Olivia loves being underfoot, especially when I'm cooking. She squeezes between me and the counter in case a bit of cucumber or watermelon (her favorite) drops off the cutting board.
Sometimes, this can lead to me accidentally stepping on her paw. Surprisingly, she shows no outward signs of pain when I do this. Not a yelp, not a twitch.
Quite the opposite is true for people with chronic pain. They can develop a hypersensitivity to pain. In those cases, the pain is no longer related to the original injury, but is more likely a dysfunction of the central nervous system.
Massage therapists see clients with varying types and levels of pain every day. It's our most common client complaint and something we're very good at resolving, or at least managing.
But when pain goes on for a long time, people can develop conditions like central pain allodynia (increased response of neurons that triggers a pain response from stimuli that doesn't normally provoke pain) or central sensitization (a persistent high state of pain).
When that happens, it can take more than massage to relieve the pain.
I read a research summary on a study using virtual reality to improve pain and motor function. It reminded me of the simple things we can add to a massage session to improve outcomes: breathing, small movements, and visualization, to name a few. The article spoke of the importance of "altering the central representation of the body through multisensory bodily inputs" and how this can help to understand and treat chronic pain.
In my book Integrative Pain Management: Massage, Movement, and Mindfulness Approaches, all the authors spoke to the importance of integrative and multidisciplinary care. I chose to address those three subjects–massage, movement, and mindfulness–because these are things we as massage therapists can potentially combine in a session and can encourage our clients to take home and continue as self–care.
Funny how easy it is to forget those lessons and go back to habitual ways of providing massage. I have adapted to always including movement and awareness exercises, and I'm recommitting to expanding my sessions to include visualization and breathing.