Massage therapists need enough information from our clients to understand where we are heading in a massage session.
Working at spas, therapists get used to brief intakes and a question or two before starting a massage. In my practice, I get to take the time to do a longer intake and get more detail.
Yet I have learned not to ask the P-word upfront. The P-word is a big turn-off for clients, and makes them associate massage with illness instead of wellness. Even though it is very important to know about it before starting a session, it is very delicate to handle.
The P-word? Pain.
I like to list some goals on my intake sheet. I ask clients to circle their choices: recovery from stress, recovery from work, relax/improve sleep, reduce soreness from sports/exercise, reduce headaches and all of the above.
What I don’t list as a goal is relief of pain, largely because many people do not like the word itself. For some, admission of pain is some sort of failing. I see this particularly in men, but not exclusively. Later in the intake, after asking about discomfort and tense areas, I do ask if there is an area of pain.
Many people, no matter how ice-picked they feel, admit to discomfort and tension only. The P-word is off limits to them. On the other hand, for people whose primary complaint really is pain, they have answered enough questions to allow an admission that there is pain they want addressed.
It’s a bit tucked away in the middle of the intake, where I think I can get a heads-up on pain issues without the psychological politics involved in using the word. It helps get the conversation about the session going, and allows people in pain to step out with more safety.
When pain is an issue I will ask about pain on the 1-10 scale used in medical settings, with 10 being unbearable and 4 just being annoying. When doing trigger point work and follow-up questions after sessions, I use the scale to note any increase or reductions in perception of pain.
The scale gets people to realize if the pain is up or down and opens the door to the idea that the pain can decrease with treatment. The only time I find the pain scale unreliable is when the person is also habituated to opiates. These drugs are known to create pain arcs in the body to satisfy a craving for more drugs.
(Note: Research has shown this pain is real. In the past, there has been a mistaken assumption that the habituated person is lying just to get drugs. Obviously it affects the healing relationship for a therapist to assume someone is not truthful.)
So dealing with the P-word is an important part of massage work, but it is best tread with empathy and kindness. It carries a lot of baggage for some folks and can get in the way of a healing touch.
