Waslaski’s 12-step approach to pain management consists of a set of detailed functional assessment skills for specific pain conditions that guide the formulation of an individual treatment plan based on the client’s history.

The 12-step flow chart identifies the steps and shows the general order the therapist should follow to allow the client history and functional assessments to define the most appropriate treatment and self-care plans.  This is not used as a ‘cookbook’ approach to therapy, since it will vary with each client.

Steps 5-12 may not all be needed, but those steps required should always occur in numerical order.  You will always follow steps 1-4, but the utilization of the remaining eight steps can vary depending on the client’s condition, whether or not there is an injury present, and the client’s response to the preceding step.

To apply the 12-step approach successfully, you must be able to accomplish two tasks:

1.   Identify the therapeutic techniques needed to address specific structures.

2.  Differentiate among the soft-tissue problems caused by:

• Myofascial restrictions
• Musculoskeletal problems
• Skeletal alignment problems
• Trigger/tender point tension
• Joint capsule adhesions
• Strained muscle fiber
• Scar tissue
• Nerve compression

Your goals in applying the 12 steps are:

• To restore structural balance and postural alignment
• To create pain-free movement by balancing opposing muscle groups throughout the body
• To increase joint space throughout the body
• To create aligned or functional scar tissue
• To restore normal muscle resting lengths throughout the body