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December 29, 2005

Low Back Case Study

A new client came to me with back and leg pain. They had undergone two surgeries in the lumbar area one of which was a spinal fusion in April 2004. They were in such pain that I could barely palpate their back for assessment. Immediately, I pulled out the pain scale (one for no pain, 10 for unbearable pain, 5 being "hurts so good"). Everything I did ranked either a zero or a nine.

I decided to work the back and hip areas that registered as a zero to calm the client. This was their first massage and they may have extra tense not knowing what to expect. I worked my way into more painful areas using light touch and good communication. We discussed daily usage patterns and sleep habits.

After a while the client reported that the afflicted leg was going to sleep. Loosening the hips was essential for relief in the legs. I had them lay on their side and bolstered between their knees and ankles to take the stress off of the back and for comfort. I suggested they sleep with a pillow between their legs.

After we finished with the session I hid my surprise when they rescheduled. They could tell their back felt looser and the leg had woken up. Whew!

So when they came for their second session today, I was pleased to hear that they felt better for three days after the massage. They still hurt, of course, but upon palpation today, there was no flinching and I could use more pressure in general. Also, for the first time I could work directly around the incision site with good communication. I felt we made good progress. I assigned stretches with instructions that if anything hurt, stop immediately. What seemed to helped them the most was my instructing them to sleep with a pillow between their legs. Whatever works is fine with me.

Posted by linda at December 29, 2005 12:01 PM