Practice Tips- Keep Your Perspective

"I have this pain, right here." 

How many times in a day do you hear that?  After which, you check their history, do your assessment, and do you best to help your patient correct what is wrong.  But what if that isn't enough?  A week later they're back in your office, saying,
"I have this pain, right here."  So, you do the assessment, get the same results, do your best to correct it, but a month later they're back again. 
"I have this pain, right here." 
Now, a good therapist is one who wants to correct the problems as much as they can.  Despite our best efforts, all of us at times come up against pain that we, quite frankly, are puzzled as to how to address.  Is it emotional pain?(check out  Waking the Tiger, Nature's Lessons in Healing Trauma, by Levine)  Might it be menopause, andropause or an undiagnosed autoimmune condition?(look into Fibromyalgia and Chronic Myofascial Pain Syndrome:  A Survival Manual by Starlanyl and Copeland )   I'm just an RMT, how can I help? 
Before you start screaming in frustration, take a deep breath, and take a step back.  An RMT is one of many in the chain of healthcare.  We don't make a diagnosis, but we do our best to find what is wrong and assist our patients.  But what do we do, when we've done all we can do? 
First of all, get some perspective.  Even their medical doctor is not going to know EVERYTHING that is going on.  Healthcare, like fixing a car, is unfortunately a "best guess" process.  You're not Jesus, you won't be able to heal everyone no matter how much you care, so don't expect yourself to. 
Secondly, take stock of what you DO know, and HAVE already done.  Have you done an assessment? Researched their current medical conditions and the effects of any medications they might be on? Taken into consideration the effects of any upsets in their personal life, as they reveal them?  As RMTs, unless we have further training, we are not counsellors, but occasionally personal matters arise.  Do we notice the body's reaction, and recognize the possibility that at least some of the underlying issue is beyond massage therapy scope of practice?  
If you're still stuck in a corner, do what the doctors do - refer out.  WHAT?  Tell my faithful every-week patient to go see someone else?  Yes.
This is not to say that massage every week is a bad idea.  However, expectations on the side of the patient and therapist should be clearly communicated, and reviewed on a regular basis.  Are they looking for maintenance, is it for stress relief and relaxation?  It is a good idea to review current ethics courses, to make sure no boundaries are being ever-so-slightly shifted. 
"I have this pain, it was right here, but after my last massage it moved."  Ah, now that's music to my ears!