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A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
November, 2003, Vol. 03, Issue 11
CranioSacral Therapy Outlawed in Mississippi?
By Cliff Korn, BS, LMT, NCTMB and Rebecca J. Razo
Mississippi law governing massage therapy prohibits therapists from engaging in the "manipulation or adjustment of osseous tissue," and it appears that the Mississippi State Board of Massage Therapy (MSBMT) has lumped CranioSacral Therapy (CST) into this definition as a prohibited massage therapy practice.
Massage Today first learned of the situation from Mississippi therapist Brenda Eiland, NCTMB, RMT.Ms. Eiland, who studied Visionary CranioSacral work at the Milne Institute in Big Sur, Calif., was alarmed when she discovered that the Milne Institute application to become a Mississippi CEU provider was denied. A letter signed by MSBMT Executive Director Beverly Limbaugh to the institute stated that its program "does not meet the requirements for approval."1,2 Eiland subsequently contacted the MSBMT to find out if practicing CST in Mississippi was illegal.
"I didn't get a straight answer," she said. Instead, she received an e-mail from Limbaugh stating, "Our law does not permit the movement of osseous tissue" [emphasis ours].3 Unsatisfied with the response, Eiland contacted the Mississippi attorney general's office for a clearer explanation, wherein she received a response from Leyser Hayes, the special assistant attorney general representing the MSBMT. He stated: "Mississippi Law does not permit the movement of osseous tissue [CranioSacral Therapy has been defined by the board to involve this movement] ... Section 73-67-7 (h) Miss. Code Ann. (1972) as amended ... defines what massage means for purposes of the practice of same in Mississippi."4
Mississippi law §73-67-7(h) provides the following definition of massage:
Subsequent inquiries by Eiland and Massage Today to the MSBMT about the practice of CST were referred to the new Mississippi "Scope of Practice" rule, which was mailed to Mississippi therapists in September.
Generally, scope-of-practice statements outline permissible practices for legally operating massage therapists. Mississippi's scope of practice, however, only states what cannot be performed legally. The new scope of practice says:
Massage Today Editor Cliff Korn contacted the Mississippi Attorney General's Office and the executive director of the MSBMT: "Osseous tissue manipulation or adjustment are typically terms referring to chiropractic or osteopathic high-velocity, low-amplitude (HVLA) thrusts or techniques," Mr. Korn said in a letter. "Is it the interpretation of the board that 'manipulation or adjustment' is synonymous with 'movement'? I noticed in your listing of continuing education providers that all of John Barnes' myofascial release seminars were approved, and CranioSacral Therapy is an integral part of his teachings. Please ... confirm or deny the legality of a trained CranioSacral therapist to practice under the Mississippi Professional Massage Therapy Act," he added.7
In its response to Korn, the MSBMT stated the "Attorney general's office does not speak for the board of massage therapy. The Mississippi State Board of Massage Therapy speaks through its minutes." Again, Korn was referred to the Mississippi scope of practice rule.8
In a final attempt at clarification, Massage Today asked the MSBMT if the attorney general's office was incorrect in stating that "movement" of osseous tissue is illegal.9 In a written response, MSBMT President Lynn Cox stated: "The board has not interpreted any particular modality as the manipulation or adjustment of osseous tissue, but rather, reiterated in its statement on scope of practice that any technique that manipulates or adjusts osseous tissue is in violation of the law that governs massage therapists, as well as laws that govern other professionals. If the board ruled that one couldn't do CranioSacral, the name would probably be changed to SacralCranio, wouldn't it? The law has not changed. Massage therapists in Mississippi are prevented from the manipulation or adjustment of osseous tissue, regardless of one's 'expert' training."10
But according to Eiland, Cox's statement is untrue: "They have indeed signaled out a modality, as proved by the e-mail from [Hayes] and a message for me [from Limbaugh, stating] 'you cannot practice CranioSacral work as a massage therapist in Mississippi.' "11
Still, the MSBMT has yet to define the terms "manipulation" or "adjustment." In a letter to the MSBMT, Dr. John Upledger, Massage Today columnist, stated, "CranioSacral Therapy does not incorporate any techniques that involve direct osseous manipulation, mobilization or adjustments. Instead, practitioners focus on releasing restrictions in the soft-tissue, fascia and musculature that surround and protect the brain and spinal cord. How can I be so sure? Because I developed CranioSacral Therapy and coined the name... ."12
Despite repeated requests, the fact remains that the MSBMT has continued to be vague in responding to questions related to the practice of CST in Mississippi. It remains unclear if the MSBMT is defining the terms "manipulation" and "adjustment" to mean HVLA thrusts - or something more. Look for updates of this situation in future issues of Massage Today.
Former editor of Massage Today, Cliff is owner of Windham Health Center Neuromuscular Therapy LLC. He is nationally certified in therapeutic massage & bodywork and is licensed as a massage therapist by the states of New Hampshire and Florida. Cliff is a member of the International Association of Healthcare Practitioners; a professional member and past president of the New Hampshire chapter of the American Massage Therapy Association; a certified member of the Associated Bodywork & Massage Professionals, Inc.; and a past chairman of the board of directors of the National Certification Board for Therapeutic Massage & Bodywork.
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