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A typical experience

I had a new client the other day for an 80 minute massage. I asked him if there is anything that he wanted me to know.  He told me that he suffers from a herniated disc that he has had for a few years. He has constant low back and right hip pain that at times radiates down the back of his leg to his knee. He told me that he has had two injections in his low back and has to stay on anit- inflamtory medication.  Anything to avoid surgery. The pain is always there. I asked him if he ever saw a chiropractor for his pain.  He said yes.  But the adjustments hurt his hip so bad that he could not continiue.  So here is a guy that thinks he is on the verge of surgery. I knew that there was a very strong probubllity that was not the case. The vast majority of pain people experience is nocioceptive pain( soft tissue- muscle, tendon, ligament, facia).  MDs and Chiropractors see pain as neuropathic pain( nerve pain).  With that asumption they give the wrong treatments and therapies.  Now there is no denying that at times injections and surgery is needed. Not denying that.   But most of the time - NOT.  70% to 85% of all pain comes directly from trigger points.  Anyway I showed my client a testimonial from a client that I was able to help out of a very painful condition that she had delt with for a couple of years. I showed him that testimonial because all pain has a psychological eliment too it. I wanted him to start thinking maybe he is not on the edge of surgery.  I palpated his entire back upper torso, both hips, and right leg. I found a very painful spot on his right L5 erectors.  Another very painful spot on his right greater trochantor.  A painful spot in the middle part of his lower right hamstrings.  And also a tender spot on the right spinous of L3.  I knew that if Iwas able to eliminate all those painful palaptory spots that I would most likely eliminate his pain problem.  Because a healthy body had no painful spots even with deep massage.  Ive been hunting and eliminateing trigger points for thirty years now.  He walked out of the massage room pain free. He was pain free for the first time in years. All those other professional people misdiagnosed him because they assume neuropathic pain over nocioceptive pain.  I assume the other way around.  I'm a Massage Therapist.  

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Permalink Reply by Gordon J. Wallis on July 21, 2014 at 9:30pm

Gary, you can have true sciatic nerve pain in one leg only.  I know personally.  I had a herniated disc.  It was horrible.  They wanted to operate, but I knew that if I gutted it out it would heal.  It took me 14 months. I could not walk for four months. Then I hobbled. . I will attach a diagram of a herniated disc.  But the thing is, true sciatica from a herniated or bulging disc is rare compared to trigger point pain which can be just as dibilitating and painful.  

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Permalink Reply by Gary W Addis, LMT on July 21, 2014 at 10:49pm

As you've said a few times yourself, sometimes clients are manipulated and told things that are not true in order to get them to have an expensive and debilitating operation.  They might even be shown someone else's xrays.   You wouldn't be so easily duped, I know.  But still....   I'm not sure that a herniated disc can spontaneously heal by itself. 

I don't think I've ever disagreed with you about anything, buddy.  But still.... 

The sciatic nerve is formed from scads of nerves that originate from L4-S3.  Looking at the pictures, a herniated disk is bulging out one side of the vertebra, but the entire nerve is being pinched-- it is still one nerve, carrying one nerve signal. Notice in the second picture the tiny nerve branches; they re-form further down to form the thickest, longest nerve in the body, the sciatic nerve.  I believe that they emerge one tiny nerve channel at a time from several vertebra so that they cannot be pinched by vertebral movement or even a herniated disc.  When the spinal cord itself is compressed, the pain would extend down both legs. 

Or so it seems to me.  And I am probably all wet about this.

