Case Study: Amy

Amy [not her real name] first came into my clinic for an acupuncture treatment because she had heard it might help her pain. And it might have, in the long run – acupuncture is great for pain relief – but the needles themselves hurt so badly that Amy couldn’t continue beyond the first session.

Unsure of what to do (since the treatment was causing more pain than it was fixing), the acupuncturist called in one of the clinic’s doctors. Together they discussed the client’s condition, and somewhere in that talk the words “trigger points” came up. Well, they knew who to send Amy to next.

Amy came in for her first massage with me during the second week of December. Reason: debilitating shoulder pain.

Amy’s job had her both working at a computer and working with children. This meant that, not only did she have the classic desk-work posture problems (Amy admitted to not usually sitting up straight in her chair), but bending forward to talk to children put a strain on her muscles as well. And, naturally, high stress in the workplace didn’t help either.

On the body diagram I give every new client as part of their intake, Amy had circled her entire back, shoulders, neck and head, indicating pain in all of these places. Dots – to note extreme pain – were all along the right side of the neck, shoulders, and upper back.

Amy assured me, however, that she didn’t hurt everywhere all the time. But she hurt a lot, she hurt often, and that was a problem.

She got on the massage table and I started to work on her muscles. Sure enough, there were trigger points everywhere – and they were so sensitive that even the slightest touch had Amy flinching. She told me that it felt like I was digging my nails into her body (which, I assure you, I wasn’t).

In general, trigger points are very sensitive to touch. That is, a little pressure from massage goes a long way in fixing the problem. And since Amy couldn’t tolerate much, a little was all I could do for now anyway. Gradually, as the trigger points decreased in severity, we would be able to increase the pressure and fully release the points.

I outlined my treatment plan for Amy at the end of the first session. She would continue to come in for weekly massages to work on her trigger points. After three more sessions, she would feel a noticeable improvement in pain levels and muscle tension. In seven more sessions, the trigger points would be released.

At the start of the next few sessions, Amy would report that her muscles had felt better immediately following the previous treatment and had remained like that for the next few days. But then the pain would return, back to where it had been before. I assured her that this was normal, and that the pain-free days would increase until eventually the pain didn’t come back at all.

At the start of her fourth session, Amy told me that she realized she hadn’t been complaining about her pain at all during the week. Noticeable improvement! During the massage that day I noticed that, although pressing on the trigger points still made her flinch, I was using much more pressure than I had been before. We were definitely getting somewhere.

After eight weekly massages, the trigger points had diminished in size and strength so much that we decided to push her treatments to every other week. At the end of February, after two more sessions (making ten in total), Amy’s trigger points were gone and she reported no pain.

Amy still comes in for monthly massages, mostly for general wellness and tension relief. Trigger points do pop up in her neck and shoulders occasionally, but never to the extent or severity that they did before – and I can usually release them within a session or two.

While, sure, I like maintaining some humility in my profession, it would be foolish of me to undervalue the importance of massage. Amy’s case is a clear example, but it’s not terribly unique. Massage in general (and trigger point therapy in particular) can relieve pain, even fix the muscles so that the pain doesn’t return. Simple as that.

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