QuestionHi,
A 60 year old woman, with no prior history of herniated disc, receives a deep-tissue massage (first massage of her life). The massage therapist uses her knuckles on "knots: near her upper back, lower neck. The woman experiences pain shortly after the massage. The pain continues to worsen and 3 days after the massage, the woman is diagnosed with a pinched nerve, which turns out to be herniated disc, C-6, C-7.
Questions: 1) If the woman complained of pain in her right shoulder, is that a contraindication?; 2) should the massage therapist have used her knuckles?; 3) is it possible the deep tissue massage caused the herniated disc (have you ever heard of this before?); 4) should the massage therapist have performed a deep tissue massage for a first time massage patient, although the patient requested; 5) should the massage therapist have performed some type of evaluation prior to performing the massage?
I appreciate any help you may have. Thank you.
AnswerHi Homer,
I hope this didn't happen to one of your own clients! :)
1) Not at all, pain is usually an indication for massage, rather than the opposite.
2) It all depends on *how* she used them and where. Pressure tools (including ones own knuckles and elbows) can be used to great effect, but it is not generally a good idea to use them on the neck.
3) Doubtful, unless the therapist was putting a lot of overall pressure into the client's neck (as if she were a chiropractor using body weight to thrust).
4) Sure, provided the client's health history didn't present a contraindication for deep tissue. She should have checked in frequently to ask her client how the pressure level felt, though.
5) Certainly, especially with a first time client.
Hope that helps!
