“This is a very complicated situation. I just need to know if you would be willing to take on something this unusual.”
After I assured Mrs. S. that I appreciate complex cases, she went on to explain the details of her odyssey with pain after suffering a whiplash injury more than a year ago. The trepidation and fear in her voice was obvious.
“My husband and I moved here from Israel about a year ago. This is all new for us: different job, different culture, and a whole different life. Even the weather is not what I am used to. I had never seen snow, let alone had to drive in it. One day, while driving in a snowstorm, another car slammed into the rear of my vehicle. The impact caught me totally by surprise. At first, I did not feel injured, but my neck became very sore about 48 hours later. For the next two months or so, my neck, shoulders, and arms were very painful. I often had tingling sensations down both arms, which was very disturbing.
“The worst was yet to come. One day, I suddenly felt searing pain in my lower back. Soon after, I felt tingling sensations in the front of both legs, which the doctors have told me is from a disc problem in my lower thoracic spine. The tingling has persisted to this day. As time has gone on, I feel like my legs are wooden and stiff—like they do not belong to me. To make matters worse, about six months ago my family and I were in another accident, sort of.”
“How do you ‘sort of’ have an accident?” I asked.
“My husband was driving, and my two children were in the back seat. A car approached the intersection too quickly, headed right toward my door. The car hit us, but the impact was actually very slight. No one in either car was hurt, but I was in intense pain by the next day. The pain has been bad ever since. I can’t explain why I hurt so much afterward; I think it was perhaps a form of posttraumatic stress.”
“That is quite possible,” I replied. “Even the medical definition of pain says as much: ‘an unpleasant sensory and emotional experience associated with actual or potential damage.’1 The car didn’t have to slam into you; the potential trauma alone was enough to elicit the pain experience. The other three people in the car felt nothing afterward because the impending crash did not have the same meaning to them, as they did not have the same history going into the event. Your reaction is perfectly reasonable.”
“Even though this is embarrassing, I need to confess how terrified I am to let you touch me,” Mrs. S. said. “I am very afraid that treatment could make me worse, but I need to try.”
I assured Mrs. S. that I understood her fear and would do everything in my power to make her feel comfortable and in control of the process. “Where would you like to start?” I asked.
“The most pressing complaint I have now is the lack of feeling in my legs, especially the right one,” she stated. “I’d like to start there.”
I began with the lightest of touch, helping her to experience touch as a positive experience and not a threat. After some light fascial work, I applied lotion with gentle effleurage to her tolerance. After perhaps five minutes, I switched to the left leg with almost exactly the same protocol, sensing her relaxing more deeply with each passing minute.
Returning to the right leg, I began to methodically trace each muscle of the lower extremity as though I was painting them on a blank canvas. My goal was to provide clear sensory feedback to her somatosensory strip, the part of the brain that creates a topographic map of the body. That map is created in large part by sensory input, and Mrs. S.’s sensory input had been quite compromised. In this application, touch is food for the nervous system, providing the brain with sensory data to help create and update our knowledge of our own body.
As I was finishing, Mrs. S. propped herself up on her elbows and looked at me with a big smile on her face. “I feel like I am reclaiming my body. I’m getting my legs back!”
When Mrs. S. returned for a second session, she reported that after returning home from the first session, she put on some music and began to dance, something she had not done for many months.
“It’s like my body remembered how to move again, moving with joy instead of fear,” she said.
If touch is food for the nervous system, then massage is a feast!

Note
1. Definition from International Association for the Study of Pain, 2007.

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