Background: Fluctuations of good days and bad days-in physical symptoms and emotional states-are common for individuals with chronic illness. This pilot study examines these fluctuations during bodywork treatment.Purpose: We analyzed changes in daily selfreports over a period of five months for five individuals who received weekly treatments of Rosen Method Bodywork (RMB), which uses touch and words to enhance body awareness of physical sensations and emotional states.Subjects and Design: Five subjects (aged 31-56) who had chronic low back pain (CLBP) received 16 weekly treatments given by three experienced RMB practitioners.Measures: Pre-and posttreatment assessments covered demographics, disability, and pain. Clients also completed daily bedtime assessments of pain, fatigue, emotional state, and sense of control during the entire treatment period.Results: All clients reported reductions in pain and/or disability in post-compared to pretreatment. In spite of a high level of day-to-day variability in the daily assessments, there were significant reductions in pain and fatigue, and significant increases in positive emotional state and sense of control across the treatment period. In reaching this end, however, some clients had slow and steady improvements, some improved more rapidly, while others got worse before they got better.Conclusions: The natural course of healingwith its inevitable fluctuations in symptoms-is part of a process leading to successful treatment outcomes. Rosen Method Bodywork may be especially helpful in developing and accepting both sensory and emotional body awareness changes that facilitate overall improvement.KEY WORDS: Rosen Method Bodywork; chronic low back pain; pain; fatigue; emotion; sense of control iNTrODuCTiON Fluctuations of good days and bad days are common for individuals with chronic illness. (1,2) While these ups and downs are also likely to occur during treatment, there is relatively little research about this in any health care modality. This study examines day-to-day variability in the perception of physical sensation and emotional state, in a sample of five individuals with chronic low back pain (CLBP) across a period of five months in which they received 16 weekly sessions of Rosen Method Bodywork (RMB).
Chronic Low Back painIt is estimated that 60%-80% of the population will experience CLBP over the life course. As many as 25% of individuals will not find relief from conventional treatments. (3,4) CLBP has both sensoryphysical and emotional symptoms. In addition to chronic pain and fatigue, individuals with CLBP show higher levels of anger, fear, despair, and lack a sense of control. (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16) It is generally recognized that CLBP is a dynamic, fluctuating condition with multifactorial etiology and complex pathogenesis. Normally, mechanistic models for CLBP have tended to focus on the mechanicalsensory aspects of musculoskeletal tissues. Psychosocial factors contribute emotional distress in these patients from sources including job diss...