In early 2023, one too many clients arrived with a fifteen year history of chronic headaches. Within a couple of months, with no apparent changes but weekly bodywork, these were all but gone. Related episodes of tension and the occasional headache continue to arise, but no familiar pain is constantly waiting around to swallow hours or days each week. My client also now has a toolbox full of new and helpful strategies to use whenever symptoms do come along, beyond simply taking an anti-inflammatory and gritting it out.
My client had seen medical professionals with respect to the headaches since high school. They had tried half a dozen kinds of holistic and conventional therapies. They had experimented at home. Other bodywork hadn't helped. Why should these headaches have ended? Did bodywork help with it, or did some other, unseen set of factors change everything?
The fact that we can't specify what the ever varying art of bodywork can do for a particular client in a particular case in the rigorously tested and analyzed way that we do with drugs and surgeries holds it back from becoming one of the more often prescribed modalities for pain.
It's a shame, because the kind of story I recount above happens all the time. It's also a shame because the information available through touch is immensely valuable and completely personal. Responding to that information in real time, in detail, and over a course of weeks can greatly improve the functioning of certain tissues of the body.
Simple touch is in short supply in most medical professions now, and so people receive medical treatment based upon aggregate information collected through population studies that their labs and history-defined stats suggest are relevant to them. That's a valuable perspective to take. However, we overlook this other important perspective: the essentially personal, intimate information about the material of the person present before us, relayed through the sense of touch and reflecting the sum of all that other stuff. Though all that information is present right before us, it takes time to gather and much more time to respond to appropriately--a few special, highly practiced skills as well. For reasons of time and specialty and the urgency of using their own much more rare skillset, dealing in depth with this information can't be the place of the doctor. But it shouldn't be ignored as it generally is at present within the larger medical context.
This intimate space of interacting with the information present on the table is the realm of bodywork.
Our other role as I see it is to help the client themselves become more intimately aware of their bodies--it's capacities and needs. I see myself as a teacher within the small realm that I cover professionally. I tend to speak a lot with clients on the table, reflecting my observations about the qualities of texture and tone in their body and sharing my interpretations and to some extent how that is guiding the suggestions I offer as to how to use our time together. The client learns from the felt-sense of receiving bodywork tandem to hearing what that feels like from my side and what the feature is likely made of.
Over time, the new knowledge of muscles and fascia and their features develop into their capacity to perceive more deeply how these materials of their selves respond to chemical changes due to stress or hydration status or accidentally missing a meal or getting some exercise. I have found for myself and for my clients that this personalized education in the manners of operation of the body is as useful as and more lasting than the hands-on work itself. It begins to inform clients day to day strategies in resolving their pain and even promoting their own comfort and ease. All of which together can transform a life.
I have worked as a medical massage therapist since January of 2015 and have specialized in medically oriented bodywork since the beginning, so I have seen a lot of clients with chronic headaches and migraines by now. Managing my own frequent migraines quietly at that time, whenever these clients walked in I could only think "it can't hurt to see what we can do." They were there for that... neither of us would expect miracles; migraines in particular are exceedingly complex challenges and thus not particularly well addressed even in our vanguard and statused leader of medicine more broadly. We'd almost always make progress just as I was gradually doing with managing my own.
But I'm becoming wiser all the time and now feel a little more hopeful and a lot more driven to share the possibilities that have taken me from miserable symptoms of onset more days of the week than not--and monthly to weekly or worse full migraines--to rarely having to think about how I'm going to beat the current threat of an episode back.
I'm becoming wiser, more hopeful, and more driven to help with headaches and migraines largely because of my own excellent results finally, but also because occasionally a client achieves something akin to complete relief. This is more common with headaches than with migraines in my practice. The latter generally need further medical support to resolve lastingly or to further improve the results. With both headaches and migraines, whatever results bodywork alone may provide, work on the table often provides valuable information that can help send clients in the right direction.
