**Before I get into the meat of this post I want to take a quick minute to define “chronic pain” in some very general terms. First, the pain needs to have been present for a prolonged period. Second, the pain is usually felt as dull, achy, diffuse, or deep (as opposed to the sharp, stabbing, or intense sensation of acute or injury related pain). Third, the pain does not cause your blood pressure to rise or your breathing or heart rate to increase. Pain that lasts long after an injury has healed is chronic pain. Pain in your knee every time you run is not chronic pain, even if you’ve had this pain for 5 years; you’re simply repeatedly re-injuring your knee each time you run… so stop it already… let it heal 😉
OK, now that I’ve gotten that out of the way, onto today’s post…
If you have chronic pain, you may have had some really painful experiences with massage therapy. You may even think that you don’t tolerate massage well. Well that’s certainly a possibility, but it also could be that you just haven’t found the right therapist for you.
In an effort to help you find the right therapist, I’m going to give you 5 questions you need to ask any massage therapist you’re thinking about working with. I’ll also tell you what you’re looking for in their answers. These won’t guarantee a great massage, but they will help weed out the ones you don’t want to experience.
1. Do you work with a lot of people who have fibromyalgia or other types of chronic pain?
If they haven’t worked with very many people who have some sort of chronic pain, they may not have enough experience working with chronic pain to be the best fit for your needs.
One caveat: Just because they’ve worked with hundreds of clients with fibromyalgia or other types of chronic pain doesn’t mean they actually helped anyone… or that they saw any of them a second time. I know that sounds harsh, but some therapists are great at getting clients in the door the for the first visit (sales), but not so great at getting them to return (service).
You can always ask this follow up question of those who answered this first question in the affirmative: Roughly what percentage of your chronic pain clients are repeat clients?
2. Do you use special techniques to release muscles that are in chronic pain or do you use your regular techniques with lighter pressure?
Simply using a lighter pressure MAY work, but it may not. If the pressure it too light, it has the potential to be stimulating instead of relaxing (that’s one of the reasons that so many massage therapists use something called a feather stroke to end their massages).
Chronic pain causes changes in the brain and changes in the pathways that the pain-signaling chemicals take. This means that the techniques that work really well on the acute pain of an injury won’t work so well on someone with chronic pain. Therapists who truly understand the difference in the pain mechanism of chronic vs acute pain will have taken the time to learn special techniques to use with chronic pain – which funnily enough also work on injuries.
If you’re lucky, the therapist will say that the majority of the techniques they use are designed to work with the body of someone in chronic pain.
3. What’s your specialty?
First, you really want a therapist who specializes. You know the old adage “Jack of all trades, master of none”, right? ‘Nuf said.
There are many ways for a massage therapist to specialize: in a specific technique, in a couple techniques, in body areas (like neck and shoulders or hip and low back), or in conditions. None of these is inherently better than another, but the answer you get will tell you more than you may think.
If they specialize in just one or two techniques, write them down and look them up on the internet to see if they are indicated primarily for injuries or for chronic pain. As a caveat to this type of specialty, here is a quote I learned in massage school: “If you only have a hammer, you tend to see every problem as a nail.” ~ Abraham Maslow. That said, there are some very versatile techniques out there so just because someone specializes in just one technique doesn’t mean they don’t know others or don’t put their specialty to a wide variety of uses.
Specializing in body areas is great if your pain tends to be in those areas. These therapists will generally have some amazing insights into your pain because they have spent time focusing on specific areas.
If your pain is because of a specific medical condition such as fibromyalgia, a massage therapist who specializes in fibromyalgia might just be the right fit for you.
4. Do you believe that soreness the day after a massage is good &/or necessary?
More and more massage experts are speaking out against the idea that soreness is necessary the day after a massage. Next day soreness could indicate that the therapist went too deep or massaged too fast and injured the tissue. They often work out your knots at the same time, though, which is why many people feel tons better on the 3rd or 4th day.
Run from any therapist that still says that the soreness is from toxins or lactic acid being released from your muscles. Research has proven this false time and again, and has been covered in depth by all the major massage publications and professional associations. If they aren’t staying current on important information like that, you’re better off looking elsewhere.
5. Have you or a loved one ever experienced chronic pain?
This one may be a bit unexpected, but before you ask “what the what?”, let me explain. A therapist who has either experienced chronic pain themselves or who has a close loved one with chronic pain will score huge on the compassion and empathy scale. If you get very little compassion or empathy from family, friends, and/or your healthcare providers this may be the therapist for you. Compassion and empathy from your massage therapist will make it easier for you feel safe, which will allow your muscles to soften more easily, which makes you feel better physically. Compassion and empathy can also sometimes bridge the gap of inexperience.
Remember, these are just guidelines. They are designed to aid your search. Ask the questions and mull over the answers, but in the end you have to follow your own intuition.
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