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Pain Levels

Pain Levels, Let Them Guide You!

Use the 4-Point Pain-Change as a Guide

On a pain scale of 1 to 10, the most realistic decrease you should strive for is a 4 point change in one massage session.

Now, I know what you are thinking, “But I want to help my client MORE! I want them to go from an 8 to a zero!” We would all love to be able to do that for the people we serve. However, what you need to realize is that in a well-meaning way, by trying harder to get rid of someone’s pain, many times you can actually create more pain for your clients by the end of the session.

To make this concept simple, pain levels have everything to do with inflammation. Pain is one of the markers that turns on the inflammatory process. The more pain you have, realistically the more inflammation you can have. The more inflammation you have, the less the body can change for you in one session. (Read that last part again)

If we try to force a reaction out of our clients who have higher pain levels, typically the result of the session is more pain. It may be different pain or in a different area, but if you really stop and ask your client for a pain level at the beginning of a session and at the end of a really hard, deep session for pain management many times they will tell you the pain level is the same with a “but I feel better” comment. The client feels better because they sense that they/you did something for their body so it should help….. But did it? I can tell you that it is possible to slowly and effectively drop pain levels in a controlled manner that produces the results that both you and your client are looking for. I have often called this process “creating the energy to heal”.

Let me explain it this way. Inflammation and healing are basically a simple process of energy allocation. If you have enough energy to heal, then you will. If you don’t have enough energy to heal, then you will continue in inflammation – sometimes for years! Massage therapy can actually dictate that energy allocation. We can direct energy to an area to heal, give an area energy to heal (by releasing stuck tissues or patterns), or we can inflame the area and force the body to find the energy to heal what we did. It can heal if it has the energy – it cant if it doesn’t. The power is in your hands; the selection processes you use to determine what to work and what NOT to work, and understanding when to stop and let the body do the rest can be empowering.

Have you ever had a massage where you were so sore and depleted that it took you a week to recover? That is massage directing energy in the form of inflammation but there isn’t enough energy available to heal. More pressure, more time, more work does not actually make pain better if the body is too depleted to heal. The answer would be to make only a 4 point change where you don’t over-dictate what the body has to do to recover.

As massage therapists, it is essential to the success of our work to have both a starting point AND a stopping point in our work. It is also essential to train your clients to have the same starting and stopping as well. Healing is like a 2 steps forward, 1 step back process. It is that 1 small, consistent step forward that healing truly occurs in. That consistent step occurs when you work within healing boundaries.

Below is some information about pain levels as they correlate to inflammation. The fun part about understanding pain levels is that you can become more proficient at your work by knowing how much inflammation your client has. Inflammation starts to control what you can do at a pain level of 5. By understanding just that number, you can begin to more effectively treat your clients by selecting the best tools out of your toolbox of training for their body that day.

A number can make all the difference.

For this and more information about pain levels, you can view the Massage Your Market 6 CE Hour Course for Defining Expectations for Massage Therapists.

Clients Pain Levels

0 – 3: This person is not necessarily in pain. You usually feel sore in this range or something has just started to bother you. Maybe you have felt the pain before and you know it could get worse if you don’t stop the pattern.

4 – 6 (this is the beginning of Inflammation): This is where you will start to feel pain. It’s not sore anymore, it hurts. This pain level doesn’t stop you from doing what each day. But it hurts and you need to get help for it.

7 – 9: At this pain level, you are hurting enough that you may take pain killers or at least seriously want to. When this pain flares up, it stops you from doing what you need to each for work or fun. The pain is intense!

10: This pain level is usually an indication of something more serious. If you are truly feeling pain at this level, then you have something wrong going on structurally or physiologically (sometimes emotionally).

CONSTANT pain levels in this category can indicate things like rotator cuff tears, bulging disc, ACL tears, subluxation of ribs in the back, SI joint dysfunction (they are walking ½ sideways), or even gallbladder attacks, kidney stones, heart attack, etc.

You should be in the hospital if this is a true pain level (think giving birth or broken bones). If you are walking around with no fresh injuries, then they are an emotional wreck (stressed) not a physical one.

To be successful with massage, it would benefit both you and your client to:

#1 Do a Health History Intake Form and/or some type of S.O.A.P. notes with each client.

  1. To purchase a Health History Form

#2 Take beginning and ending pain levels for each massage session.

  1. We teach you how to work with pain levels and so much more with our Massage Your Market: Defining Expectations Class

Good luck and we wish you success!

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