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Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
Why Young People Need Chiropractic Now More Than Ever
According to a recent study published in BMC Musculoskeletal Disorders, "It is now widely acknowledged that neck pain (NP), mid back pain (MBP), and low back pain (LBP) (spinal pain) start early in life and that the lifetime prevalence increases rapidly during adolescence to reach adult levels at the age of 18."
MPA Media Wins 7 Publishing Awards
MPA Media, publisher of Dynamic Chiropractic and DC Practice Insights, among other titles, has been recognized for editorial and design excellence with an unprecedented seven publishing awards by the American Society of Business Publication Editors (ASBPE), the nation's largest organization for business-to-business publications.
Pain Underfoot: Metatarsalgia
Foot pain can interfere significantly with normal activities and severely limit participation in sports. Metatarsalgia is foot pain involving the metatarsal bones in the forefoot – the complaint of pain on the bottom of the ball of the foot.
News in Brief
National Chiropractic Health Month: Be Proactive; Collegiate Roundup: Academic Appointments at Parker, Logan.
A Vibrating Capsule for Constipation? Relevance to Your Chiropractic Practice
The relationship between gastrointestinal (GI) complaints and back pain is not typically written about or discussed.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
Waking Up the Gluteus Maximus
In previous articles in this series, we expounded on the importance of the gluteus maximus (GM) in athletic performance and protecting the knee from injury. We also know there is a link between iliotibial band syndrome and GM weakness.
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
Chiropractic Research in Review
Chiropractic Treatment of Lateral Epicondylitis; Cost / Benefit Analysis: Different Doses of SMT for Low Back Pain; Imaging for Occult Rib and Costal Cartilage Fractures; Treating Neck Pain: Thoracic Thrust Manipulation vs. Non-Thrust Mobilization.
Don't Turn a 2 Into a 10
The Wong-Baker FACES Pain Rating Scale1 is so useful because it can be used by almost anyone. Patients can use the numbers associated with the faces depicted on the scale or select the face that demonstrates their current level of pain from 0-10.
CCE Finally Takes a "Baby Step" Toward Reform
During a 16-month period from October 2010 to February 2012, I devoted four separate columns to the heavy-handed attempt by the Council on Chiropractic Education to radically change the chiropractic profession through the accreditation process.
9 Common Causes of Thyroid Imbalance and How You Can Help
How you sleep, how easily you wake up, and how much energy and stamina you have during the day are directly related to levels of the thyroid hormones.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
March, 2003, Vol. 03, Issue 03
Working With Clients Who Have Reflex Sympathetic Dystrophy Syndrome
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
My last article on hyperthyroidism prompted some interesting responses. In that article, I mentioned I had an unusually difficult time finding any useful information on alternative treatment options for hyperthyroidism patients who wanted to avoid surgery or radioactive treatments to their thyroids (because of the increased risk of developing hypothyroidism).As usual, you came through in a big way. Here's an excerpt from one of the most hopeful letters I got:
This month's column is dedicated to a condition quite different from thyroid dysfunction. Over the course of my time with Massage Today, many readers have requested some information on a disorder that is not at all well understood, even by the professionals who try to treat it. Reflex sympathetic dystrophy syndrome is a condition involving an initial injury (usually) to an extremity (usually), which results in a disproportionate amount of pain, disability, and trophic (growth-related) changes to the damaged tissue. In some cases the symptoms of RSDS can move progressively through the body and affect areas distant to the original trauma.
In October 1864, a group of doctors compared their observations of Civil War soldiers recovering from gunshot wounds. Their comments were remarkably astute, and constitute a vivid picture of the experience of the condition eventually termed "causalgia" from the Greek kausis (burning) and algia (pain).
Reflex Sympathetic Dystrophy Syndrome: What Is It?
RSDS involves tissue damage, overactive sensory neurons, an excess of pain-sensitizing chemicals, and resulting inflammation followed by atrophy of the affected area. Because it is called so many things, and the criteria for making a diagnosis varies by medical specialty (orthopedists use different methods than general practitioners or internists, for instance), it is extremely difficult to pin down and get any solid statistics on its incidence or demographics.
Part of the confusion around this disorder lies its name. Chronic progressive pain syndromes have many labels, and RSDS just happens to be the one that is most popular at this moment in time. Here is a short list of other labels for this or very similar conditions:
The most conservative discussions of RSDS limit it to problems that begin in the hand or arm. This discussion won't limit the damage to the upper extremity, but please be aware that clients who live with this condition may have learned to call it by a different name, depending on where it has affected them, and what kinds of professionals they work with for treatment.
