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Massage - possible herniated disc - 09-08-13, 12:40 AM

I hope I have put this in the right place and sorry for the long post.
I want to see a male client of 64; he is very fit as he practices and trains karate every day.

I have been seeing him since June for deep tissue on his legs, today he requested a back massage as he has been having lower pain around the illum/thoracolumbar fascia area, and it starts on left and travels to the right.

I spoke with him as to how long he has had the pain and it stems from a trip to Japan last year when he had a shock to his spine. The next day he couldn't get out of bed. When he got back to England he went and saw his Doctor who sent him for an x-ray, nothing was visible.
He has had the pain on and off since, and been back to the Doctor on a number of occasions who advises he take ibrofen.

I have done some research as I was interested in what could be causing it and had read about Herniated Discs. Now we are not allowed to give medical advice etc, but I feel his Doctor is not listening to him...

What advice should I give my client?
Herniated Disc's cannot be seen on an x-ray, he would need an MRI scan.

Thanks
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09-08-13, 12:45 AM

Of course it could just be ligament pain!
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09-08-13, 12:45 AM

As an MRI technologist, he does need an MRI of his lumbar spine. If he has radiating pain, numbness or tingling, it usually stems from a disc impinging on a nerve root. I have dealt with this pain myself. I ended up having surgery because of a ruptured disc. Send him back to his doctor.

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09-08-13, 12:56 AM

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Originally Posted by Devonnaydf View Post
As an MRI technologist, he does need an MRI of his lumbar spine. If he has radiating pain, numbness or tingling, it usually stems from a disc impinging on a nerve root. I have dealt with this pain myself. I ended up having surgery because of a ruptured disc. Send him back to his doctor.

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Should I mention Herniated Disc as a hint to tell his doctor, or just tell him to go back and request an MRI?
Doctor's hate it when patients self diagnose!
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09-08-13, 01:15 AM

Here in the States, if conservative therapy (steroids, physical therapy, massage, negative Xray) fail or don't provide relief, then the next step is an MRI. Depending on his health insurance, he may just be better off asking his dr if he could order an mri. My pain was not relieved by steroids, massage, chiropractic care. It got worse and was constant plus I had weakness in my leg which warranted an mri.

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09-08-13, 06:11 AM

Personally I wouldn't work on him at all. I would tell him to go see a different doctor or an osteopath.
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09-08-13, 07:54 AM

I think we have to diagnose ourselves nowadays unfortunately.He needs to go back and say that he wants to be referred to a specialist.
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09-08-13, 08:38 AM

My husband had a ruptured disc and was fobbed off with ibuprofen but went back to the doctors again and asked for an MRI he ended up having surgery and has since had 2 more MRI scans and physiotherapy.
Tell him too be persistent and maybe try seeing another doctor, that's what my husband did.
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09-08-13, 08:42 AM

I've had a slipped disc ( is that the same) it was found after an MRI. I was prescribed diazepam, naproxen and co codamol and I was able to walk again. It's just flared up again after 3 years and the drugs def help it. I avoided surgery so lets hope your other half can . Demand an MRI scan now as the waiting list is lnormally a couple of kings
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09-08-13, 08:42 AM

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09-08-13, 08:58 AM

Quote:
Originally Posted by Male Waxing View Post
Personally I wouldn't work on him at all. I would tell him to go see a different doctor or an osteopath.
The pain in his calfs are not related to the pain in his back (does not travel) and his legs have improved since my first visit.
Yesterday I massaged his upper back and his side waist area but did not massage where he described the pain was.
On request I did gently feel over the area to see if I could feel anything, tension, knots etc...I didn't.
I told him I was going to do some research, so think I'll give him a call and tell him to go see his Doctor and suggest he mention that he thinks it might be something to do with a disc and ask for an MRI.

Thanks for all your advice.
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09-08-13, 11:37 AM

Quote:
Originally Posted by mobile-hands View Post
The pain in his calfs are not related to the pain in his back (does not travel) and his legs have improved since my first visit.
Yesterday I massaged his upper back and his side waist area but did not massage where he described the pain was.
On request I did gently feel over the area to see if I could feel anything, tension, knots etc...I didn't.
I told him I was going to do some research, so think I'll give him a call and tell him to go see his Doctor and suggest he mention that he thinks it might be something to do with a disc and ask for an MRI.

