Pain Management and Palliative Care

The Ariana Institute’s Medical Massage Therapy Manual is part of a series of massage manuals that are designed to help deepen the knowledge of current massage therapists and introduce new massage therapists to the world of massage and bodywork. The Medical Massage Therapy Manual features topics that are also available as NCBTMB approved online CE courses through the Ariana Institute at, including:

  • Pain Management
  • Headache and Allergy Relief
  • Lymphatic Massage
  • HIV/AIDS Information for Massage Therapists
  • Prenatal Massage
  • Geriatric Massage

This manual incorporates detailed protocols, photos, links to online videos, marketing strategies, personal stories, and resources to encourage a comprehensive understanding of medical massage therapy modalities beneficial for your massage practice.

Here’s a personal story about pain management featured in the Medical Massage Therapy Manual.


It began on Valentine’s Day five years ago. I was at the Apple Store and my friend Suzanne told me that a mutual friend, who, for the sake of anonymity we’ll call “Douglas” was very ill. She said that on his birthday when he went to the doctor for a routine exam, he was diagnosed with advanced pancreatic cancer. I was stunned. Outwardly, he was the picture of health. Just weeks before the diagnosis, he had climbed a 14,000 ft. mountain in Colorado with a group of friends from his men’s group. He and his wife, “Victoria,” had been friends of mine for over thirty years.

I decided to call Victoria and get a feel for her desire to have me visit them. She was grateful for my call and she gave me the go–ahead. I was honored.

I went to visit them on Valentine’s Day. Douglas was in bed upstairs. I remember that he was wearing a jewel–tone purple corduroy shirt that seemed to brighten his pale appearance, but it was obvious that he was in a significant amount of pain. Victoria and I sat by the side of the bed and comforted Douglas by holding his hand, offering him bits of tangerine, encouraging him to drink water to stay hydrated, playing some music he liked, talking with him when that seemed like the right thing to do and sitting in silence when that seemed like the most appropriate route to take.

After Douglas drifted off to sleep, I went downstairs with Victoria and we talked about how they were doing and we discussed Douglas’s ongoing care. I asked Victoria how I could best serve them? She warmly invited me to be with them during Douglas’s dying process. The members of his men’s group had already begun regular visits with Douglas. They even set up a schedule so Douglas would never be alone and so Victoria would have the support she needed. I cleared my schedule to make myself available to both Douglas and Victoria 24/7.

It was at this point that I started offering compassionate palliative care to one of the most extraordinary people I had ever met, while concurrently comforting his wife of 40 years. Palliative care relieves suffering and improves quality of life for people at any stage in a serious illness, whether that illness is curable, chronic, or life threatening.

We were aware that the pancreatic cancer had progressed to the point where there was no hope for recovery, so I focused my presence in their lives on assisting with pain management and palliative care. Being able to provide comfort for my friend through massage made me grateful to have studied Compassionate Touch with Lisa Curran Parenteau, Therapeutic Touch with Marsha and Jonathan Walker, Reiki with Denise Busk and oncology massage with Tracy Walton. These classes provided me with techniques that I was able to use in this situation.

Even though Douglas was my friend, I followed procedure to give him professional as well as compassionate care. I performed an assessment of Douglas’s condition and logged it into his file in my client records. I received permission from his physicians to offer palliative pain management and massage. With Victoria’s blessings, I began developing a treatment plan that included a pantheon of modalities for pain management and palliative care. Being careful to honor contraindications and carefully avoid areas that were painful for him (his lower and mid–back and his abdominal area), I considered the modalities that seemed appropriate in each moment including Reiki, Reflexology, Therapeutic Touch, myofascial treatment, aromatherapy, foot and hand massage, face and scalp massage, and oncology massage. I also called a dear friend of mine, Geri Ruane, who had years of advanced training in oncology massage and asked her if she would consider being a part of the treatment team. I was grateful that she agreed to join the team. We were mobilizing our support network for Douglas and Victoria.

Douglas’s condition, as we expected, continued to progress. As the inoperable tumor grew and caused more and more pain in the abdominal area and the lower back, I limited my pain management and palliative care to other areas of the body and I also utilized comforting Reiki, a non–contact to low–contact therapy. I felt that my presence was a calming influence in a difficult situation. Many people from the community, as well as Douglas’s family, gathered around, while being mindful to also provide some quiet time for him to rest peacefully. Victoria was grateful that she had such a wide circle of loving support. It was an honor to be a part of the outpouring of love.

Eventually, the time came for Douglas to go into hospice care. We all continued our vigil. I continued my role, offering compassionate care that included a spectrum of pain management modalities. People came from near and far to pay homage to this great man’s passing and to comfort his wonderful wife. The care continued until late one evening at the hospice center when a friend and I were by Douglas’s side and he peacefully took his last breath. I was holding his hand as he passed. It was a very tender moment.

At Douglas’s memorial celebration, Victoria released two white doves that flew into the big, blue skies over Texas. There was not a dry eye in the room. I was grateful and honored to be chosen to be with Douglas and Victoria during his dying process. It was a profoundly moving and transforming experience. My heart felt happy knowing that my skills and training as a massage therapist had contributed to easing the transition from this earthly plane for my dear friend Douglas. I never dreamed that when I took my first core curriculum massage therapy class and subsequent advanced classes, that I would be able to synthesize the information to be of service in such a meaningful way for two people who I love and adore.

Ariana Vincent was awarded the 2015 CE Provider of the Year Award by the Alliance for Massage Therapy Education. She is the CEO of the Ariana Institute and a Nationally Certified Massage Therapy Instructor whose classes are accepted throughout the United States. Ariana is also a Massage Therapy Hall of Fame Honoree and author of the Ariana Institute’s therapy manual series available on Amazon.

To read the foreword of the Medical Massage Therapy Manual, visit
The Ariana Institute’s video introduction to the Headache and Allergy Relief, Lymphatic Massage, HIV/AIDS Information for Massage Therapists, Pain Management, Prenatal Massage, and Geriatric Massage CE courses can be accessed on the Ariana Institute’s YouTube Channel at
To order your copies of the Ariana Institute’s Medical Massage Therapy Manual, visit
For additional information about the Ariana Institute and to register for online continuing education and MTI courses visit

Ariana Vincent, LMT, MTI, NCTMB
Ariana Vincent, LMT, MTI, NCTMB


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