Etiology: What Happens?
When a person experiences any stimulus on the skin, a sensory neuron carries that information to the spinal cord, where a reflex response begins. At the same time, that impulse travels up the spinal cord to the brain, where the stimulus is interpreted at a conscious or subconscious level. If the stimulus is perceived as something safe and relaxing, it initiates a parasympathetic response; if it is interpreted as threatening or painful, a sympathetic response follows.
In RSDS, as far as it is understood at this point in time, a stimulus initiates a sympathetic, but this response long outlives its usefulness. The affected part of the body goes through a localized cycle of pain, which causes sympathetic responses, which reinforces the pain, which exacerbates the pain response, ad infinitum. The healing processes that would normally interrupt this sequence are unable to break through the vicious circle of pain - stress - pain. Eventually, the physiological changes that occur when a specific part of the body is stuck in a sympathetic loop cause their own kinds of damage - damage that can be irreversible. Tissue that experiences chronic inflammation will become essentially "walled off" from the rest of the body, and develop severely restricted blood and lymph supply. This leads to atrophy, bone thinning, and permanent loss of function.
Although it happens only rarely, this pain cycle also has the potential to spread proximally on the affected limb, to the eyes, internal organs, and even to the contralateral limb.
Signs and Symptoms
Four main symptoms have been observed in most RSDS patients: constant burning pain with little or no stimulus; local inflammation and sweating; spasm of both skeletal and smooth muscle in nearby blood vessels; and chronic insomnia (which can contribute to increased pain perception, as sleep deprivation can disturb neurotransmitter levels).
RSDS can be broken down into three or four loosely defined stages. Overlap of these stages often occurs, so they are useful mainly as a time reference for how long a person has been affected by this condition, and what treatment options have the best chance of interfering with its progression.
Diagnosis and Treatment
Because the diagnostic criteria for RSDS and related disorders vary according to medical specialty, it can be difficult to reach a conclusive diagnosis in the early stages of the disease. This is a problem, because the long-term outlook for someone with this problem is significantly better if he or she can begin treatment in Stage I, rather than Stage IV.
Visible signs and patients' descriptions of symptoms are usually straightforward with this condition. Diagnosis can be confirmed with thermography: a test that measures blood flow and localized heat in the body. X-rays or bone scans may be used to look for signs of osteoporosis at the site of injury.
Stage I RSDS may be treated with simple analgesics: NSAIDs or short-term steroids if necessary. Patients get good benefit from heat, especially moist heat applications like paraffin baths or hot packs. Ice is generally not useful for RSDS patients in any stage. Stage II and III RSDS patients need to be more aggressive with their pain management. Anti-seizure medications and morphine pumps are used with mixed results. TENS machines are successful for some people but not all. Calcium channel blockers may improve blood flow and relieve pain. Eventually, a patient may consider a sympathectomy: the surgical severing of parts of the sympathetic nervous system in order to stop the endless cycle of repeating pain signals. This intervention can be successful, but many patients report that the benefits are short-lived and the pain comes back post-surgically.
Can Massage Help?
This is where it gets interesting. Usually, when I research a particular topic, I look up that subject plus "massage," and get exactly nothing. Then I try that topic and "alternative treatments" and often have marginally more success. But for RSDS, this acutely painful, poorly understood sensory dysfunction, I found much more information about massage than I usually do. I found testimonials of RSDS patients who felt their massage therapists had prevented them from developing contractures in their affected muscles; I found suggestions to use massage to help desensitize over-stimulated areas; and massage is frequently recommended along with some other alternative therapies for chronic pain management. I also got some feedback from therapists who specialize in working with RSDS patients; an excerpt from one letter follows:
The upshot of it all is that although RSDS is a painful, inflammatory, potentially progressive condition (all of these qualities raise some cautions for massage), bodywork can serve a useful purpose in the treatment options (or just coping options) for the person who is affected by this disorder. Exactly what modalities to use, and how to avoid causing more pain than necessary while working to maintain muscular and joint health, will depend on the tolerance of the patient and the skills of the therapist.
This is an excellent example of a condition in which a massage therapist should work as part of a health care team, not as a solo practitioner. For more information about RSDS, I highly recommend the following Web sites:
Next time, I'll discuss another frustrating, chronic, progressive condition, but one that has a generally more hopeful prognosis: adhesive capsulitis, also known as frozen shoulder. Send me your success - and failure - stories, so we can all benefit!
Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.
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