resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
After two treatments for back pain, a patient presents for a third
session complaining of rapid breathing and wheezing that is made worse
during cold weather.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
March, 2002, Vol. 02, Issue 03
Working with Multiple Sclerosis Patients
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
You've done it again: I put out a request for input, and you came through in a big way. December's article on central nervous system dysfunction seemed to hit a cord with many therapists, so for the next couple of columns I will respond as best I can.(Editor's note: Ruth's December 2001 article is available on line at www.massagetoday.com/archives/2001/12/16.html.)
Although I had feedback on several issues related to central nervous system disorders, the majority of respondents requested information on multiple sclerosis (MS). This is a mysterious disorder; its population distribution is unusual, its progression is unpredictable, and its diagnosis is often a particular challenge. Patients with MS can benefit greatly from carefully managed massage, however, and most therapists probably have some clients who live with this disease.
This article will provide some brief information about how this disease develops and whom it affects, followed by a discussion of how various types of bodywork might and might not fit into the picture.
MS: who gets it? The highest incidence of MS is among Caucasian people who live in Northern or extreme Southern latitudes, or who lived there for the first 15 years of life. It is generally diagnosed in patients somewhere between 20 and 40 years old. Women are diagnosed with the disease approximately twice as frequently as men. It affects about 300 thousand Americans, with about nine thousand new diagnoses each year.
MS: what happens in the body? MS often works in cycles of inflammatory "flares" followed by periods of remission. During flares the myelin is damaged, probably by specific types of white blood cells, and is replaced by scar tissue. MS usually affects the optic nerve, brain stem, cerebellum, and spinal cord. During remission, inflammation subsides, and some regeneration of myelin may occur. In this way, MS patients may lose some neurological function during flares, but regain some or all of it during remission. The cause or causes of MS remain a mystery. Leading theories suggest that a combination of factors is at work: exposure to some pathogen that stimulates an ongoing immune system attack, environmental factors, and genetic predisposition may all be part of the picture. At this point no specific genetic, environmental, or pathogenic factors can reliably predict the incidence of multiple sclerosis.
MS: what does it look like? This disease is sometimes called The Great Imitator because its initial symptoms can look like a variety of other diseases, depending on what area of nerve tissue has been affected. The order with which symptoms appear also varies greatly from one person to the next. Some of the most dependable signs and symptoms include:
MS: how does it progress? The progression of MS is highly unpredictable. It has a few characteristic patterns, but some patients move from one pattern type to others within their disease process. Some of the basic patterns are as follows:
MS may also present as a combination of the R/R and P/P varieties.
MS is not a terminal disease in and of itself. MS sufferers generally have a lifespan about six years shorter than the average, although that statistic may improve as new medications prolong the time between flares and limit central nervous system damage. People who die prematurely from MS are usually immobile, and they fall prey to an opportunistic disease such as a kidney infection, urinary tract infection or pneumonia.
MS: what about massage? This is where it gets interesting. I've received letters from some people asking, "what do I do for this type or that...?" and letters from others saying, "I've had success with this approach..." I couldn't be happier to put all of this information together here in this article.
First of all, let me offer some words of warning. In its acute, or "flare" stage, MS is an inflammatory condition. True, the inflammation is happening in the CNS where we don't have access, but the general rule for massage and acute inflammation is to let it pass.
During an MS exacerbation, the body has a lot of activity to process. In my opinion (and absolutely anyone is invited to disagree), I think it's a better idea to let the dust settle before adding any more input in the form of massage. Some varieties of energetic work may be appropriate during MS flares, as long as the process is respected and the client is not overwhelmed or overchallenged by the stimulus being supplied.
During remission, however, we have a different story. The level of function a person achieves during remission depends on the severity of the flare, and how deeply the myelin was affected. If it was only a superficial attack, the damaged myelin may grow back and no permanent changes may occur. If it was a more intrusive flare, however, some amount of permanent damage may accrue to the nerve tissue, resulting in muscle weakness, sensory changes including parasthesia ("pins and needles"), or even complete numbness. This is where massage (as well as other therapeutic modalities) may have a profoundly positive impact. While we generally say, "if a client can't feel it, we shouldn't try to change it," some massage therapists have found that working deeply and specifically on the antagonistic muscle groups of isolated numb or weak muscles of MS clients yields exciting results.
Here is what one therapist (Jim McFarland of Virginia) has found:
Another reader, Michael Eisenberg of Washington State shared with me that Thai massage, which he describes as being just as beneficial to give as it is to receive, has helped him to manage his own MS:
And yet another reader has a client with very advanced MS who has lost most of the function in his legs. This is what she has to say:
All of these wonderful stories point in the same direction: massage has a lot to offer clients who live with MS, as long as some basic principles are kept in mind: avoid mechanical or manipulative work during periods of flare; respect numbness; only work deeply where the client has sensation; and monitor your results carefully so that you can continue to make positive choices for your client's needs.
Readers who are interested in learning more about MS, either for themselves or for their clients, would do well to visit this website: www.mic.ki.se/Diseases/. This site has an extensive list of recent articles on just about any disease you could think of. MS is listed under Neurological Diseases as a demyelinating disease.
In next month's article, I plan to discuss another aspect of CNS dysfunction: working with spinal cord injury survivors. I've had several questions from readers about "do's" and "don'ts" for these clients; what advice do you have for massage therapists?
Ruth Werner, LMT, NCTMB
Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.
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