Features,Terminology

On a Level of 1 to 10: Knowing How To Communicate Pain to Bodywork Therapist

When your body is going through issues, it is important to have an understanding of what is what. You want to be able to describe what type of pain or discomfort are you going through.  This is so when you go to a massage therapist, a bodyworker, or yoga therapist you will know how to explain your experience so that they can successfully help you. There are particular considerations and techniques that are used for specific issues; so if your therapist has a more accurate understanding, he or she will be able to know how to approach your chief concerns.  This also helps the therapist know when to use alternative methods in case there is an awareness or contraindication for a condition.  If this is your first massage, this is what to expect.

Be specific when talking to your massage therapist

In addition, this information can be very helpful to you, as the client.  It will empower you and help you to be prepared for your session.  Sometimes this information can be a lot to remember and a lot to talk about, but if you are prepared you will save time and get the most out of your actual, hands-on service.  How and when to explain why you booked the service will depend on where you are getting the service from.  Not all therapist will ask and get into the details of your concerns.  If you booked an appointment at a spa, they may not ask too many questions, due to the type of business it is and time limitations.  Although, it is still good to mention key concerns and awareness even if they don’t ask.  Using this guide will assist you in being able to do so efficiently.  However, therapeutic specific places or independent therapist may want more insight.  They are the ones who may see you more than one time and want to get to the root of the problem to resolve it.

The Importance of Communication

One thing to keep in mind is whether you go to a spa or a therapeutic therapist, if you are dealing with anything major or a medical issue, let your therapist know even if he or she does not ask.  It is in your best interest to make them aware of key things like recent cancer, a recently major surgery, pregnancy, etc. Below are more examples to guide you. Don’t be afraid to let the person booking your appointment know (so that they can ensure you are with the right therapist) or let the therapist know. The therapist should be able to adjust your service so that it will be an ideal and satisfying one.

In my experience as a therapist, most people (clients) will not communicate this important piece of information because they are afraid they will be told they can not have a massage.  This does not have to be the case.  Massage, bodywork and yoga therapy have come a long way and have more knowledge in knowing how modalities can compliment medical issues when done properly.  If you do not say anything and the service was not given a chance to be customized for you, then there is a chance that mild or severe complications could occur.  So communication, whether brief or extended (depending on the setting) is essential.

Listed below are the medical explanation and definitions to common body sensations.

Definitions of Common Sensations

When talking to a massage therapist

Know your sensations and be relieved

This list includes common sensations that are felt in the body when there is an issue.  The type that makes you say, “Um, I need a massage”.  These sensations are the results of many different factors.  They are the tail end result of an injury, surgery, stress, etc. [click here for what to do when similar sensations are the result of a more serious medical condition].  When you use these terms to a therapist, it gives him or her a better idea of how to address your concerns.

Note: words in “burnt orange” color includes definitions when you hover over the words. If you are not able to hover, definitions are provided at the bottom for this page.

Pain

An unpleasant sensation that can range from mild, localized discomfort to agony. Pain has both physical and emotional components. The physical part of pain results from nerve stimulation. Pain may be contained to a discrete area, as in an injury, or it can be more diffuse, as in disorders like fibromyalgia.[MedicineNet]

Soreness

Tenderness on palpation or specific movement, occurring 24 to 48 hours after intense or prolonged muscular activity.  When you are sore, it can be unpleasant for that area to be touched or moved.

A state of muscular discomfort that begins several hours after a period of intense exercise, particularly with eccentric muscle actions.   Discomfort usually persists from 24 to 48 hours; thought to be due to microtrauma to muscle fibers.  

Cramping

A muscle cramp is a sudden and involuntary contraction of one or more of your muscles. Muscle cramps can cause severe pain that can stop you in your tracks.  [Mayo Clinic] 

Muscle cramps are when a muscle gets tight (contracts) without you trying to tighten it, and it does not relax. Cramps may involve all or part of one or more muscles.   

Tightness

The state of activity or tension of a muscle beyond that related to its physical properties, that is, its active resistance to stretch. In skeletal muscle, tonus is dependent upon efferent innervation. (Stedman’s Medical Dictionary 25th Edition)

Stiffness

Muscle stiffness is when your muscles are more difficult to move than usual, especially after rest. You may also have discomfort. This is different from muscle rigidity and spasticity. With these two symptoms, your muscles stay stiff even when you’re not moving. [Healthline.com]

Knots

Muscle knots, or ‘myofascial trigger points’, are painful, lumpy regions of tense muscle. These are usually fascia adhesions.

Tension

Muscle fibres that tend to shorten. Tension is a muscle held in a sustained contraction (Travell, Simons, 1983). Typical tension usually take place with headaches, neck, upper shoulders, arms & hands, and back.  Tension tends to occur upon stress and worrying (mental activation).

Spasm

Muscle spasm is an involuntary contraction of a muscle that can cause a great deal of pain.  Spasms can be so severe that it can be hard to move; almost as though you are stuck in the position you were in when the spasm started.  They can make it so that no position is comfortable.  Example: When the facet joints of the spine become injured or inflamed, the muscles supporting the spine can spasm causing low back pain and limitation in motion.


