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Massage Today
January, 2001, Vol. 01, Issue 01

Chronic Pain

By Ben Benjamin, PhD

Question: What is the secret of treating chronic musculoskeletal pain?

Answer: The secret of successfully treating chronic pain problems is identifying the exact source of the pain and then matching the appropriate treatment in order to eliminate the pain.

Massage therapist performing resisted flexion of the thigh on a patient.
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- Copyright – Stock Photo / Register Mark"> Resisted flexion of the thigh, hilighting the semi-membranosis belly and ischial tuberosity. In most cases of chronic pain, the culprit is adhesive scar tissue formation, whether the pain is in the low back; the neck; the shoulders; thighs; knees; calves; ankles; and so forth. Adhesive scar tissue is indeed responsible for the majority of chronic pain in the musculoskeletal system. When scar tissue forms in random patterns or adheres inappropriately to adjacent structures, pain usually results. The scar tissue is like glue poured into the wrong places, causing independently moving structures to stick together. Movement that pulls, stretches or compresses the area where adhesive scar tissue has formed causes pain.

If you can identify the source of the client's pain, which is frequently adhesive scar tissue in a particular muscle, tendon or ligament, and have the skill to eliminate it, successful treatment will have been accomplished.

For example, an injured hamstring muscle tendon unit is identified by the appropriate anatomical testing procedures; then, through palpation, the precise areas of adhesive scar tissue are located in the belly of the muscle and at the attachment to the ischial tuberosity; now successful treatment can be administered. Once all of the adhesive scar tissue has been eliminated by manual therapy or other means and full movement is restored, pain will be gone and normal strength can be rebuilt.

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