Permalink Reply by Gordon J. Wallis on July 21, 2014 at 11:07pm

Gary you are my friend.. You know that.  A herniated disc can heal.  The body heals itself as much a possible.  You get a cut, a few days later its gone.  Herniated disc takes a lot longer, but it heals.  I was massaging an Orthopedic surgeon one day.  I told him about my herniated disc and how it took me 14 months to heal.  He said.  Yea they they do heal, but its so painful and people have to work and they just cant be off work that long and they want to be fixed. So we do surgery.  I was crying every day.  I thought my life was ruined.  But I remembered a long time ago when I worked in a physical therapy clinic. This patient came in with a herniated disc. I saw his pain, and how he struggled to walk.  They had him doing minimal exercise.  After three sessions with the physical therapists he quit coming in.  I accidently met him a year later in Safeway.  I asked him if he remembered me.  I reminded him I worked in this PT clinic.. he said yea.  But he saw what his therapy was and figured he could just do it himself and not cost his insurane an arm and a leg.   I said how is your back now.  He said its fine.  Mine is fine now  too.  But every once in a while I can percieve a slight pain sensation on that left side of my back.  And there is no Trigger point present.  The body heals, until you wear out and die I guess?  lol   Any way reguardless.  Most pain is TP pain.  85% easy. It doesn't matter to me if you are right or wrong when it comes to a herniated disc.  The point i want to make is that the vast majority of the time, its Trigger Points.   And yet, Truth Remains Hidden.

Permalink Reply by Gary W Addis, LMT on July 22, 2014 at 6:30am

I don't doubt that-- if the person is active, a trigger point will eventually heal in those bodyparts that are regularly used despite the pain.  But if they allow the pain to stop the movement, it will get worse and worse and eventually the whole system will become supersensitive with fibromyalgia

Permalink Reply by Gordon J. Wallis on July 24, 2014 at 9:42pm
Saw this client for the second time. A few days ago she came in with her mom. The young lady was 17. She had been complaining about right hip and right back pain for several weeks. I found trigger points in her right glute med., piriformis, and PSIS, as well as three trigger points on her lumbar erectors at about the L5, L3 and L1 levels. Also a very tender upper sacrum just below L5. She was young and healthy. When she came in today she said her hip is no longer hurting, but her back still hurts. Even though her hip was not symptomatic I still palpated a Glute med. trigger point. It was sore on palpation only. So thats a latent trigger point( only sore on palpation). I found only one sore lumbar trigger point at L1(her area of complaint). I eliminated both those trigger points again. None of the other trigger points were there. She is young and very healthy, so I figure one or two more 15 minuted sessions and her pain problem should be over.
Permalink Reply by Gordon J. Wallis on July 26, 2014 at 8:57pm

Nothing real dramatic today, but in a sense cool.  One client after reading one of my testimonials told me she has no real problems but recently every once in a while her low back bothers her.  Not enough to see anybody for it.   So I figured latent trigger points as being the culprit.  I palpated from her hips up to her neck.  I only found one ILLOCOSTALIS  trigger point at about the L3 level on the left side.  It was not really that sore( no flinch or jump response), but the exact same spot on the right side was not tender at all.  So I deactivated it.  I didn't really think that was all there was too it.  So I casually mentioned that perhaps we will find a tender spot on her abdominal area because sometimes low back pain is generated from trigger points in those muscles.  Then she told me that she had surgery in her abdominal area four months ago, and that her back pain did not start up until after that.  On palpating her abdomen I found a very tender spot on lower right quadrent.  Ive included pictures of the trigger point loacations.  She was suprised that her abdominal area was sore.  Anyway she was non-symptomatic when she came in, but those trigger points were deactivated( no longer sore on re-palpation).

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Permalink Reply by Gordon J. Wallis on July 28, 2014 at 9:15pm

This client came in today.  It was ten days sense I last saw her.  She was still symptomatic free.  However she still had four low level latent trigger points that I released again.  But she feels fine.  So next follow up, unless she developes symptoms, is in 20 days.  She knows truth now.  These are only 20 minute sessions.  The physical therapy were hour sessions.  Truth Remains Hidden.  It really does.

Gordon J. Wallis said:

One of my clients today came in for her fourth session.  Prior to seeing me she had been going to physical therapy for weeks and it was not helping her.  Her complaint was very bad  left shoulder pain that was interfering with her work and sleep.  They were giving her strengthening exercises for her therapy.  The exact wrong thing to do sense her problem was trigger points. After her first massage session she quit going to physical therapy.  When I first met her she had a lot of trigger points.  Mostly on the left side of her body.  All the shoulder muscles,  up and down her para-spinals. Even several lateral spinous.  Today she came in symptomatic free.  However on palpation she still had three latent trigger points.  One on the paraspinals on the left at L3, one in her area of initial complaint on the left para-spinals on the left at T3.  And another Trigger point on the left lateral posterior neck about the C5 level.  Sense she was symptomatic free I suggested she schedule another appointment in ten days, but she could come in sooner if symptoms return.  On thinking about this, I might call her tomorrow and have her come back in five or six days , sense she still has three latent trigger points.

