Client low back pain *after* massage

[hopeless4love]

I'm hoping someone else has had this experience, because I feel just wretched right now....Had a client a couple of weeks ago with some low back pain and stiffness; did a 1/2 hour massage, not a lot on the low back to be honest, just to get the circulation going, and spent the rest of the half hour on arms/hands, feet, and upper back.Now I find out that the client was *really* stiff and sore in the low back the next day; she's been seeing a chiropractor since then and is better, but I feel just awful. What, if any, are some more-or-less definitive warning signs that this could happen? Do you suppose her back got too relaxed and something slipped out of place? I do massage for relaxation, and I feel like a complete idiot about this situation.... any input, stories, commentary you have would be so greatly appreciated.A.

 

[scruffycat]

If I am prone without the correct support for any length of time I am out of commission.I am talking even five minutes.I have to use a pillow, wedge or bodycushion.  I have lumbar and SI issues and need the help.  Sometimes the bolsters/pillows/cushions  don't even help.I am also overweight as many Americans are.Is your client overweight?Does he/she complain of backache?Try a small pillow(travel) or towel under the hips while prone.I usually opt for sidelying when getting work done.  I all to often am in so much pain otherwise I can hardly get off the table.

 

[Michael J]

I keep a travel pillow handy for clients with low back pain.  I offer it to them for support while they're face down.  A bolster under their ankles while prone and moved up to their knees while supine also helps.Lower backs can be tricky.  It may not have anything to do with your massage.  I have a client that hadn't had back pain in months until she turned in her chair to drop a banana peel in the garbage and felt a twinge.  That day she was achy, the next three days she could barely walk.It is possible to irritate a lower back that is already angry through massage.  I tell my clients that if their pain isn't better in the next day or two they really should consider a consultation with the chiropractor.  And ice...lots of ice.When I first started deep tissue training, one of the therapists at my office asked me to work deep on her sore shoulder.  She wanted a lot of pressure during the massage, but afterward she was in a lot more pain.  I must've triggered a spasm or something.  She ended up taking the next day off and had the doctor do ultrasound and muscle stim for the next few days.  I learned that deeper isn't always better, and that I should always go with my instincts about what the tissue is doing.Katykangaroo

 

[johnny j]

Client low back pain *after* massage

If anyone has lower back pain (general) on their intake form, I discuss the importance of working not only the back, but the hamstrings & especially glutes & IT band. Even if it's a half hour. I often end with biofreeze for these people too.

 

[nestprop]

I always use a pillow under the low hips to take the added pressure off when laying prone and when in supine I have a good big bolster to go under the legs.  And as Jill says include glute and ham work as well, also explain the importance of strengthening the abs and give good strethes for them to do at home.  I recommend pilates to alot of my clients who experience lower back pain......"core strength".Jillian, RMTCanada

 

[Pompal 09.]

Client low back pain *after* massage

Thanks for the input, everyone.I did have the client's ankles bolstered while prone, and the knees while supine. And I definitely would not classify my technique as deep, but whatever it was, it was enough, I guess.My client did hint that she was considering a hot bath after the massage; I suggested ice instead, but I don't know what her final choice was. I need to ask her that. It's possible that she chose the heat and the spasm (or whatever it was) occurred as a result of that massage/heat double whammy. She said she asked her chiropractor what the cause could be; they couldn't conclude anything specific, so I feel a little better about that. And I did suggest that she use IcyHot or some such ointment, but I should have used it in the session.Anyway, just thinking "out loud" through my fingers. I'm so glad you guys are here to bounce stuff off of. Again, thanks for the input --Andrea

 

[Khan]

I also experience low back pain if I'm prone for 30 minutes or more.  Support under the hips is a tremendous help!!!  Stretching for the back after the massage also helps.  Of course.....the bolster under the ankles is just standard and helps.  

 

[Kerensa]

Client low back pain *after* massage

Did she drink enough water after her massage? And yes the heat could be the culprit, she should've iced.

