Body Work

When somebody asks me about how good a certain kind of therapy is, I usually tell them that no matter what's wrong with them, they'll get a standard treatment no matter where they go. A chiropractor will adjust them, an allopath will prescribe, an herbalist will mix herbs. "If you're lucky, your problem matches their practice."

Because there are over 640 muscles in the human body a muscle therapist is a good place to start if there is a pain problem.

On Sunday I was visiting my parents, and my father, who is 86, told me he was having pain down his leg, but that it was just a part of growing old. He had been to the doctor and was told the problem was a pinched nerve in the spine, and they referred him for back surgery. There was no effort to solve it as a muscular problem, which should always be the first possibility to eliminate.

He could hardly lay down on the carpet when I asked him to lay on his stomach so that I could check the trigger points in the quadratus lumborum (along the lower spinal column). All the trigger points were sore, but they all released without too much trouble. After ten minutes he got off the floor with the pain relieved.

I checked some other points first, because the referral pattern was unusual for the quadratus, but I've seen exactly the same situation before. The muscles pull the spinal column out of alignment, the xray shows the disc "problem," and the person is referred for surgery.

Like I said, if you go to an M.D. (unless you hit somebody unusual), there is going to be a flow of patients per hour they are trying to see, in order to maintain an office income level. Prescribing is very fast, and allows the doctor to move from one person to the other without getting tied up with anything that takes hands on time.

Usually you will be referred for surgery, physical therapy, or prescribed a muscle relaxant.

When I worked in a doctor's office fifteen years back, the doctor explained to me how he has in his mind a "shutter" that comes down between himself and female patients, so that there is never any question of his behavior being too intimate. He also sent me four people an hour, all of them accident victims, expecting that I would treat them with passive therapy for 80 percent of their visit.

To make that okay with me he paid me by the person, appealing to my greed for money.

Passive therapy included putting them on heat packs, with space music and eye mask; putting them on something that runs automatically, like an electro-muscular stimulator, or putting them on some kind of exercise routine. The important thing was that I didn't have to be there, so that we could charge for time when we weren't really doing anything with that person. We were setting up somebody else. So we could bill the same hour to four people, and it was legal. It's just the way it's done.

This has become popular with chiropractors now, who put customers on machines which "work" their back muscles. Those machines are simply bought and depreciated out. They don't collect wages. The more work you can pass to robots, the more money you make, because you can charge it to their insurance.

If people had to pay for their medical care there would be no crisis. Can you imagine putting somebody on heat for half an hour and charging them a hundred bucks? They'd punch you in the nose. "I can do that at home for nothing, you idiot."

The major medical procedures would be tax supported, because there would be no choice. Nobody can afford them. It would be like asking somebody to personally pay for a highway because they drove on it. The ninety percent of things people go to the doctor for would be handled inexpensively, including prescription drugs, which we pay twice as much for as anybody else in the world. And other people pay too much for them because the companies are allowed to price by working out an average in which we are included, driving up prices in other countries.

Because of the time required to set up the passive therapy, I ended up with maybe ten minutes to spend in hands on time with a patient. The good news was that I made more money than I ever made at any other kind of therapeutic bodywork. The bad news was that it was a rip off. The insurance was being charged for an hour of physical therapy.

That's how it works under the present system. The name of the game is getting as many people through as possible and billing their insurance for as many treatment modalities as possible. "Massage, heat therapy, whirlpool, trigger point therapy, ultra sound (a quick treatment that is impressive because it uses technology)." And you wonder why medical costs are through the ceiling? The person got ten minutes of hands on time.

I quit and started my own business, working a minimum of an hour and a half on each person, with no gadgets, rocks, or mumbo jumbo hand waving. I concentrated on trigger point release and hypnosis for pain management. I also informally helped anybody and everybody who was having pain problems if they wanted my help.

I remember walking into a clothing shop in Noe Valley (San Francisco) with my girlfriend, and one of her friends was there. She was having pain in her chest, and was convinced that her smoking had given her lung cancer. I used a thumb to put pressure on the trigger point of the pectoral muscle and quickly released it, leaving her pain free. She thought I was some kind of magician.

Would I argue the point? (pun intended) I recall Lenny Bruce describing the missionary talking to the natives about god. And one of them says, "Uh, are you, god?" And he gives this little laugh and equivocates; "let's not worry about that right now." It's all a matter of knowing where to push. I trained myself in trigger point therapy from the medical texts.

You can go to a spa and get a massage, but often you'll find you still have the pain you came with. That's because while you can get improved circulation and tension release from massage, the only place from which you can really release a muscle that's causing pain is the trigger point (some muscles have two or more, some just one). The best in the world in my book is massage by somebody who works the trigger pointing into the massage as needed, by knowing where they are and checking the feel of them.

A trigger point is the point from which the muscle releases. The nerve receptor which fires the muscle gets an accumulation of waste around it, that can be detected by touch. To release it involves pressure techniques (a body worker), stretching and cold spraying (chiropractors), or injecting it, (doctors).

The good thing about going to a body worker first to solve a pain problem is that each trigger point has a predicable referral pattern. For example, if the heel of your foot is very sore, the related trigger point that would cause that is near the center of the calf, in the soleus muscle. If the pain is in the side of the head, it is typically a problem with the occipital muscles near the base of the skull.

In my father's case, the pain was right down the back of the leg, which suggested sciatica. But there was no problem in the hip, where the periformis muscle would impinge on the sciatic nerve. There wasn't pain in the hamstring insertion. It was a disc problem, all right, but the x-ray only showed a bulging disc, which was most likely pressing the spinal cord and causing pain.

The x-ray can't show that the disc is pulled out of place by the muscles. One man I worked on was scheduled for surgery the following day. One of his friends urged him to try me first. I was working with the lower back, and combining it with hypnosis. He suddenly had a memory of his grandmother hitting him. He became very emotional, the tension released, and he had no more pain. He canceled the surgery and he never had the problem again.

If he had gone to a chiropractor the problem would have been that there was a misalignment, which is true. But the origin of the misalignment would not have been reached. An adjustment didn't help; he'd tried that. He'd tried acupuncture and medication. He finally matched up the problem with the person whose therapy fixed it.

Much of the time this match isn't made, but there is a perception of getting better because when the client pays the money, there is a motivation to feel better. Nobody likes to pay for what doesn't help them.

And that's what I like so much about bodywork. Even if it doesn't solve the problem, because the problem wasn't muscular, or was an injury ... a torn ligament for example ... you're still getting something valuable in the release of the trigger points, and are going to feel better than you did.

Posted: Tue - September 28, 2004 at 04:15 PM