Permalink Reply by Gordon J. Wallis on July 29, 2014 at 9:56pm

THE SUCCESS OF OUR ACTIONS DEPENDS ENTIRELY ON OUR ABILITY TO RELATE APPROPRIATELY TO WHAT IS ACTUALLY OCCURRING IN OUR CLIENTS BODY.

Another grossly misdiagnosed client came in today for an 80 minute massage.  She told me that she has Sciatica due to two bulging disks in her lower back that radiate pain down both legs.Sounds good right?   I asked her how long has she had this Sciatica.  She told me six years,  and that it started after the birth of her 1st child.  I told her that its highly unlikely that she has Sciatica.  I'm not denying her pain.  Just denying the Sciatica diagnosis.  Real Sciatica is from a pinched nerve in the low back.  L5, L4 or whatever.  I showed her one of my testimonials and told her that if she wants out of pain, I won't be doing a spa massage.  Which she would love, but that I would be palpating for sore spots and that she is to tell me when I come to one.  Because I have found out in my experience, that if Im able to down grade or eliminate those sore spots,95% of the time I eliminate the problem.  She said the pain radiates all the way to her ankles.  The MDs gave her that diagnosis. Yet they can do nothing about it? Like that diagnosis explains it, and its over?   Gosh I palpated, with her help, trigger points in all the hip muscles.  Piriformis, Glute. Med, Glute. Min., Vasits Lateralis,  Gastrocs, Soleus, Inner thigh muscles.. A bunch.  More on the right then the left, but still.  I also found trigger points on her lateral ribs in the Serratus area below the arm pit on both sides( she said her breathing has been difficult).  I also found one very painful trigger point on her left Illiac Crest where the lateral portion of the QL connects.   Anyway she left the spa pain free.  She was supprised that she could walk without pain.  She is coming in on a follow up in a few days.   My experience.. This Sciatica diagnosis is very often( almost always) misdiagnosed.  You can see it in the Attachments. Anyone with real Sciatica, I couldn't help.

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Permalink Reply by Therese Schwartz on July 30, 2014 at 4:34pm

Gordon, because of your posts, I have been MUCH more successful at treating my "sciatica" clients.  One of them, a mom in her 30's (she has 3 boys ages 7 and younger!!), had horrible hip and leg pain.  I started looking in more places for tender spots, worked them out and at one point she was pain free for 5 weeks!  She was thrilled!  I'm sure I'll get better with more experience (6 1/2 years vs. your 30+ years) but I'm definitely encouraged with how things are going.

Permalink Reply by Gordon J. Wallis on July 30, 2014 at 8:09pm

Ok, she was pain free for five weeks. Awesome!  She could be pain free for a year or forever if you have her coming in every three days for half hour follow up session.  Maybe six or seven sessions and she will have long term relief.  Each time she comes back for follow up sessions there will be less trigger points.   
She may have been symptomatic free, however on palpation you might still find some tender spots.  You just keep downgrading until the trigger points are gone or nearly gone.  After six sessions the client should be dramatically better if not completely pain free.
Therese Schwartz said:

Gordon, because of your posts, I have been MUCH more successful at treating my "sciatica" clients.  One of them, a mom in her 30's (she has 3 boys ages 7 and younger!!), had horrible hip and leg pain.  I started looking in more places for tender spots, worked them out and at one point she was pain free for 5 weeks!  She was thrilled!  I'm sure I'll get better with more experience (6 1/2 years vs. your 30+ years) but I'm definitely encouraged with how things are going.

Permalink Reply by Therese Schwartz on July 30, 2014 at 10:07pm

It would be great if she could do that!!  It's hard for her to get here for a session; she has to find a baby sitter than can wrangle 3 small, energetic boys! :-)  She comes every 2 weeks, unless things go wrong - which happens frequently, unfortunately.  But we do the best we can!!

Permalink Reply by Gordon J. Wallis on July 31, 2014 at 12:06am
Ah, ok. Yea, you just do the best you can.

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