How do you handle a massage client you can’t help?

As massage therapists, there’s so much we can do to help people. From helping to heal our clients’ bodies with our various techniques, to being the one person all week who has actually listened to them. Giving them a quiet space to emotionally release, or maybe just the touch of another person is all they need. But occasionally, something might happen. Something that we, as people pleasers, as natural born helpers, don’t want to admit. We don’t want to admit it to ourselves, and we most definitely don’t want to admit it to our client.

Occasionally….. along comes a person… that we can’t help.

Yes, its true. We are not gods. We are not magical. We do not have all the answers. We can’t fix all the problems. Though we’ll be damned if we don’t try.

Why am I writing about this? Well, as with most of my posts, it was inspired by a real life circumstance.

(I feel a story coming on..)

Once upon a time, about 3 months ago, a new client came to me. She had been experiencing non-stop dull headaches, with some days giving way to migraines. The migraines would cease, and what was left was that ever present mild ache. ALL. THE. TIME. This had been going on for 4 years. I can’t begin to imagine how she, or anyone else plagued by this kind of pain manages to function as a pleasant, and productive human being. My heart goes out to those of you who do.

Anyway, she hadn’t tried a whole lot, other than the usual at home headache remedies, and when she came to me, she was very specific about what she wanted out of the treatment. Neck, Shoulders, and Occipitals. Pain relief, headache relief.

After chatting with her about her repetitive movements at work, and during personal time (shes a teacher, and spends a lot of time over a desk correcting papers), I determined that the best plan of action was the same treatment plan it always is with this type of complaint.  Work the pecs, scalenes, traps, levator scaps, SCMs, erector spinae, occiput, scalp, a little jaw work. I’d find any trigger points hiding in the upper body, stretch her out, give her some homework to do once a day, and within 3 or 4 treatments, we’d see some improvement.  We’d then maintain the headaches with massage every 4-6 weeks depending on how she’s doing, and everything would be hunky dory. Happy head, happy client. Case closed.


On the 3rd visit, she still hadn’t experienced ANY relief. The headaches were the same, all day, every day. I pulled out a few other techniques, some different kinds of stretching, talked with her about hydrating throughout the day, and about shallow breathing, since a lack of water and lack of oxygen can contribute to headaches. She listened intently, just as a student would and I sent her on her way.

By the 5th treatment, we still hadn’t gotten anywhere. This is when I knew that massage might not be the answer. I needed to put my feelings of inadequacy to the side. I needed to take a risk, to put the well being of my client before the certainty of a future appointment. I needed to be very honest with her.

I told her that although massage is wonderful, and can do many things, I didn’t think it was going to help her with this specific problem. I told her that I didn’t want to withhold my thoughts, simply to ensure a return client. I recommended she try chiropractic, as well as check-in with her primary care provider, possibly even acupuncture if that seemed like something that resonated with her. To be sure she wouldn’t feel uncomfortable if she DID in fact want to keep coming, I explained that, of course, she was more than welcome back, and that she’d benefit from all the other wonderful things massage has to offer.

Once all the words were out, and my spiel was over, I  couldn’t help but hold my breath. Would she be disappointed? Would she not want her massage today? Have I tainted her perception of massage therapy?

Nope, nope, and nope.

By putting her well-being before my pride, I gained her trust. She followed my words of advice, and has been seeing her PCP, using chiropractics, AND massage therapy together for a couple months now. She intends to see a specialist at a nearby hospital next month, but says that she’d love to keep her monthly massages, because it helps keep her stress levels in check, and helps the pain in her upper back. Still not much relief on the headache front, but I know that with a team of professionals on her side that she can trust, she will find the root of the problem soon enough.

In the meantime, I will see to it that the tools in my “headache kit” keep accumulating. I am researching other ways to help her that are within my scope of practice, and learning new techniques that may help her.

I will update in the comments below if she reports a headache free day. Keep your fingers crossed for us!

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