Did I do something wrong?

[Pompal 09.]

I have a client who has been coming twice a week for 30 minute neck/back sessions. She also sees a chiropractor twice a week, usually the morning after her sessions with me. A month ago she had 6 pinched nerves in her neck, and now there is only 1. Her chiropractor told her that he was certain seeing me was helping her to adjust better, and that she should keep coming. She said she felt like a new woman. She could turn her neck without pain, and her TMJ was improving. When she told me this, I was just over the moon! I felt so great knowing that I had helped this woman.

Now for the downer- She cancelled her appt. with me on Monday, and just called to cancel today's appt. as well. She said her neck was really tight, and after her last session (8 days ago) she couldn't turn her head. The next day she was nauseous & dizzy, and her chiropractor told her that her neck was in worse shape than at her very first visit with him. She implied to me that it was my fault, and said her body can't handle getting massaged twice a week.

I just don't see how this could've been my fault :undecided: I don't pull on her neck (even though she repeatedly asks me to) and I don't do anything more than medium pressure & cross-fiber friction to her neck. The friction is primarily done to her left SCM, because it is extremely tight & pulls her head to the left. I just don't see how I could've done anything to pull her disks "out of place" again. She told me at her first appt. that she sleeps with her head in an odd position, and almost always wakes up with a stiff neck. Could that cause her problems??

I'm sorry this is so long, I'm just really upset & worried right now. I hope that it wasn't my actions that have caused her pain, and I'm worried I'll lose her as a client, and that she'll tell other people that I hurt her. She also has 3 more sessions that she's paid for in advance, so if she stops coming, I suppose I have to return her money. Any advice will be extremely appreciated!

 

[Pompal 09.]

I doubt that anything you have done caused this, especially if she knowingly sleeps in odd positions that mucks up her neck nightly.

Rather than worrying about being blamed - and most of us would worry, so don't beat yourself up for that, either - try going at it from the assurance that you were helping, yet she somehow hurt herself again. With that mindset, you could send a friendly card saying you are sorry she's hurt her neck again, and you're hoping she gets the pain under control very quickly. Let her know you are thinking of her and wish her best. You could also add a reminder that she still has three prepaid appointments, to be used whenever she feels up to it.

Don't assume responsibility or that you're being blamed. People in pain have a very hard time with how to say something, and sometimes they're not very nice. Think of her as the "real" her, that you already know - the grateful client who appreciates what you do for her. Ignore any crankiness and chalk it up to the pain talking. Stay open - she may end up worried about coming back after having said something she didn't mean, or worry about how you took what she said. If you present yourself as the same old you that she knows, it will be easier to get past this and resume the therapeutic relationship. And if she doesn't come back for whatever reason.....don't worry about it. Someone else will fill the place in your schedule. You helped her for the time you were allowed and I'm guessing she's already told plenty of people about that.

 

[Loogle]

Did I do something wrong?

first off do not blame yourself.

A month ago she had 6 pinched nerves in her neck, and now there is only 1.......She said her neck was really tight, and after her last session (8 days ago) she couldn't turn her head. The next day she was nauseous & dizzy, and her chiropractor told her that her neck was in worse shape than at her very first visit with him.

This is a common unwinding pattern. My mother has gone through the same exact thing. Her chrio stated that is is because she has lived her life in a holding pattern that compensated for the injuries to her spine and her body wanted to revert to that pattern. Her body was not used to being in proper alignment.
She got through it by seeing her chrio 2x a day 3 days a week for a week, while recieving body work from me at the same time. She was in ALOT of pain, each adjustment hurt and the work I did was gentle and subtle and she had tears streaming down her face the whole way through it. but in the end a week later, she was back on track to recovery.

The nauseousness and dizzyness can be caused by trigger points in the SCM and surrounding neck muscles that may have been activated and should be addressed to release further.

The friction is primarily done to her left SCM, because it is extremely tight & pulls her head to the left.

Does she have torticollis? I would just be concerned about agressive treatment with this condition. (I don't know much about it)

that she sleeps with her head in an odd position, and almost always wakes up with a stiff neck. Could that cause her problems??

ABSOLUTLEY! the chrio should have addressed this with her and suggested the proper positioning for how she sleeps (side or back)

More than anything, you need to converse with the chrio about her condition and come to an agreement with him on a course of treatment. Then, discuss with the client the fact that many conditions can get worse before they get better, and discuss what options you have agreed upon with the chrio.

Don't beat yourself up over this! Good luck!

 

[jamai]

Did I do something wrong?

This is a common unwinding pattern. My mother has gone through the same exact thing. Her chrio stated that is is because she has lived her life in a holding pattern that compensated for the injuries to her spine and her body wanted to revert to that pattern. Her body was not used to being in proper alignment.
She got through it by seeing her chrio 2x a day 3 days a week for a week, while recieving body work from me at the same time. She was in ALOT of pain, each adjustment hurt and the work I did was gentle and subtle and she had tears streaming down her face the whole way through it. but in the end a week later, she was back on track to recovery.

The nauseousness and dizzyness can be caused by trigger points in the SCM and surrounding neck muscles that may have been activated and should be addressed to release further.

That is so interesting, thanks for sharing that! I am curious if your mother did anything else besides the chiro/massage to re-align. Such as stretching/strengthening particular muscles on a regular basis. Could she have handled such exercise? Also what kind of injuries did she have to her spine?

