resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Four Ways to Attract Patients
Acupuncturist A has been in practice for six years and has struggled since day one. She spends as much time and money on marketing as she can, but since her practice is slow, her budget isn't that big.
Six Things Every DC Should Know About the Zika Virus
The Zika outbreak continues to spread across the continental United States and U.S. territories. We offer this brief overview on this important public health problem for the practicing doctor of chiropractic.
Pediatric Asthma: A Case Study
I have had very good success with pediatric asthma, combining acupuncture with Chinese herbal products. Treatment is given over four to eight months, twice monthly, with herbal formulas rotated every month.
Workers' Back Pain: Causes, Costs & Solution
You will want to share two important papers published in the past several months. Why? When read separately, each provides valuable information relevant to your patients, community and practice; together, they tell a compelling story.
Treating Peripheral Neuropathy: Multi-Faceted Approach Including Laser Therapy
Peripheral neuropathy affects at least 20 million people in the United States1 and nearly 60 percent of all people with diabetes suffer from diabetic neuropathy. Many suffer from the disorder without ever identifying the cause.
National Board Apologizes for Testing Issues
The National Board of Chiropractic Examiners (NBCE) has issued a formal apology following a series of computer-based testing malfunctions that impacted two separate examinations (March and June 2016) and caused "widespread confusion and frustration" to the nearly 1,500 examinees taking the tests.
Update from the International AIDS Conference
The 21st International AIDS Conference in Durban, South Africa, brought together more than 15,000 of the world's leading scientists, activists, funders, policy makers, and consumers from 153 countries.
Treatment Success at the Won Institute
According to the World Health Organization's 2003 report titled, "Acupuncture: Review and Analysis of Controlled Clinical Trials," acupuncture has been shown to improve many physical, emotional, and mental conditions.
Using the Lens of Chinese Medicine
One of the most common medications I see in clinical practice on a daily basis is fluoxetine or Prozac. Consequently, I hear many complaints concerning the side effects of this medication and am frequently asked by patients to help manage these side effects with acupuncture and Chinese medicine.
Pediatric Footwear: Function Over Fashion
As practitioners, it is not uncommon for parents to bring us their children to treat or ask us questions related to the pediatric population. Children's feet tend to be a perplexing region for parents and practitioners alike.
Natural Cancer Prevention: Pomegranate for the Prostate
In recent years, the ingestion of pure pomegranate juice (8 ounces per day) has been shown in clinical studies with human subjects to slow, and to some degree, reverse, the progression of prostate cancer – the second leading cause of cancer death in North American men.
Going Beyond Just Feeling Good
We all know that most patients come to us for some pain complaint: neck pain, back pain, sciatica, carpal tunnel, etc. We also all know that acupuncture is a great first-line care for these issues, as well as supporting overall health and wellness.
Dysautonomia: The Medical Condition You May Already Be Treating
TCM practitioners have spent thousands of years healing patients without knowing or needing the names of their diseases as defined by allopathic medicine. We have syndrome names that are both poetic and efficient.
First Annual ICD-10 Updates Take Effect
Yes, there was an update to ICD-10 codes on Oct. 1. It was a regular update to the diagnosis coding system and will take place every Oct. 1, just as it did when the ICD-9 system was in place.
Integrative Cancer Care: Chiropractic for Chemotherapy-Induced Hiccups
Hiccups (singultus) are a frequent occurrence during cancer treatment. The cause of the hiccups may be the chemotherapy drug itself, such as Cisplatin; or the prophylactic use of corticosteroids such as Decadron, which is used to prevent nausea and/or vomiting.
Getting Paid by Medicare Is Getting a Major Adjustment
The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law to implement a new approach to clinician payments and replace the Sustainable Growth Rate formula.
ITB Syndrome: Treat the Tensor Fascia Latae
Iliotibial band syndrome is usually the result of repetitive knee flexion, such as in runners or cyclists. Pain may be experienced in the knee and/or the hip. The patient may express a sense of the hip dislocating, popping or snapping.
Decoding the Mystery of Medical Insurance Acceptance
In the constantly evolving profession of acupuncture, one of the least understood areas is medical insurance acceptance. The profession is filled with controversy surrounding this topic: Is it ethical?
Power to the Patient
Against a backdrop of splintered political parties, polarizations within nations, civil unrest, and distrust of established government (such as the growing anti-Washington, D.C. sentiment) comes the not-so-surprising finding that health care authorities and practitioners (with perhaps the exception of insurers) are turning over more and more powers to the individual patient.
Upgrade to "Parker 2.0" in Las Vegas
Continuing your education and refining your practice: two key elements of a successful chiropractic career. Parker Seminars promises both as it celebrates its 65th anniversary in Las Vegas next February, according to Parker University President, Dr. William Morgan, and seminar consultant Dr. Mark Sanna.
