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8 Questions About Back and Shoulder Pain

In my line of work, I've come across all sorts of reasons why people end up dealing with the annoying duo of back and shoulder pain. And you know what? Back and neck pain are like inseparable buddies, influencing each other and making our lives a bit more uncomfortable.

So, in this chat, I'm gonna spill the beans. It's not just about the massage techniques but about understanding your situation. So, let's dive into the nitty-gritty of what makes our backs and shoulders throw a tantrum.


1. What are some of the most common causes of back and shoulder pain you see in clients?

Repetitive use injuries commonly cause back and shoulder pain in my practice. These injuries often occur when starting a new activity or hobby. I'm usually fully booked in the spring with people who hurt their backs working in their gardens. Other examples include beginning an exercise program, moving to a new home, or starting a new job.

However, lack of movement causes back and shoulder pain as well. Staying in a cramped position for a prolonged period causes some muscles to shorten and others to lengthen, leading to tension and trigger points. Some common examples include a long trip in a car or plane, sleeping awkwardly, or working long hours at a desk.


2. How do back and shoulder pain intersect? Does one make the other worse?


Absolutely, back and shoulder pain intersect. There are layers of muscles throughout our neck, shoulders, and back, many of which are involved in the same activities, like bending, lifting, and turning. These muscles often share attachment sites. When tense, overcontracted muscles pull on their attachment sites, it often causes the surrounding muscles to overcontract.


Also, any strain or injury impacts your ability to move comfortably. When we're in pain, our movement patterns change subconsciously to compensate, often leading to pain in areas other than the initial complaint. Think of the way you might walk after leg day at the gym.

3. How does working on a client with a back muscle injury differ from a client experiencing back pain due to sciatica?

In both cases, I use a combination of standard massage strokes, including effleurage, petrissage, friction, and compression. The techniques I use don't vary much from client to client, but the pressure, speed, and direction of movement do.

Every session is unique, but that's because people are different, not because there's a radical difference in treatment plans for each cause. Everyone has different sensitivity levels, a preference for pressure, and a different response to massage therapy. My client's goals and comfort determine how I approach a session, and their body's response to the work decides how I move forward.


4. With many possible causes of back and shoulder pain, how do you assess a client's condition and specific needs before beginning a massage for back or shoulder pain?

First, I observe their movement patterns as they arrive for their appointment. Then, I start our discussion with fundamental questions about their pain, such as:

  • Where is their pain located?

  • What type of pain are they experiencing (throbbing, aching, burning, etc.)?

  • How often does it hurt?

  • What activities make it worse?

  • How long has the pain been present?

  • Does anything provide relief?

  • Have you seen other healthcare professionals for this problem, and what was their assessment?

Their answers to these questions direct my follow-up questions and allow me to dig deeper into the possible cause of their pain, giving me a place to start.


5. Can you describe what a typical session may look like? How do you begin, what massage techniques do you use during the session, and how do you end?

I begin my massage sessions with a warm compress and compressions to the affected area. Starting this way warms the tissue and allows me to explore the area, palpating for tension and trigger points. When I've located the problem, I use the techniques I mentioned above as I gradually increase the pressure, change the direction of my strokes, and add movement until I feel a difference in the muscle tissue. I end my sessions with a few minutes of soothing massage to the scalp or feet to help my clients relax and reset.


6. Do you suggest any post-massage recommendations or self-care techniques to clients?

After booking their next appointment, I encourage my clients to hydrate and rest after their massage. Not all clients are receptive to "homework," so I've found it's best to keep my suggestions simple. Other recommendations include a basic stretch to try, a slight adjustment to their sleep position, or the use of a heating pad.


7. Do you have any examples of successful outcomes for clients you worked on who suffered from back or shoulder pain?

What was their condition when they first came to you for help? What techniques and frequency did you use? How did their condition improve?


Chronic Tension Headaches

One client came to me for help with persistent headaches. For a month, I administered

weekly neck and shoulder massages. As a result, her headaches decreased from 3-4 times per week to once a week. Subsequently, we adjusted the session frequency to biweekly, and within three months, her headache frequency had further reduced to approximately one occurrence per month. Currently, we maintain her reduced headache frequency with monthly sessions.


Frozen Shoulder

Another client sought me out for help with frozen shoulder. Her recovery journey extended longer than some because she could attend sessions only once a month. However, we shared an emotional moment after working together for a little over a year. Overwhelmed with gratitude, she cried from relief because she regained the ability to move her arm. At one point, she doubted if such mobility would ever be possible again.


Pregnancy-Related Pain

Lastly, many seek my help to alleviate lower back pain during pregnancy. The hormonal changes, fluid retention, and shifts in their center of gravity often make pregnancy an exceptionally uncomfortable experience. Numerous clients have shared that their weekly massages are the only time they find any physical comfort during their pregnancy. Many have also expressed that they only sleep well after their massage sessions.


8. Is there anything else you would like to add?

I don't endorse the "grin and bear it" approach that many other massage therapists use. Massage shouldn't be painful. If a massage results in severe discomfort or pain, it might indicate an underlying injury or inflammation.


Furthermore, it's important to note that pain can cause you to tighten your muscles, hindering the effectiveness of the massage therapy. I'm not about the no-pain-no-gain life; massages should feel good. If it hurts more than a seven on a pain scale, holler, and we'll dial it back. It's a team effort, y'all – let's keep it comfy and pain-free.


Until Next Time


After chatting about everything from chronic headaches to conquering frozen shoulders, it's pretty clear – relieving back and shoulder pain is as diverse as a snack aisle. We're not just talking about fancy massage moves here; it's about getting what makes each person tick. The stories shared here aren't just victories over pain; they prove that a bit of personalized care can work wonders.


Ready to give your back and shoulders some love? Schedule your session, and let's make it happen. Cheers to healthier backs and happier shoulders!



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