Supporting a Frequent Traveller With Persistent Back, Glute, Neck and Jaw Discomfort

How an individualised combination of remedial massage, movement and practical self-management strategies helped one client manage recurring discomfort

A man in his late 50s came to Gabrielle Moore experiencing significant discomfort through his back, gluteal area, neck and jaw. He travelled frequently for work.

This case study explains how Gabrielle used consultation, observation, movement assessment and hands-on remedial massage techniques to respond to the client’s presentation. It also shows how treatment was supported by practical strategies the client could use while working and travelling.

Identifying details have been limited to protect the client’s privacy.

At a glance

What brought the client to Gabrielle?

The client described substantial discomfort affecting several areas of his body. His back and gluteal area were causing concern, alongside recurring neck and jaw symptoms.

Frequent work travel meant that his routines and surroundings regularly changed. This became part of Gabrielle’s broader conversation with him about how he managed his symptoms in daily life.

The client had previously attended an osteopath working at the same practice. He then decided that massage might be a useful addition to the way he was managing his symptoms.

Gabrielle did not assume that one factor explained everything the client was experiencing. Instead, she began by learning about his symptoms, daily activities, working positions, travel patterns and sleep habits.

“Before I decide on a treatment plan, there is a lot of conversation and observation.”

Assessment within the scope of remedial massage

Gabrielle’s first step was a detailed conversation with the client. She asked about his day-to-day activities, work demands, travel, sleeping arrangements and the positions that appeared to make his symptoms feel better or worse.

She also observed how he held and moved his neck, shoulders and upper body. Selected movements, including raising his arms, helped her observe the movement of his shoulders and shoulder blades. During hands-on treatment, she used palpation—assessment through touch—to understand areas of soft-tissue tension, sensitivity and restriction.

These observations helped Gabrielle decide which remedial massage techniques were appropriate and how the client was responding during a session.

Why the client’s daily context mattered

Research involving office workers has examined the relationship between lower-back discomfort and sitting time, posture and sitting behaviour. A 2025 scoping review covering 22 studies and 7,814 participants found that sitting behaviour—including prolonged static sitting and fewer movement breaks—showed the most consistent association with lower-back pain.¹ This does not establish the cause of this client’s symptoms, but it helps explain why Gabrielle considered daily routines and movement habits when planning practical support.

An individualised treatment approach

Gabrielle selected techniques in response to what the client reported, what she observed and how his body responded during treatment. Rather than applying the same routine at every appointment, she adapted her approach as the presentation changed.

Myofascial techniques

Gabrielle used sustained, targeted pressure and movement where appropriate. At times, she asked the client to move his neck or focus on breathing while she worked with a particular area. This allowed her to monitor his comfort and observe changes during the technique.

Neuromuscular and trigger-point techniques

Targeted pressure was used in selected areas of soft-tissue tension and sensitivity. The location, pressure and duration were adjusted to the client’s response rather than applied according to a fixed formula.

Active movement

Movement formed part of both assessment and treatment. Gabrielle observed how the client’s neck, shoulders, shoulder blades and surrounding areas moved, then used that information to guide the session.

“Everybody responds differently, so I observe how movement and soft tissue change and adapt the treatment to the individual.”

Combining hands-on treatment with active strategies

A 2025 systematic review examined manual therapy used alongside exercise for adults with chronic lower-back pain. The manual-therapy approaches included massage, soft-tissue mobilisation, myofascial release and muscle-energy techniques. Eight of the ten included studies reported improvements in pain and/or disability when manual therapy was added to exercise.² The review supports a combined approach in which hands-on care is accompanied by active strategies, rather than relying on one intervention in isolation.

The research provides context for Gabrielle’s treatment philosophy. It does not establish that the client in this case had a medically diagnosed condition or that any one technique caused his reported progress.

Practical support between appointments

Gabrielle and the client looked beyond what happened on the treatment table. Because he worked and travelled across different environments, the strategies needed to be practical and adaptable.

Their discussions included:

• positioning his mouse, keyboard and computer screen;
• changing position between sitting and standing;
• getting into and out of a car;
• adapting to unfamiliar hotel beds and pillows;
• appropriate movement and stretching;
• recognising when familiar symptoms were beginning to return; and
• using previously discussed strategies between appointments.

Over time, the client began contributing his own observations. He would tell Gabrielle about stretches or movements he had found useful and became more confident recognising what his body needed when familiar symptoms appeared.

“I want clients to understand what helps their body and have practical strategies they can use between treatments.”

A person-centred combination of care

The World Health Organisation’s guideline for non-surgical management of chronic primary lower-back pain emphasises holistic, person-centred care. It identifies education and self-care support, exercise and some physical therapies—including massage—as options that may form part of care.³ This broader model is consistent with combining hands-on treatment, movement and practical strategies suited to the individual.

Gabrielle did not diagnose this client with chronic primary lower-back pain. The guideline is included to provide broader context for the person-centred principles reflected in her approach.

Progress over time

The client’s progress developed over a series of treatments, with Gabrielle adapting her approach as his presentation and needs changed. There were several areas to address, and changes to his work, travel and daily habits complemented the hands-on treatment.

In the early phase, the client attended more frequently. Gabrielle recalled noticing clearer changes in his soft-tissue presentation after approximately one month. As the client’s understanding and management improved, appointments were progressively reduced to weekly, then fortnightly and eventually monthly maintenance visits.

This schedule describes one individual course of care. It is not a recommended appointment frequency for every client.

What changed for the client?

Gabrielle observed a transition in the client’s understanding and confidence. At the beginning, he was frustrated and unsure how to respond when symptoms appeared. With time, he became better able to recognise familiar patterns and choose from the movement, positioning and self-care strategies they had discussed.

This was particularly relevant when he was travelling or working away from his usual environment. Rather than waiting until the discomfort became difficult to manage, he developed a clearer sense of when to use an appropriate strategy or arrange another appointment.

The most meaningful outcome was not a claim that the client had been permanently “fixed”. It was that he had become more informed and active in managing his recurring symptoms, with remedial massage forming part of his ongoing care.

What this case demonstrates about Gabrielle’s approach

This case illustrates several consistent features of Gabrielle’s work:

• she begins by listening and understanding the client’s broader circumstances;
• she assesses movement and soft tissue within the scope of remedial massage;
• she selects and adapts techniques according to the individual response;
• she discusses practical strategies that can be used outside the clinic;
• she monitors progress over time rather than promising an immediate result; and
• she supports clients to take an informed and active role in their ongoing care.

Important information

This case study describes one client’s individual experience. Responses to remedial massage vary, and this experience does not guarantee that another person will have the same outcome.

Remedial massage does not replace medical diagnosis or medical treatment. New, severe, worsening or unexplained symptoms should be assessed by an appropriately qualified medical practitioner.

About Gabrielle Moore

Gabrielle Moore is a diploma-qualified remedial massage therapist with more than 19 years of clinical experience. She is a member of Massage & Myotherapy Australia and is registered with participating health funds.

Case study based on an interview with Gabrielle Moore, conducted by Nick Moore.