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Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
May, 2003, Vol. 03, Issue 05
Spotlight on Research
By Editorial Staff
Editor's note: This periodic column keeps you abreast of the latest research documenting the benefits of massage and bodywork. Published research is summarized, with references to the full study text provided; abstracts of research projects planned or in progress are reproduced verbatim whenever possible.
Factors associated with choice of massage therapy in a trial of treatments of acute low-back pain.
Purpose: The majority of patients in a randomized clinical trial (RCT) of conventional allopathic care ("usual care") versus a choice of therapies for acute low-back pain expressed a preference for massage therapy (MT) over acupuncture (Acu), chiropractic (Chiro) or usual care. We sought to understand whether those choosing MT differed in demographic characteristics or self-reported pain severity scores from those choosing any of the other three subjects.
Methods: Eligible subjects were adult members of a multispecialty medical practice who had uncomplicated acute low- back pain for less than three weeks with no co-morbid explanation for symptoms. Baseline data were obtained by face-to-face interview at enrollment. Enrollees were randomized to either usual care or to a choice of Acu, Chiro, MT or usual care. Prior to randomization, all enrollees were asked which treatment they would select if randomized to the choice group. Since most enrollees chose MT, we used MT versus all other choices as a dichotomous dependent variable in a logistic regression. Demographic and pain factors were included in this model to examine whether they were associated with massage choice.
Results: Of 2,262 subjects screened for enrollment, 477 were eligible; of those, 293 enrolled. Fifty-one percent were women; 63% were white; 57% were college graduates; and 33% earned >$75,000/year. The average age was 43 years, and the mean self-reported pain scale (0-10) was 7.23 (SD=2.13). The majority (52%) expressed a preference for MT; 18% preferred Acu; 24% preferred Chiro; and 6% preferred usual care. Other than age, (subjects aged 40-49 were less likely than other age groups to select MT; odds ratio = 1.78, 95% CI=[1.08, 2.92]), neither pain scores nor any other demographic variable were associated with the choice of MT. For those subjects randomized to the choice group, 86% of those who expressed a preference for MT select it as their treatment, indicating a high reliability of expressed preference for treatment with actual selection.
Conclusions: Prior research has shown gender, education and income to be associated with higher utilization of complementary and alternative medicine (CAM); however, none of these variables predicted preference for massage therapy in our study. It appears the appeal of massage therapy is not restricted to any particular socioeconomic group, and therefore might be broadly accepted as a treatment option for back pain. Beyond demographics and baseline pain scales, further exploration of variables driving patient choices and examination of effectiveness and economics, will be important to evaluate massage therapy in the management of acute low back pain.
Massage therapy as a technique for coping with stress.
This study assessed the effectiveness of massage therapy as an intervention for coping with stress in 34 healthy university students approaching final examinations. Participants were randomly assigned to an attention control condition (watching three different television programs) or to a massage therapy group in which each participant received one 45-minute massage per week for three consecutive weeks.
Measures of blood pressure, heart rate and state anxiety (State Trait Anxiety Inventory - short form) were taken before and after each session. Stress (Perceived Stress Scale) and coping (Coping Efficacy) were measured three times at baseline (T1), immediately after the three sessions (T2) and at one-week follow-up (T3).
Both groups reported lower anxiety after each of the sessions; however, the massage group experienced a greater reduction, compared to the television group (p<.05). Participants in the massage group also experienced reduced heart rate after each of the massages, whereas the television group showed no change (p<.05). There were no significant differences in systolic and diastolic blood pressure between groups. At T2, the massage group reported a significant decrease in perceived stress and an increase in coping efficacy (p>.05); however, by T3 these effects were no longer evident. Implications for stress and coping from a self-regulatory perspective will be discussed using Leventhal's Parallel Response Model (1997).
Editor's note: Both of the above abstracts were presented at the 2002 AMTA National Convention; they appear in Massage Today with permission from the respective authors.
Correction: In the first installment of this column (Feb. 2003), we referenced Marian Wolfe Dixon's abstract, "Developing a Massage Protocol for research of temporomandibular Joint Disorders," as funded by the AMTA Foundation. Ms. Dixon's research and resulting abstract were actually funded by a developmental grant from the National Center for Complementary and Alternative Medicine (NCCAM), a branch of the National Institutes of Health (NIH).
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