I have heard from a number of clients that the verbal and physical feedback alone that can be offered through bodywork--its educational components--has helped to clarify longstanding health issues with profound impact in rerouting toward effective research and diagnoses in other offices. Being able to send clients back to their doctor or to seek out a specialist with active questions on any of the long, long list of other health details that our work together may suggest would be worth looking is valuable and is one of the unique opportunities of our profession, given that we work with clients repeatedly over the course of generally an hour or more, in which they tend to share with us questions, symptoms, and concerns that may never have a chance to come up in another professional space and that may take some work for them themselves to figure out how to express concretely and confidently enough to offer them their due regard.
So results were good and growing with a number of clients at the time in the area of migraines and headaches. As more and more clients with regular migraines arrived in my office and brought them up incidentally alongside the things they thought we could actually work effectively on--headaches or back pain or shoulder dysfunction...--I began to realize that if happenstance alone was bringing me so many clients with progress like this, there was room to specialize in headache and migraine work, make this work findable, develop it further, and likely help a lot of people find their way toward relief.
Bodywork offers a unique context and perspective that I have seen to be increasingly useful personally and effective professionally as I've developed in my craft. I don't want to suggest there's any magic or cure in bodywork. In massage therapy we're supplying labor in very basic techniques. But I also don't want to downplay the potential of our craft to help the body. The skill of our hands in perceiving, interpreting, and responding to the information in the body varies and grows with time. As seen in practice, as reputed by clients, as acknowledged by the many conventional and integrative health professionals who do send their patients to us bodyworkers, there is good potential for growing this craft into a much more pointed aid to those trying to put together the toolkit and resources to relieve themselves of migraines or chronic headaches.
One often promoted principle of bodywork and in similar spheres is that the body knows what it needs. I think we should take a subtler view. The drive of life itself to grow, maintain, and reproduce is reflected in the degree to which the body knows what it needs. But sometimes the body needs help to learn to listen to itself well. The surge of life is in there somewhere--it's hard to feel that I'm adequately indicating the thing that I mean--in the statement for instance that massage therapists hear so often that "it hurts so good" when we find that therapeutic edge in which work to reset the tissues is happening at a brisk rate and the moderated discomfort is quite welcome because at the same time it feels like such relief of a long held limiting pattern.
Those of us who are operating relatively busy practices may not notice it at times, and those who are still building a clientele may not yet have the context to feel it, but because of the potential of bodywork to help those in pain, it is really sad that bodywork is not doing more work.
I began by telling you of my client who had spent fifteen years looking for a way to end their chronic headaches only to see them end within a few weeks of beginning regular bodywork. That kind of story shouldn't even happen, but as I've gone along in my profession I've seen that it does all the time. So I feel by now strongly that bodywork should have its place in medicine. It shouldn't take ten or twenty years for clients to find their way to this specialty of using such simple tools and time and a priority of listening. It should be one of the things that is thought to go to early in the process to see what it can offer, since it will offer benefits for most clients at some level. And it should be better included in the opportunities which insurance can regularly cover. Especially those who are unwell need the financial benefit of working through insurance. And if massage is to become a go-to specialty
Bodywork as practiced, like everything else, has plenty of room to improve. Training is minimal in the United States. Training standards and execution vary widely. This is presently a huge barrier to integrating bodywork in medicine.
We as bodyworkers ought to work to elevate our craft individually by engaging with and mastering certain basic areas of knowledge as fully as possible and by knowing and respecting the boundaries of our profession.
The kinds of humans who are attracted to providing bodywork are caring, giving people who may not have confidence in learning in certain areas. We may not have as much potential there either as we would like, for any number of reasons. We can have good hands regardless. And at present bodywork professions are a relatively financially and academically accessible opportunity to enter a satisfying and decently paying career. While we need to elevate the field, it does not make sense to bar those who are well capable within certain realms and make this yet another specialty where access is difficult for lack of therapists credentialed and working. There is a market and a need for more general but valuable, wellness oriented work, and there is a need for more incisive work provided by those therapists who have a particular passion for that. Both would be valuable within medicine, but there's risk and lost potential for all parties where the formal boundaries for the work are somewhat vague and quite the same regardless of level of training.
