should be our first step in treatment. Basically speaking, cold therapy such as ice packs, ice massage or cold stones are applied in the acute stages of pain. And heat, such as warm moist packs or hot stones for chronic pain conditions.
Fascia. Learning basic myofascial techniques that we teach on our Foundation course in Holistic Medical Massage allows you to work and relieve constrictions in the facial system, which is often the missing link in massage work. The fascia is connective tissue that in cases every structure of the body like a 3- dimensional body stocking. If there is a pull or a snare some where in this powerful fabric, it causes greater tightening in other areas causing great amounts of pain.
Muscles- One needs to know not only the muscles that most likely may be damaged when low back pain is presented, but how to find them and treat them. In our 2-day low back pain course we look at all the muscles that may be causing pain. We teach parishioners how to find and treat all of muscles effectively.
Don't waste time
One major mistake therapists make is going directly to the area of pain and over working it. The pioneering work of Janet Travell in Myofascial and Trigger Point therapy has given us a wondrous amount of scientific research into the causes of pain through out the body and certainly with low back pain. She has documented the most reoccurring patterns of muscular dysfunction that cause specific pain patterns. Trigger point therapy is one of the advanced techniques we teach on Jing Advanced courses.
In our experience back pain is often coming form muscles distant to the area of pain and can be easily relieved with specific work.
Muscle indicated in Low Back Pain
The muscles most often indicated are
• Erector Spinae,
• Piriformis- which when tight can often mimic "sciatica",
• Psoas- an anterior deep muscle,
• The Gluteus group
• Quadratus Lumborum.-According to Travell and Simons " The Quadratus Lumborum muscle is one of the most overlooked muscular sources of low back pain and is often responsible, through satellite gluteus minimus trigger points for 'pseudo disc syndrome' and the 'failed' surgical disc syndrome'."
Knowing how to find and treat these muscles can change your massage practice from one of basic relaxation massage to one where you are dramatically changing your clients' everyday lives. It is what we focus on our courses.
Acupressure- at Jing we believe in an integration of Eastern and Western techniques and in our medical massage protocol we incorporate local acupressure points that help reduce pain in specific areas
Stretching - Stretching your clients and teaching your clients stretching is an incredibly valuable tool. We teach a 3- day advanced stretching course that gives you the tools of sports therapy to apply to all your clients. So that they can enjoy prolong periods pain free. To open up someone through stretching is to open their body's' to health.
There is nothing more rewarding and powerful than to feel that you are truly helping people out of pain. This will have a huge effect on you and your clients. Your business will naturally grow and so will your confidence in your profession. Just this week, a client who had been coming to me for low back pain that he had been suffering with for 10 years said the most profound thing to me. After his 5 th session, he said, "I never came here looking for a cure only some relief and now I am at the stage that I have forgotten I was ever in pain. My life is completely different." I can not put into words how that made me feel.
It is the goal of Jing Advanced Massage to raise the standard of massage therapy in the UK , so that when asked the question "Who is it that you go to see when you are in pain? Everyone says with confidence and passion; " A fantastic advanced massage therapist.". This can only happen one therapist at a time with the right training. We welcome you to the Jing revolution.
About Jing. www.jingmassage.com
Jing Advanced Massage + Training is an organisation dedicated to excellence in all aspects of postgraduate massage training. Offering a unique range of Holistic Medical Massage workshops for treatment of pain, including low back and neck and shoulder, we also offer courses in Hot StoneFusion, Advanced Stretching and Pregnancy Massage. Based in Brighton , we offer courses around the country
Tel: 01273.628.942.
Email: info@jingmassage.com
Text Copyright Rachel Fairweather and Meghan Mari 2005