Pain Management

Pain management is a topic in which massage therapists are generally not familiar enough. We encounter it daily, but we're woefully ignorant about it, and under-equipped to help people manage it.


It must be stated: Massage therapists are not medical professionals. We cannot diagnose, and we certainly cannot claim to have the ability to take on, or manage, somebody's painful conditions. However, I argue we MUST be familiar with the topic so that we can point our clients in the right direction, rather than potentially make the situation worse.


What is Pain?


First it must be stated that pain is a product of the brain. It's a protective mechanism, much like our immune system. It will deliver the sensation of pain in order to protect the body. Pain also shuts off with the brain. If you are not conscious, you are not experiencing pain. The brain is in control.


The brain is constantly receiving information from the body's various receptors. These receptors sense changes in things such as temperature, pressure, etc. When the receptors sense changes that are potentially dangerous we call it, 'nociception.' The brain then makes decisions using this information (though most of these signals are filtered out at the spinal cord before reaching the brain, as they're not important enough).


This is not the only information our brain takes into account before deciding to produce pain. There's a wide variety of contextual information. Information from our biology, psychology, and social interactions. Diving into this would need to be an entirely different article.


Danger and Safety


In their book, 'Explain Pain,' Dr. Moseley and Dr. Butler suggest that resolving pain is like a pilgrimage. During the journey our brain collects information that could be labeled either, 'Safety in Me' (SIM) or 'Danger in Me' (DIM).


SIM is anything that informs our brain of safety: gentle massage, movement, resolving trauma (physical or psychological), or being told by a trusted healthcare provider that you're healthy and resilient. This is good information that our brain takes when deciding whether or not protection (pain) is necessary.


DIM is anything that informs our brain of danger: overly painful bodywork, over-reaching in exercise, trauma (physical or psychological), or being told by a trusted healthcare provider that you're weak and fragile. This is bad information that may encourage our brains to protect us even more.. Ouch!


Collect SIMs, and Reduce DIMs


This is our task when managing pain. Take notes about what thoughts, activities, and habits promote a sense of safety, and well-being. Figure out, and avoid what does the opposite.


I believe these 3 items to be tremendously important. They make pain less of a mystery and potentially manageable:


1. Understand what pain is, and where it comes from.


2. Respect the multi-dimensionality of painful conditions.


3. Collect valuable information that promote a sense of safety.





*This article is designed to be bite-sized and easily digestible. If I've failed in my job and you're confused about certain concepts, or have any questions, please feel free to reach out in the comments.*

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