Recently a client I'll name Joe for privacy's sake came into the office for chronic low back pain.  It was his first visit to my office, and what I call a "massage newbie".  Joe has never had a massage before, and was told by a friend that it may help with his low back problems.  

Through a written & verbal intake, we hypothesized that one of the possible causes to Joe's back pain was all of the sitting he does at his desk job.  This is one of the common causes of low back pain.  Joe also runs 2-4 miles three or four times a week to try and control his weight, which can factor in as well.

Low back pain can come from several weakened or shortened (contracted) muscles in the body.  It can come from neuromuscular dysfunction (pinched nerves).  It can come from herniated or bulging disks in the lumbar vertebrae of the spine.  Joint dysfunctions in the hip could also be a factor.  With all of these possible reasons that Joe could be suffering from low back pain, it can take up to an entire first massage appointment to figure out what exactly is going on in the body.

Joe's initial plan was to get a general "full body massage".  After I explained that massage could help facilitate healing of his low back problems, he was open to the more specific work of figuring out what was going on with his back.  So I explained the treatment protocol I use for low back pain to Joe, showing him the muscles I would be working on from a muscle chart.

During the massage, I discovered SI (sacroiliac) joint dysfunction, and contracted hip flexor muscles that were the likely causes of low back pain.  After the massage, Joe was surprised that he sat up from the massage table with relatively no pain.  He was amazed that the massage was able to do so much for him.  This is where I came in to tell him that this relief will not last long.

Why am I being negative if Joe felt so good?  Because realistically massage cant just "fix" somebody in just one session.  That low back pain didn't just happen overnight.  It took time to get there.  So what happens is that the body will want to return to homeostasis (the body's known "normal" state).  Even if the body's known state is in dysfunction, it will want to return that way.  I told Joe that best case scenario is that his low back pain will get about 10-20% better if it gets better at all.  Most likely after a first visit the pain/dysfunction creeps back within a couple of days.  So what is the point for coming in for massage if you don't get an instant fix?

Think of it this way.  Someone may be 40-60 pounds overweight.  Did this happen overnight?  Even though it may have felt like it did, we know that it took months, if not years to get to the point of being overweight.  It's not easy to lose that extra weight either.  It involves changing bad habits, being conscious of your body, and patience.  Healthy weight loss is about 2-3lbs a week.  The same can be said for healing the body from everyday pain & dysfunction.  It takes time, changing bad habits, and consistent self-care to get your body to heal.  That is why I recommend massage more frequently for those who live in pain.

If someone gets sent to physical therapy (which many do for low back pain), the physical therapist will never recommend to just come once and send you on your way.  A physical therapy office will want to see you at least 2-3x a week to get someone started on a program.  If your initially seeing a chiropractor for low back pain, they're going to want to see you at least 2-3x a week to get that low back pain under control.  So as you can guess, I recommended that Joe comes in for massage at least 1-2x a week.  

In my experience, clients who I've seen 1-2x a week have the greatest results.  My promise to all my clients is that we will see permanent lasting change within 3 sessions.  That doesn't mean the problem wont be completely resolved, but it might mean that quality of life improves and that the pain is much more manageable.  I explained to Joe that I would like to see him at least once a week at first to start getting his low back pain under control.  At first, Joe may have been a little skeptical.  I pointed out that massage is a process, with further sessions we would see greater results.  I also recommended some strengthening exercises to try at home in between sessions to make sure his back keeps improving.  

My favorite part of the job is client education.  I get an entire hour or more with each client to educate them on what might be causing pain symptoms and how to address it themselves.  That is more time than any medical doctor, most physical therapists, or chiropractors can give you.  That is what makes the field of massage therapy unique.  I'm glad Joe decided to start seeing me twice a week until his low back pain becomes more manageable.  I'm looking forward to showing him the results that massage therapy will have on improving his life.