A solution some have proposed to the problem of welcoming in those who are well geared to work in this field while not limiting the potential of the field by trying to hard to leave the door open is to create a tiered system of credentialing such as exists in nursing. In the most accessible levels there is less responsibility and a smaller scope of practice with more oversight. Working in lower tiers provides experience, context, and income from which to advance. In higher tiers with much more advanced training that must be earned by those who are willing and able, responsibility and autonomy grow along with the likelihood of having learned what is needed to protect the relevance and safety of that level of the profession. I am for these aims.
We as democratic regulatory voices need to honor the potential of this art and help to integrate it within medicine so that it can do the good for people that it would do if it were nearer at hand and better supported to grow into its potential.
We as a profession need to promote more research. We need to better understand what we are doing, what is working when it works and why not when it doesn't. We need to know more about when to apply what method with whom.
And then we as bodyworkers need to return to our art. Because in the end, bodywork can only remain what it is with the potential it has by honoring the fact that it is in fact an art. Further information can help us practice our craft more skillfully, but it is the unique value and role of bodywork to hear the unknown, the unique, and the as-yet-unexplained by having enough openness and humility to do so.
Although my experience as a bodyworker working with migraine and headache is fairly rich, the results are not yet scientifically meaningful. I would like to learn to study to what extent and for whom each little piece of a solution appears to be effective. The dream would be to better identify in a translatable, teachable, accessible way whom to present with what options. Then we can better hope to stop seeing people suffer for decades before finding an age-old solution. I'm still learning and building the ways to study the bodywork and migraine/headache connection on a larger scale. I do know that in order to do study the efficacy of my methods, I need to work with and hear from more people than I can possibly put hands on. So please share this page as freely and widely as you know anyone who might benefit from it. The broader exposure and the more people take me up on testing what I've learned the better we can assess efficacy together and hone the knowledge and skills to help people get out of pain.
I have learned about migraine both as a migraineur off and on over twenty years and as a bodyworker. Those two identities have each provided context and experience to the other. My own migraines weren't diagnosed and resolved for so long in part because they were the least of my health concerns--amidst crushing fatigue, chronic shortness of breath, painful muscles and joints, constant anxiety attacks, and etc. In early 2023 I found my own migraines resolved. One more helpful piece of information made it possible, after much progress in management elsewise. I still have to do some management. There are many factors involved. But the need is generally scant compared to what it was and I do know the map of my experience well enough to have so far, over a year and a half, managed to turn every threat around.
I understand firsthand that migraines, headaches, and other chronic pain can often be disabling. Those who suffer navigate a compromised capacity to work and to manage life and often are through with spending money earned under unusual burdens hoping for a solution only to be disappointed again and again. I understand how difficult it is to find information on the web and otherwise--even working one on one with quality providers.
I have collected a lot of information that has helped me and my clients and am beginning to publish it for the convenience of anyone who may happen to find it who is going through what I and so many I've met have gone through, scouring all available sources with flagging energy for anything of use. I'm determined to find ways to reach audiences that otherwise would not have assistance from someone in my field. My work may be lowly but it offers a unique perspective that I have found increasingly useful personally and effective professionally.
My book will at some point before too long be presentable and I will offer it free here in digital format when it is. I want to see as many people as possible learning to read their headaches or migraines from pain back prior to onset and learn to prevent them. I can't give away my time one on one, but I can offer in bulk what I have learned working with others. For those who find my book or my work valuable for whom money is not tight, feel free to leave a donation. That money will over time allow me more capacity to work at a reduced cost hands on with people who need support and can't afford it and in the present to more effectively continue learning how to make a difference for my clients.