Thanks for all your advice.
Unfortunately, GPs don't tend to be that clued up about back issues. The xray should have highlighted if he had an impact facture on the spine (if he received it doing karate), but won't show a lot else. An MRI would be needed for a prolapsed disc, however, I think it would be a little early for this and in your position would refer him to an osteopath/chiropractor or remedial/sports massage. There could be a number of reasons for the problem and he needs to see someone who is equipped with the knowledge to deal with it. Swedish massage (even deep tissue) doesn't give that knowledge.

I've read lots of posts from therapists trying to treat problems when they are not qualified and do not have the skills to do so. Swedish massage and even deep tissue massage is a relaxing therapy, not a remedial treatment. It's good that you are doing research, and do it for yourself, but please don't use it advise a client. If they want more than you are qualified to do, the key to being a professional is to refer... A GP, who is trained to a wider degree in general medicine is not a specialist - they will refer - and the same applies to us. As professionals, we must work within the confines of our knowledge and ability.

Sorry for the rant and good luck.
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09-08-13, 12:34 PM

i had horrendous lower back pain last week and instantly booked in to see an ostepath/acupuncture lady. i knew if i went to my doctors they would give be super strong pain killers, which just hide the cause. I wanted treatment that would ease the pain and help me to walk straight without wanting to cry

Everyone is different but me personally i would always go to an "expert" in the field, yes it is annoying that you have to pay but my friend had an issue with her back, drs were no good so she went to a chiropractor who REFUSED to treat her and made her go to a&E, she was operated on within hours and the chriopractor saved her from a life of being unable to walk. the dr (who in repsect to them are not experts in the field, they just no a little of everything) had no idea how bad it was

So choices are back to drs and demand to be referred to a back specialist or pay and see someone for the problem

Me, well a week later I am still in agony but it is much better than it was

I feel his pain, and you are lovely for being so concerned xxx
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09-08-13, 07:32 PM

As much as I appreciate doctors (and God bless the NHS!) the reality is they are pretty much “sales men/women by proxy” for the pharmaceutical companies. If there’s no money to be made selling a drug then they really don’t get trained/informed about what to do. If no drug is available they just refer you somewhere else. I went with pain in my knee and was told to go see a sports massage therapist!

HAVING SAID THAT - IF YOU HAVE A HEALTH PROBLEM......GO SEE YOUR DOCTOR!
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09-08-13, 09:32 PM

Quote:
Originally Posted by jcpark View Post
Unfortunately, GPs don't tend to be that clued up about back issues. The xray should have highlighted if he had an impact facture on the spine (if he received it doing karate), but won't show a lot else. An MRI would be needed for a prolapsed disc, however, I think it would be a little early for this and in your position would refer him to an osteopath/chiropractor or remedial/sports massage. There could be a number of reasons for the problem and he needs to see someone who is equipped with the knowledge to deal with it. Swedish massage (even deep tissue) doesn't give that knowledge.

I've read lots of posts from therapists trying to treat problems when they are not qualified and do not have the skills to do so. Swedish massage and even deep tissue massage is a relaxing therapy, not a remedial treatment. It's good that you are doing research, and do it for yourself, but please don't use it advise a client. If they want more than you are qualified to do, the key to being a professional is to refer... A GP, who is trained to a wider degree in general medicine is not a specialist - they will refer - and the same applies to us. As professionals, we must work within the confines of our knowledge and ability.

Sorry for the rant and good luck.
I didn't see it as a rant, just advice! So don't worry!

I do want to help but knew yesterday that the lower back issue was out of my professional ability which is why I didn't massage that actual area and advised that he did go back to see his doctor even though past experience hasn't been good.

The actually injury was done when he went over a bump in a taxi in Japan, (a sharp up down motion).

I have spoken with him this evening and advised he go see an osteopath/chiropractor. I have said that once they have given him the all clear to give me a call and I will continue with the relaxing massage for his aching/tired calf muscles.

Thanks everyone for the advice and help.
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