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Posted by jacqueline wilkinson, Nov 1 2008 5:54PM

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Tricky Case Study with Back Pain

I wonder if there is anyone out there that would be able to help me. I am currently working through my case studies whilst training for my ITEC Holistic Massage exam this coming March. One case study is a 54 year old gentleman, a heavy smoker of around 40 a day, diabetic Type II, high cholesterol (although recently stopped his statins without the knowledge of his GP to try alternative herbal treatment) has suffered for around 5 months with back pain. He firmly feels it is Sciatic pain. Having had an MRI scan and review of a specialist back pain consultant who has ruled out the possibility of sciatic back pain, however, not giving him any indication of what else the problem could be. Of my understanding massage has a contraindication over the affected area for people suffering with Sciatic back pain, which due to my inexperience and perhaps some confidence issues leaves me feeling unable to continue with him, however, not wanting to leave him in this situation what else would holistic therapy be able to offer him, and if any well experienced massage therapists are able to help I would love to hear from you.

Thanks Jackie
Herman Fenton
Nov 2 2008 2:46PM
Yes I believe that I maybe able to help please give me a call at stonehenge therapies.

Angela Rawlins
Nov 3 2008 7:15PM
Hi Jackie

You should send him back to his GP. He should not just stop his medication without informing his GP. He also is a diabetic, so he should be under the GP for that also.

I would not be very happy with a gent who is a heavy smoker with back ache - assuming that the pain is not referred. He really needs more diagnostic help from the GP to establish where the back ache is coming from. Back aches can be a problem with an organ.

You are right to refer him to a more experienced practitioner:)

I'm a reflexologist plus healer.
Mike Colquhoun
Dec 21 2008 11:44PM
Hi Jackie

Sorry it has taken me so long to pick this one up. Sciatica is a pinching of the sciatic nerve which runs across the buttock and right down the back of the leg from L5 to the sole of the foot. So the pain runs down the back of the leg. It is not in the back.
Though not the normal cause of back pain, Kidney and liver problems can cause pain in the low back so unless you are sufficiently qualified and able to rule this out as the cause, you should not treat low back pain without having first referred the patient to a doctor.
You have covered this with your patient already and as you are not the therapist giving the herbal treatment though his wisdom is questionable it is his right to refuse medication if he so wishes and to smoke etc:
If we only treated the wise we would not have many patients. But we can advise.
Your standard massage that you have been taught in class will not hurt this patient and may well help relieve some of the symptoms. As with all massage the rule is ‘if you do no good, it is acceptable but if you do harm it is not’, so gently and with feeling.
The most useful help you can give this patient is probably to teach them ‘contrast bathing’. Ten minutes is the equivalent of a whole day’s healing so if done six times a day, a week’s healing can be achieved every day.
I have a leaflet on this, if you would like it e-mailed to you contact me at
Yours aye Mike

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