Spotlight 7: Massage therapist blessings

I understand that massage therapy can be soothing and calming, but using it as a main treatment for chronic, severe anxiety needs more studies and clear evidence—however helpful it can be for situational stress. I believe sending patients for massage therapy to treat their chronic anxiety is a waste of their insurance money which can be used for another valid reason. Sick leaves Paul is 34 years old with severe anxiety. I have given him sick leaves due to his anxiety probably more than anybody else in my practice. He knows he has anxiety but doesn’t want to be treated—neither by medications nor by psychotherapy. Most of our discussions end up going nowhere but I still keep trying in hopes I can convince him to get some help. I see Paul four to five times a year. Every time I see him, he comes up with a new request or idea to manage his anxiety. It will be hypnotherapy one time and neurofeedback the next. I usually send him for whatever he asks for as long as it doesn’t uselessly cost the system. Read: Spotlight 5: Specialists’ blessings In one of his visits, he asked me to send him for massage therapy to treat his anxiety. I, as usual, had a lengthy discussion with Paul regarding the role of massage therapy in his case and that he needed to be seriously treated with at least psychotherapy. But I again collided with his rigidity and resistance. Because I knew the end result of the discussion, I ended up giving him a referral for massage therapy. One month later he called the office and booked an urgent appointment. “Paul, how can I help you today?” I asked after I greeted him. “I just want an MRI for my neck,” he firmly replied. “What for?” I asked “The massage therapist told me that I have a herniated disc and pinched nerve in my neck and asked me to ask you for an MRI,” he confidently replied. “What does this have to do with your anxiety?” “The massage therapist thinks the neck problem might increase my anxiety.” “Do you have pain in your neck, Paul?” “No.” “Do you have pain, tingling or numbness in one or both arms?” “No.” “Then what is the MRI for?” I asked “I just want to check my neck because the massage therapist told me that my neck is not good,” he said pettishly. I examined Paul’s neck and found everything completely normal. I said: “Paul, your neck is completely normal and you don’t have symptoms, so I don’t really see any indication for the MRI.” Insisted He insisted he be sent for an MRI—otherwise he said he would find another doctor. But I informed him that there is no need for it and asked him to call back and book another appointment if he develops neck pain or pain and numbness in one or both arms. He looked at me and asked, “So you are not sending me for an MRI?” “No,” I replied. He stood up, looked at me and said: “It is my fault that I made you my doctor.” Then he left . . . and that was the last time I saw Paul. It was a tough encounter. I probably should’ve had a good massage after. Dr. Jabir Jassam is a family physician who works at Health Treasure Medical Center in Ottawa. This spotlight series looks at his patients’ encounters with different kinds of health workers.

Spotlight 7: Massage therapist blessings

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