A massage therapist should always keep in mind the possibility of several independent conditions occurring in the same area of the body.
To make this clearer, let’s look at an example.
A client comes to your clinic complaining of pain in the upper right part of the back. During the routine examination (for example, using my differential diagnostic algorithm), you identify signs of right-sided overload of the neck extensor muscles and compensatory involvement of the upper portion of the trapezius muscle on the right. The client notes that the pain appeared just two days ago and associates it with having to sit at the desk noticeably more than usual recently due to work demands.
However, in addition to this, you discover complaints of periodic numbness and tingling in the fingers of the right hand. The presence of such neurological symptoms completely changes your opinion of the case. You may well ignore the muscular changes and direct all therapeutic efforts toward addressing the neurological issue.
Let’s carefully analyze this case. On the one hand, you clearly see a muscular pattern that is logically and consistently explained by the recent overload. At the same time, the neurological symptoms clearly do not fit into this picture.
If you always remember the possibility of multiple conditions, then during a more detailed history-taking you discover an important fact: the numbness and tingling in the right hand have been bothering the client for approximately a year already. They occur periodically, and there have been no changes in this symptomatology recently.
In other words, the neurological problem is most likely unrelated to the current episode of muscular overload. Therefore, the main efforts should be focused specifically on correcting the muscular changes — this will bring a quick and noticeable effect (see also: Neck and Shoulder Tension and Pain).
Whereas if you begin to actively work on the neurological symptoms, you will not achieve any noticeable improvement. The muscular problem will remain, the client will not feel any result, will lose trust in you, and most likely will not return.
Thus, if during the examination you encounter overly diverse symptoms, remember the possibility of multiple conditions and differentiate the symptoms according to their time of onset.
For more on distinguishing neuropathic symptoms from muscular ones, read Neuropathic Pain vs Nociceptive Pain.
Advertising
If you found this article useful and are looking for professional therapeutic massage in Calgary SE, you can book a session with me here: Book an Appointment
New clients are welcome. Read my First Visit Guide to know what to expect.