resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
How Many of Your Patients Have Sarcopenia?
Figure 1 demonstrates the typical appearance of sarcopenia in the paravertebral muscles. Have you considered evaluating your patients for this problem? Sarcopenia is the progressive loss of skeletal muscle mass and function that affects the older population.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
Excited to Share the Science of Chiropractic: An Interview With Dr. Heidi Haavik
Dr. Heidi Haavik has become known in the circle of chiropractic researchers as not only a rising star, but also one willing to do research that can have a major impact in the scientific world and how chiropractic is perceived.
Day in the Life of an Advanced-Practice DC
Can you tell us a little about your background in the profession? Why did you want to become a DC? I studied at Boston University from 1968-1972 as a pre-med student majoring in biology.
Identify & Adjust the Apex Posterior Sacrum
Low back pain involving an apex posterior sacrum (+θX-axis misalignment) typically presents with signs of lumbosacral joint impingement or facet syndrome.
An Alarming Lack of Accountability
Accountability seems to be a lost quality today. The simple act of taking responsibility and doing the right thing just doesn't happen as often as it should. Maybe it is the litigious nature of our society.
F4CP Launches New Social Media Campaign
The Foundation for Chiropractic Progress has launched a new service to help member doctors: a social media campaign called "Accelerator."
Let's Streamline Your Front Desk
Your front office can be your greatest source of efficiency or a constant bottleneck. Increasing the productivity of this area without sacrificing the quality of patient interaction can be a little tricky.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
Specialized Pro-Resolving Mediators: 21st Century Inflammation Fighters
Specialized pro-resolving mediators, or SPMs, are a portion of the omega-3 fatty-acid spectrum that have been shown to have a powerful effect on reducing inflammation.
News in Brief
Northwestern Student Honored for Addressing Concussions Head-On; Northwestern Announces New CFO; Life U. to Provide Unique Opportunity.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
Misconceptions & Opportunities With Medicare
As I speak around the country on how to properly document Medicare patient encounters, I get questions regarding opting out of Medicare. There are many misconceptions about opting out of Medicare, including just what it means to opt out.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
Designing a Fitness Plan (Part 4): Blending Pain Relief With Healthy Aging
Pain relief is still the No. 1 reason patients come to my office. However, most of my patients have other goals as well, such as: "I want to lose 10 to 20 pounds"; "I feel old and want to slow down the aging process"; "My doctor says I am becoming a diabetic and need to exercise"; or "I'm tired and want more energy."
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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