When going to a therapist for therapeutic, specific reasons

There is key information a therapist would need to make sure he or she is giving you the best service, and that satisfies why you booked an appointment.  Therapist will gather both subjective and objective assessment data.  The variation of these data are as follows. (this section as published by Rattray and Ludwig 2000)

Communicating to your massage therapist

Assessment Domains through direct questioning

P-PALM Assessment

Purpose – Purpose of session

Pain – What are your pain and discomforts

Allergies – Do you have any allergies or skin conditions

Lifestyle – What is your lifestyle and vocation

Medical – Do you have any medical or health issues noted by a medical doctor

Qualifying & Quantifying Pain and Discomfort

Qualifying

Onset: When did it start?

Provocative:  What makes it worse?

Palliative:  What makes it better?

Quality: How would you describe this pain?

Radiation: Does the pain radiate?

Site:  Where does it hurt?

Timing:  How often does it hurt?

Quantifying

These questions can be accompanied by an additional qualitative description of the sensation as being mild, moderate, or severe.

Measuring Levels of Sensation

Useful information is also communicated, by you, on whether the sensation is sharp, dull, or tingling.

10 Point Pain Scale

Using a scaling system from 1-10.  Level 10 being more severe.

Additional Assessments

Some therapist may also include additional assessment properties through test and measurement.  These do not necessarily use instruments. Assessments are usually done my feel, visual, and sensations as you move per their instruction:

Palpitation – Using touch to feel for anything unusual.

Postural analysis – Visually judging the body’s alignment and balance.

Range of motion – Instruction of movement to see if there are any limitation outside normal range.

Gait – Watching how the body moves while walking.  Which way does the toes and knees face when standing still.  Are there any unusual movements when walking.


Conditions that may affect your massage therapy & sometimes yoga therapy  

Contraindication:

Means a specific situation in which a procedure, drug or surgery should not be used because it may be harmful to the person.  In this article, we list two types that a massage and / or yoga therapist may consider; Local Contraindication and Absolute Contraindication 

Local Contraindication – the therapist will stay away from a specific area or adjust a treatment to not further injure or cause irritation to an area. For example:

  • If you have an injury that is less than 72 hours old, such as whiplash or a sprain (i.e. around the ankle).
  • Pressure that the therapist provides, causes unwarranted pain like corn on toes, callous, bunions.
  • If an area is inflamed like with carpal tunnel syndrome, acute bursitis, etc.
  • Contagious or irritable and is confined to a small area. Examples include athlete’s foot (or feet), irritable bowel syndrome (abdomen) respectfully.
  • Suspicious lumps, masses or moles.

Note: if you suspect you have any of these or similar, but have not gotten an official diagnoses, consult your doctor first before booking your appointment to avoid miscommunication. Major to severe medical issues are physicians specialties. They are the ones that will guide you towards the best care in these situations.  Therapist are great with supporting your healing process when it is appropriate.

Absolute Contraindication – reschedule your appointment until your physician approves or gives an alternative, when:

  • Inflammation is widespread or a condition is acute or exacerbated like rheumatoid arthritis, lupus, etc.
  • You have an infection or disease like, fungi, virus, strep throat, pneumonia, scabies, chicken pox, active shingles.  If you have any of these conditions, reschedule your appointment until you are better and you doctor says it is O.K.
  • Consult your physician if you have symptoms that have become severe for any or no apparent reason like with Parkinson’s disease, scleroderma.  If you have this or similar disease and your doctor says it is O.K. for massage, your therapist may have you to sign or provide a medical release form.  If this is the case, it is fine to do so.  This is for your safety and extended care.
  • Do not book an appointment if you have a medical emergency like meningitis, appendicitis, etc.

Medical Definitions

Palpitation  means touch.

Microtrauma  can include extremely small tearing of muscle fibres, the sheath around the muscle and the connective tissue. It can also include stress to the tendons, and to the bones [*] (see Wolff’s law).

Tonus  the constant low-level activity of a body tissue, especially muscle tone.

Spasiticity  meaning drawing, pulling. It is a feature of altered skeletal muscle performance with a combination of paralysis, increased tendon reflex activity. It is also referred to as an unusual “tightness”, stiffness, or “pull” of muscles [*].

Myofascial  pain refers to pain caused by muscular irritation.  Pain that radiates from sensitive points [*].

Fascia  a thin sheath of fibrous tissue enclosing a muscle or other organ.


References:

Travell, Janet G. and David Simons. 1983. Myofascial Pain and Dysfunction: The Trigger Point Manual. Baltimore: Williams and Wilkins.  By way of Rattray, Fiona and Ludwig, Linda 2000. Clinical Massage Therapy: Understanding, Assessing and Treating Over 70 Conditions. Ontario: Talus Incorporated.

Rattray, Fiona and Ludwig, Linda 2000. Clinical Massage Therapy: Understanding, Assessing and Treating Over 70 Conditions. Ontario: Talus Incorporated.

Stedman’s Medical Dictionary 25th Edition.  1990.

Online Reference: 

Mosby’s Medical Dictionary, 9th edition. © 2009, Elsevier.

Healthline.com article: What Causes Muscle Stiffness

Mayo Clinic: Muscle Cramp Overview 

Spine-Health: Myofascial Pain Definition

MedicineNet: Medical Definition of Pain

Wikipedia

https://en.wikipedia.org/wiki/Spasticity

https://en.wikipedia.org/wiki/Microtrauma


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  • Elwynda
    July 18, 2017 at 6:40 pm

    This is an interesting read. I am going to try this. Thank you.