Be careful! Words can damage...

By Boris Prilutsky

Previously, I already wrote about my consulting work in the research settings. While I am performing a massage procedure, scientists use recording equipment, and lab tests and they are trying to develop medications, to replicate outcome of massage. The principal investigator, who is a neurologist, Ph.D., the professor of neurology at the local medical school in LA, is a very powerful person in scientific circles. Sometimes during conferences, I do not feel comfortable when he is asking my opinion. Seriously speaking, sometimes I even do not feel comfortable at all. I'm the only one who is a massage therapist in this assembly; the rest are scientists, PhDs or students working on their Ph.D. programs.

I’m not trying to show off. This is just to explain why when three weeks ago he called me and said:” if you don't mind, approximately in 40 minutes I will bring a patient, who exhibits a very difficult case of migraine attack” I said, “Of course!”

In 40 minutes at the conference room, there were eight people, two representatives from each team.  The principal investigator requested them to present at my initial evaluation. A few minutes later, he brought a 56 years old woman, a movie star. Obviously, she was suffering: she was very anxious and shaking. In such cases, I ask to briefly present a history and describe symptoms in details. Then I do palpations, assessments of a range of motion, etc. During the last 45 days, nonstop, she suffered from high-intensity pressure headaches and couldn't sleep.

In the beginning, the prescribed medications could somehow control the intensity of pain even though temporarily. Then during the last week, the pain became unbearable. The primary care physician did all tests, including MRI. All of them turned out perfect. The neurologist performed EEG and other neurological tests. All were good. The neurologist diagnosed her, with a migraine, whatever it means. Because the prescribed medications stopped working, the primary care physician requested the second opinion from a topnotch neurologist.

Not to be confused, the principal investigator was the 3rd opinion. He didn't damage her and immediately decided that I have to see her. Straight from his office, he brought her to the research facility. I wasn't there for the second opinion visit and didn’t know the content of the doctor-patient conversation. However, according to her, when she asked about the prognosis, the answer was that it was possible that she will have to live with these headaches all her life, including the possibility of ending up in coma and death.

She said:” Boris, the doctor believes that you will know the answer to when I will die.” I said:” Ma'am, I am a massage therapist, with me people talking about life and not death.” Everyone, including her, started laughing. As she was sitting, I examined the range of motion in her neck. It was terribly limited. Preliminary I could palpate significant tension in fascia and muscles, at the neck and upper back area. Examination/palpation of TMJ muscles/fascia suggested significant buildups of tension. When somebody suffers from severe headaches, very anxious etc., I always first perform Manchurian acupressure for tension headaches. In a direct translation from Chinese, it is head pressure headaches. We interpret it as tension headaches. No matter what is the cause of a headache, fifteen minutes seven positions acupressure session immediately reduces the intensity of a headache. For example, when I am treating fibromyalgia patients, who are also emotionally exhausted, I always start with Manchurian acupressure. It works miraculously.  In such cases, the mechanism of placebo almost always gets activated, contributing to the energy boost and the sense of ” light at the end of the tunnel.”  It has always been a game changer.

As I was expecting, it worked with this actress miraculously. After fifteen minutes of acupressure, I asked her to report if intensity or a headache changed and whether she’s experiencing a change in her condition. She offered us a bit drama play and said: “…my goodness Boris, I don't feel a headache.” I responded: “Ma'am your reaction to the first acupressure procedure, is excellent and encouraging. We have a chance to help you to get rid of headaches, to stabilize your condition, and bring you back to life. Then I asked her to lay on the table, addressed tension within fascia and muscles, and trigger points. Spend time also to address TMJ musculature. It takes additional 30 minutes. Then I assessed her range of motion, and we all were pleasantly surprised witnessing significant ROM improvement, including at TMJ motion. In total, so far I have performed six treatment on her. Almost no episodes of high-intensity headaches, not less importantly, she is slipping in average seven hours each night. I am planning to provide additional 9 to 10 treatments, to sustain the results.

After the treatment was completed, the principal investigator said: “The results it is obvious. What do you think about this difficult phenomenon?” I answered:” It was the obvious case of tension headaches and not a migraine. The treatment addressed the buildups of tension. By addressing the causes of these headaches, we achieved results.”

When the lady left the facility, we talked a bit more. I asked whether the neurologist who provided the second opinion was the board certified idiot, or somehow things got complicated. The principal investigator told us, that second opinion neurologist, was a very knowledgeable and experienced physician, and that somehow things got out of control. One of the fellows, who is a neurologist, participating in a Ph.D. program, told me:”Boris, it was a great therapeutic joke, when you said”:' Ma'am, I am a massage therapist, with me people talking about life; not about death.' She laughed, and I got a good feeling about the further treatment he said.

I said:”Doctor it wasn’t a joke. I meant what I said.”

This Ph.D. student said:” you are a lucky person, sir, to believe so much in power of your occupation.“  He got my traditional answer:” In my opinion, there is a big difference between believing and knowing, Doctor. Thank God I know about the power of massage, as most of the massage therapists do.”

Currently, I am working on the article for Journal of Massage Science. Most likely, the title of this article will be “PLACEBO EFFECT AND ITS ROLE IN MASSAGE THERAPY.” In general, I will discuss the mechanisms of placebo as well as nocebo. In many ways, our approach and views on psychologically triggered placebo are different from the classic approach of the medical society. Today I presented the case when nocebo practically destroyed the patient. In fact, she could possibly die.

Thank God, it didn't happen. One can say, “come on Boris, she wouldn't die.” I disagree. There are enough documented cases when psychologically triggered nocebo led patients to death. But this is not the point. The even difficult case of nocebo, couldn't sustain and resist powerful stimulation by massage.

Best wishes,

1. On August 8th, 2018, at world massage Festival in Las Vegas,

I will teach,   Manchurian acupressure for tension headaches”

Manchurian Acupressure

8 Credit Hours

Manchurian Acupressure for tension headaches is a modern name of this method. Direct translation sounds like “For head pressure reduction”. It is sequence compressions of different points on the face, head, neck, and rib cage. This class is primarily hands-on training. In most cases, after 15 minutes of appropriate applications, the intensity of headaches is rapidly reduced or eliminated. Very effective in cases of a tension headache, but also helping in different cases of headaches including migraine headaches.

Looking forward to seeing you in my class.