Thanks!

PinkLotus, I hope you won't let this episode wound your confidence in working with her or similar clients. It's a perfect opportunity to get to know this type of healing response to be armed for the future and to also handle this client professionally. I agree with PremoMT to see about being able to discuss it with her chiropractor.

 

[LadyrootFiX]

Don't assume responsibility or that you're being blamed. People in pain have a very hard time with how to say something, and sometimes they're not very nice. Think of her as the "real" her, that you already know - the grateful client who appreciates what you do for her. Ignore any crankiness and chalk it up to the pain talking. Stay open - she may end up worried about coming back after having said something she didn't mean, or worry about how you took what she said. If you present yourself as the same old you that she knows, it will be easier to get past this and resume the therapeutic relationship.

Truer words were never spoken.
Hold the compassion that you already feel for her, and hold it for yourself as well.
I have no advice about her specific neck - we would all approach it in our own effective ways - but I do feel for both of you. Pain strikes people and their caregivers, and it is very easy to panic in its grip.

 

[condosgirl]

Did I do something wrong?

That is so interesting, thanks for sharing that! I am curious if your mother did anything else besides the chiro/massage to re-align. Such as stretching/strengthening particular muscles on a regular basis. Could she have handled such exercise? Also what kind of injuries did she have to her spine?

Thanks!

I just asked her, and she said she didn't do anything beyond those appointments. We were doing yoga at that point in time, but no positions specifically addressed her issues. No ice, no heat, nothing like that. Just rest, some ibuprophen when the pain was too much (she is a barber, and did not take off work)
There were no specific injuries. She was in minor fender benders when she was younger, fell while water skiing, tripped off sidewalks... all normal life events. They just take a toll over time. That and with what she does for a living (think arms parallel to the floor alot) it was just repetative strain patterns.
She's been seeing this chrio for 3 years now on a very regular basis. He has been walking her through her old injuries for that amount of time. She's gone through about 5 unwinding sessions in the 3 years. Most of which have been in her neck area.
She just told me she hasn't been to the chrio in a month. That's a long time for her! But, it's taken her a long time to get to this point as well.

Another thing you have to remember Pink is that her pain is a compilation of events, and has taken her many years to accumulate. Sometimes a gentle reminder that this pain will take at least half as long to get rid of as it did to create. There is generally no overnight "cure."

 

[StephenFox]

Thank you for all the helpful replies. I guess I was forgetting that no problem like hers can be fixed overnight, and that things do often get worse before they get better.

I don't know about the torticollis, I'm going to read into it further & see what I think. Something she told me at her last appt. has me thinking now- she said when she was giving birth to her daughter 10 years ago, it felt like her left SCM "tore away" from her clavicle. At the point where it attaches to her clavicle, it feels much thicker. I'm wondering if it did tear, and if she has adhesions? There are trigger points in her left SCM, and she says the pain is nearly unbearable when I go over them with medium pressure.

*sigh* I really, really hope that she doesn't get discouraged and stop coming. I think I will try to meet with her chiropractor next week (his office is next door to mine) and discuss her diagnosis & problems. I just have this huge desire to help people, especially those with chronic pain, and when she came to me and said how much better she felt, I was so happy. I'm trying to take everyones words to heart & not be hard on myself. I'm so grateful for so many replies in such a short time!

 

[Randal]

P.L., remember HIPPA laws. The chiro can't and/or shouldn't discuss her without her permission. You have the right to call and ask if you can discuss her situation with the chiro..Good luck!

 

[globeweasel]

Hi Pink Lotus.
You mentioned doing cross fiber friction on her scm's. Were you close to any nerves of the cervical or brachial plexus? Sometimes this can cause such a reaction. Deep fiber frictioning can be quite traumatic on certain areas of the body. I would greatly suggest you purchase a vibrator with available heat or cold. 'Brookstones' sells one that is quite effective. You wanna make sure the head of the vibrator moves from side to side and not like a piston because you want to reproduce that side to side 'frictioning' one normally does manually. The nice part about this type of vibrator is that it does the frictioning so rapidly, your client will feel very little discomfort and the results will be good.
You might want to suggest or discuss with her chiropractor the use of certain supplements which can speed things along and cut down on her discomfort as well.
Also, you could offer a free session to make up for her discomfort but this is your call entirely. If she is a long standing client and or you want to have good relations with her and speak kindly of you, consider it. Word of mouth goes a long way in our business.
And lastly, we all make mistakes. Chalk it up to a lesson learned.
I hope this is helpful to you.

 

[Billie]

PL,
any updates yet?

 

[alexander w]

Well, she's decided that maybe twice a week was too often for her, and has started coming just once a week. She says she feels much better now, and hasn't had any more pain. I think getting adjusted & getting a massage 2x/week was just too much on her body. She'd never been to the chiro before recently, and had only gotten massages once every 6-8 weeks. She's also fairly sedentary, so I think that her body just couldn't handle it all. Now that she's down to once a week, she says she feels great.

She told me at her last visit that she had told a couple of friends about me, and her husband called me a couple days ago wanting a massage ASAP, but I was all booked for the day & instead of making an appt. for the next day, he just said "well, thanks anyway." *sigh* But then today, his mother came in & bought a GC for him from me.

 

[Cathy]

Wonderful! I am so glad she is feeling better, AND you have gotten some great refferals from her.
Thanks for the update!