December, 2003, Vol. 03, Issue 12
Depression and the Stress Response System, Part III
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
In the first part of this series, I introduced the concept of depression and its relationship to touch deprivation and a sluggish stress response system. Last time, I looked at different types of depression and the consequences of living with this disorder.This month, I will discuss treatment options, including, of course, massage.
Most types of depression can be treated successfully: Up to 90 percent of all depression patients eventually find a treatment that significantly improves their quality of life. A combination of medical intervention and psychotherapy appears to be the most effective way of treating most types of depression.
Antidepressants - Medications used for depression usually fall into one of three categories: selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs) or tricyclics. These classes of medication aim to make neurotransmitters more easily accessible in the mood-determining areas of the brain. SSRIs, such as Prozac and Zoloft, work by preventing the recycling of secreted serotonin into axon terminals. In other words, serotonin lingers in synapses for longer than it normally would, which reinforces its power to work. Tricyclic antidepressants, including amytriptaline, essentially do the same, although they do not focus specifically on serotonin. MAOIs, such as Nardil and Parate, limit the action of an enzyme that would normally break down and clear away secretions of neurotransmitters. Lithium is used specifically to treat bipolar depression. Rather than altering levels of neurotransmitter reuptake or recycling, lithium works simply to "smooth out" mood swings.
Antidepressants are effective for most people, but they have two major disadvantages: They take several weeks to establish any noticeable mood changes, and they tend to produce unpleasant side-effects during the initial adjustment period, including dry mouth, dizziness, constipation, skin rashes, sleepiness or sleeplessness, and restlessness. Side effects usually subside within four to six weeks - about the same time the medication starts to work.
St. John's Wort - This herbal extract has received a lot of attention as a mood enhancer without the side-effects that other antidepressants carry. Early experiments indicate that it might work like SSRIs or tricyclic antidepressants by preventing the reabsorption of neurotransmitters at the synapses. The National Institutes of Health recently began a three-year study of St. John's wort in comparison to amytriptaline for the treatment of mild dysthymia.
Psychotherapy - Psychologists and psychiatrists may also employ various types of "talk therapy" to help patients improve coping skills and reduce the effects and recurrence of depressive episodes. Three major approaches are useful, depending on the personality and needs of the affected individual. Cognitive-behavioral therapy focuses on the patient's skills at managing life and making positive choices. Interpersonal therapy focuses on how relationships color a person's life, for better or worse. Psychodynamic therapy examines how unresolved inner conflicts can affect the way a person makes choices and lives with those choices. Psychotherapy, combined with medication, often works better than medication alone, because it can help the patient take control of a situation - a feeling many depressive people do not often have.
Light therapy: Individuals living with seasonal affective disorder (SAD) do not need medication or therapy; they need sunlight. Exposure to broad-spectrum lights can help to reduce symptoms.
Electroconvulsive therapy (ECT): Some depression patients do not respond to medication, but the symptoms persist and make their lives miserable. ECT or "shock" therapy may be the best choice for these patients. While this may bring up disturbing memories of the movie "One Flew Over The Cuckoo's Nest," modern ECT is conducted under light anesthesia, and with muscle relaxants to limit uncontrolled contractions. It is not entirely clear why it works, but it can be a highly effective intervention for people who do not get relief from other options.
Massage: Most people suffering from depression will reap several benefits from bodywork. Touch improves the efficiency of the pituitary-adrenal axis. Receiving non sexual, nurturing, non threatening touch is one of the most important ways humans and other mammals have to keep a healthy stress response. Massage moves people from a sympathetic to a parasympathetic state. This brings about several physiological and chemical changes in the body, including an increase in serotonin secretion and a decrease in cortisol. Research about how massage affects mood indicates a shift in electroencephalogram (EEG) activation from the right frontal lobe (usually associated with sad affect) to the left frontal lobe (usually associated with happy affect), or at least to a symmetrical reading.1 Massage is one of the few distinctively pleasurable things people can do that is also really good for them. The act of receiving a massage is a step toward self-determination that depressed people can take with little risk of having it backfire.
Be cautious when working with depressed patients. Some clients who receive massage and enjoy its benefits may wish to stop taking their medication; well-meaning massage therapists may view this as a successful outcome and encourage their clients to try it, but balancing medication for depressive people is a difficult business. Only the patient and his or her doctor should be involved in this decision.
Depression often accompanies complex emotional issues that a client may have trouble sorting out. Client-therapist relationships run the risk, in some cases, of becoming distorted when boundaries are not carefully respected. If a massage therapist has a client who is depressive in connection with other problems (for instance, recovering from emotional, physical or sexual abuse), the relationship can be precarious, especially if the client is not getting adequate support outside the massage clinic. In these cases, therapists are obliged to refer clients for other kinds of help, and to prevent the client-therapist relationship from becoming more central to the client's life than it should be.
I will be taking a short break from my column until next May. Until then, many thanks and many blessings.
Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.
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