Got Grumpy Clients? Ask Them This
Question!
By Charles Yarborough, L.Ac.
Reprinted from Les
Nouvelles Esthetiques December 2006
We’ve all seen them. They’re the clients you
make the extra effort to please, knowing that when they walk out the
door, they’ll be the same grumpy people who walked in. It’s not that
they complain or create conflict while they’re in your spa; in fact
they seem to take refuge in your establishment and the therapies you
offer. It’s just that these people don’t seem to find much relief in
your services. These are clients who avoid unnecessary conversation,
who move slowly and deliberately and who, despite their need for
pampering, dread being touched. In an effort to cheer them up,
decipher their needs and create an appropriate therapeutic program,
you’ve asked them every question you can think of. The most
important question, however, may be the one that isn’t on your list:
“Are you in pain?”
Physical pain is typically caused by
everyday activities: carrying a heavy load of laundry, spending too
many hours at the keypad or digging all afternoon in the garden.
Activities like these can result in back ache, wrist sprain and
numerous other joint dysfunctions. Usually, the aches that result
from overexertion and poor posture can be managed: a good massage,
over-the-counter medications or physical therapy will leave a person
renewed and ready to continue living. But what if those aches don’t
gradually diminish, don’t lessen with extended therapy, perhaps even
prove impervious to medication? What if the discomforts that start
out localized gradually intensify, spreading to one’s whole body,
settling stubbornly in every joint? Anyone who has experienced such
an ailment knows that unrelenting pain can change every aspect of
their life, affecting their mood, their focus, their relationships
and career. After prolonged periods of pain, they may become
detached and uninterested in pleasure. This is the person who has
moved beyond the stage of complaining about their pain, who now
seems utterly listless, joyless and whose eyes have lost their
glitter. They haven’t had a carefree moment in--quite
possibly--years.
Millions of people suffer from one of
several mysterious pain syndromes, and a good percentage of them
don’t realize these syndromes have names. This is unfortunate not
only because of the isolation that chronic pain can bring but
because these undiagnosed sufferers may be unaware of helpful
therapies and medications. While diagnosis of medical conditions is
something you must, at all costs, avoid, there are some syndromes
you may want to know about, since they probably walk through your
door every day.
CRPS: CALL
LETTERS FOR PAIN
CRPS has received a fair amount of press
lately, thanks to a televised interview with singer Paula Abdul. Ms.
Abdul spoke publicly and candidly about her affliction, CRPD
(complex regional pain DDD), also known as RSD (reflex dystrophy
syndrome), and how it ended her career prematurely. As a result of
physical traumas, Abdul developed unrelenting pain that made dancing
and singing impossible. CRPS may also result from minor cuts and
bumps and, while your client may not be a singer or dancer, it may
keep him or her from comfortably executing daily chores. Left
untreated, it can eventually confine the sufferer to complete
inaction. The symptoms of this malady include intense, shooting pain
that varies in quality; edema; noticeably increased or decreased
sweating; weakness or tremor. In the spa, this client may actually
have color and temperature changes in areas of their skin. Rigorous
massage is not recommended.
What can be done about CRPS/RSD? It’s
generally accepted that a speedy diagnosis will help with symptom
management. Not only physical therapy but psychotherapy is often
considered; a counselor experienced in pain syndromes will teach the
patient coping skills. In fighting to maintain a positive outlook,
patients must conquer their depression and frustration at the
inability to do simple tasks. Don’t expect these people to spread
sunshine when they walk in your door. While no medals are ever
awarded, the patient must often make a truly heroic effort just to
get through the day.
Physical remedies for CRPD may include a
nerve block. For many, this is a useful antidote, although not a
permanent or completely effective one. Many patients combine
therapies and remedies, changing modalities as their symptoms shift.
They may try medications, gentle movement therapies and
unconventional measures such as sympathecomy (surgical removal of a
nerve).
FIBROMYALGIA
Another syndrome, fibromyalgia, is less
obvious. Diagnosis consists of widespread muscle pain on both sides
of the body, above and below the waist, for at least three months
duration. A physical exam must reveal at least eleven of eighteen
specific tender points, although this quota is flexible. Patients
often report generalized stiffness, insomnia, debilitating fatigue,
menstrual irregularities, poor memory, wooziness (“fibro fog”) and
irritable bowel syndrome. As you might guess, fibromyalgia is
sometimes found in the same patients as CRPS/RSD, thereby doubling
their challenge to lead a normal life. While the physiological
mechanics of fibromyalgia are still open to debate, certain
therapies have been found to be helpful. Anti-inflammatory drugs,
corticosteroids, antidepressants and nutrients are often prescribed.
Support groups are essential, and in many legitimate studies on
fibromyalgia, acupuncture is mentioned as a useful palliative. The
gentlest of massage is more than adequate for these clients. As with
CRPS/RSD, the massage tech should be trained in dealing with
intractable pain sufferers.
Women, more often than men, must bear the
challenges of fibromyalgia and CRPS/RSD. This often makes the fight
against pain more daunting, as social elements become involved.
Since symptoms are usually self-reported, the sufferer may be
exposed to comments like, “It’s all in your head,” or “It’s just
hormonal.” Such misconceptions and cultural bias can lead to serious
medical consequences. In the battle against pain, a medical
professional who listens to the patient without judgment is
essential.
OTHER
CAUSES
Not all chronic pain is difficult to remedy.
Widespread muscle aches may be due to a lack of magnesium and
calcium and can be controlled through proper supplementation. Other
causes may include food allergies or the presence of toxic metals
such as mercury in one’s body. Diagnosis, as you can imagine, takes
practice and education.
If you have a client who seems incurably
listless, ill-tempered or depressed, he or she may be mired in
chronic pain. As a spa professional, you are in the delicate
position of avoiding liability yet wanting to help. Don’t diagnose.
Instead, you may reasonably urge your client to perform an internet
search for more details and to find a local support group. This will
set them on their path to helpful information and medical resources.
In your client’s quest for recovery and wellbeing, they’ll need to
arm themselves with emotional support, with knowledge and with
medical experts who understand the challenges they face.
Charles Yarborough, L.Ac., is a
licensed acupuncturist specializing in pain, stress and insomnia. He
owns Hamptons Health Circle (www.HamptonsHealth.com) in Pasadena and
can be reached at (626) 319-8725
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