 

[Drogo]

Why ice?  Heat feels so much better?

 

[walk 112 ??l?]

Client low back pain *after* massage

Why ice?  Heat feels so much better?

Hi Doreen,

I hear you when you say heat feels so much better(ahhh) but if your client is in acute seforum.xxxe...use cold(unless they are in spasm).  You can actually cause more harm than good when using heat in certain situations that require cold therapy.

Jillian, RMT
Canada

 

[Holly Hopscotch]

Client low back pain *after* massage

Heat increases blood flow and if there is inflammation you want to avoid that. It is always safe to use ice, heat must be used with caution.

 

[Tyuio]

Client low back pain *after* massage

These are all good posts...however, I experienced something similar on a male client experiencing low back pain who HAD gone to see the chiropractor a few times already. Before the massage, I made sure he had cleared it with his chiropractor which he had. Even so, I let him know I wasn't sure that maybe he should just wait until all his entire two week session was over with the chiropractor first before getting a massage, as he was STILL in a lot of pain. He insisted and so I worked on him.I had him on my table with a bolster under his ankles AND under his hip/abdomen area.I did a fairly light massage job, targeting his entire back, glutes, arms/hands a little AND applied Biofreeze on him.After the massage, I alternated hot/cold packs on him. He had trouble getting off the table and it took him about 15-20 minutes to be able walk around fairly comfortably.Were the hot/cold packs the culprit? Keep in mind that each was on for 5 minute maximum (applied heat for 5 minutes/applied cold for 5 minutes/applied heat for 5/applied cold for 5/etc. (I ended with a cold pack).Not sure what else I would have or could have done...I did tell him that I wouldn't want to work on him until the chiropractor had actually been able to finally "fix" his back. Any feedback on this would be greatly appreciated! Thanks,Jen

 

[Camille]

Client low back pain *after* massage

Do you work the abs? Sometimes if the abs are contracted, which happens quite often when sitting at a desk all day, it will cause back pain. Do not chase the pain. Just because the back is where it hurts doesn't necessarily mean that's what you need to work.Tracy

 

[Gene]

I've had chronic low back pain for years.  I do my stretches fairly faithfully.  I rarely get massages because it hurts too bad to lay on the table for an hour.  Actually, it's not the laying that hurts, it's the getting up. Now, if I want a massage for relaxation, I will ask to be on my side.Scav

 

[Theo]

My brother had a bulging disc, but no one knew until he started having massages. The massages relaxed those muscles so much that there was nothing there to help hold that disc in place. He finally had to go see a neurologist about the back pain and he explained why it hurt after the massage and not much before. It turned out that his muscles had been so used to guarding  and protecting that disc that he never really noticed how tight they were until they had  been massaged and he felt how loose they had become after the massage. Just one little reason someone could have back pain after a massage.

 

[LillyAnna]

Jenny, so is massage contraindicated for your brother now?  Any idea how to avoid a situation like that?

 

[Posleen Killer]

you know what. No one knew that was the problem  until he  had massages. No, he can have massages now, he has been on medication to help the selling in the disc. In fact, for two months before my sister moved, she was giving them to him regularly so that he would know if the disc started to act up again. that way the muscles didn't have the chance to guard that disc. I am sure that he will eventually have to have a PLIF.(Post Lumbar Inmassageplanet.netody Fusion.) But for now it is ok for him to have massages, as long as he is on the medication for his back.If you notice that after you give your clients a massage and they have back pain. Keep a close eye on it.

 

[americ.adian]

Thank you Jenny_Nebeker for answering my questions.  Good "listening" skills.  

 

[Shazia]

Jenny, Have any of your brother's doctors suggested pelvic traction?  This is usually performed in a Physical Therapy clinic. The traction creates a space allowing the herniation to be "sucked" back into the disc.Scav

 

[Robert Abuse]

no, not that  I am aware of.  His got so bad, that there were days that he could not hardly even walk around. SO I think that they did what would be the quickest for him. But I will mention that to him and see what he thinks. Thank you.