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News In Brief
A "Modern" Business Model. Acupuncturists may have a new professional atmosphere to consider, as a new concept is on the horizon - at least for one business.
The First (Only) Choice for Spinal Pain
The study on NSAIDs for spinal pain summarized on the front page of this issue is intriguing on a number of levels, the most obvious being the conclusion that "compared with placebo, NSAIDs do not provide a clinically important effect on spinal pain, and six patients must be treated with NSAIDs for one patient to achieve a clinically important benefit in the short-term."
Good Works at the Canandaigua VA
Faculty and students of the Finger Lakes School of Acupuncture and Oriental Medicine (FLSAOM) of the New York Chiropractic College have provided acupuncture to veterans at the Veterans' Administration Medical Center (VAMC) in Canandaigua, New York since September of 2007.
The Qi Focus: A Guide to Managing Stress
Stress, are you experiencing heightened stress levels? Your own, and your clients? Is Trumpitis getting to you? I recently polled a cluster of acupuncturists, Asian Bodywork Therapists (ABT) and psychotherapy colleagues on the issue.
Scope of Chiropractic Practice: Why Now Is the Time to Expand
In my January article, "Scope of Chiropractic Practice: Is It Time for Change?" I discussed the use of the term primary spine care practitioner, the loss of privileges to diagnose in Texas, and the fact that the definition of "chiropractic" varied from state to state.
What's Bugging You? Probiotics and Your Health
An estimated 100 trillion microorganisms representing more than 500 different species inhabit every normal, healthy bowel. Gut-dwelling bacteria keep pathogens in check, aid digestion and nutrient absorption, and contribute to immune function.
How to Correct a Cuboid Subluxation
Cuboid subluxation is a poorly recognized condition, even though it is not uncommon. It has been described in the literature under various names: cuboid subluxation, cuboid syndrome, locked cuboid, dropped cuboid, cuboid fault syndrome or peroneal cuboid syndrome.
Toxicity & Kids: The Importance of Environmental Intake
The old adage is true that children are not little adults. Traditional Chinese medicine (TCM) has long known that the physiology of children is unique, as are the diseases that plague them.
The Chiropractor's Guide to CRISPR
Science magazine's "Breakthrough of the Year" award for 2015 was described as "the gene-editing tool called CRISPR." CRISPR stands for "clustered regularly interspaced short palindromic repeats."
Treating the Terrain of Chronic Sinus Infections
Chronic sinus infections can be stubborn to treat, but the therapeutic path forward can be simplified when utilizing three distinct treatment principles which take into account the terrain of the body, and the way in which microbes grow.
Chiropractic: A Great Fit for the White House
Dr. Eric Kaplan is a New York Chiropractic College alumnus; a No. 1 best-selling author whose books include Awaken the Wellness Within and The 5 Minute Motivator; a chiropractor for professional sports teams and elite athletes; and even served as an advisor under the Clinton Administration to the President's Council on Sports & Physical Fitness.
Give Your Patients the Ergonomic Advantage
Prolonged sitting contributes to low back pain and is a health risk. When I discuss my POLITE technique practice recommendations with patients, ergonomics may be last, but not least!
Treating LBP the Right Way: Think Natural
An updated clinical practice guideline from the American College of Physicians (ACP) recommends spinal manipulation and other non-invasive, non-drug therapies as first options for acute, subacute and chronic low back pain, rather than pain medications, as stipulated in the original 2007 guideline.
Integrative Cardiology: The Heart of TCM & Western Medicine
Patient centered therapy is a growing trend in hospitals that are expanding to boutique services.
Shedding Light on the Benefits of Heliotherapy
I can't imagine anyone not feeling good strolling in the sun on a beautiful spring day. The sun is responsible for all life on earth and is best illustrated along the equator touting the richest biodiversity on the planet, in stark contrast to the Arctic Circle and South Pole.
Insomnia Treatment Based on the Yu Theory
In recent years, acupuncture has risen in popularity as a form of alternative or supplemental medicine for the treatment of many different types of disorders.
Waist Circumference: A Conversation Starter (Part 2)
Now let's discuss the clinical approach to reducing WC and implementation in today's chiropractic practice. The primary intervention centers around dietary modification and lifestyle habits aimed to reduce adiposity, improve insulin sensitivity and ultimately, diminish systemic metabolic dysfunction.
Caring for Refugees in Greece
At the beginning of 2016 I had no idea what was in store for me, but I was looking forward to a personal retreat on the Greek island of Paros; a graduation gift to myself after 22 years of motherhood, and four-plus years of Chinese medicine school.
Help Save an Important Chiropractic Landmark
The chiropractic profession has a splendid and varied history. Sadly, many landmarks have been lost to bulldozers and wrecking crews, such as the Ryan Building, Little-Bit-O-Heaven, Spears Chiropractic Hospital, and Clearview Sanitarium.
NSAIDs No Better Than Placebo for Spine Pain
A meta-analysis of randomized, placebo-controlled trials comparing the efficacy and safety of NSAIDs with placebo for spinal pain concludes that among 6,065 spine pain patients, "NSAIDs reduced pain and disability, but provided clinically unimportant effects over placebo."
5 Ways to Enhance Your Family Practice
Every practice has a personality style. A practice that caters to athletes, PI cases or adults, for example, projects differently to patients than a family wellness practice.
June, 2004, Vol. 04, Issue 06
Setting the Record Straight: Massage Gets a Bad Rap in National Report
By Rebecca J. Razo
Over the years, the massage profession has been no stranger to adversity. Many battles have been fought, and won, to protect the reputations of the profession and massage professionals throughout the country.Fortunately, an increasing number of studies and news reports have helped validate massage and other forms of complementary and alternative medicine (CAM) in treating pain and dysfunction. (See the top story in this issue: "Newsweek Validates Complementary and Alternative Therapies for Back Pain" www.massagetoday.com/archives/2004/06/01.html) With all of the positive aspects of the advancing massage profession, it can be disheartening when media reports indict massage as a harmful practice with little or no supporting evidence.
Such was the case in April 2004, when a short segment ran on national television suggesting that massage can be dangerous. The segment, which was written, produced and distributed by Ivanhoe Broadcast News - a health news-gathering service that produces daily media reports - was subsequently posted on several Web sites.1 One report, "Massages Could Cause More Pain Than Relief," ran on a major Southern California network with the following introduction: "People often feel better right after a relaxing massage, but many people leave the table feeling even worse. Experts say what you don't know about massage may cause more pain than relief."2
The feature discussed the case of Mary Schreiner, who had sought massage after suffering injuries in two major accidents. Schreiner claimed she felt fine during and immediately following massage, but that the treatments ultimately aggravated her injuries; in the end, Schreiner received cortisone injections to manage her pain.1,2
The piece quoted only one expert, Dr. Robert Gotlin, a physical rehabilitation specialist with Beth Israel Medical Center in New York City, who made three blanket statements in relation to massage, including that 15 percent of massage patients need corrective treatment following massage; thin people should avoid deep-tissue massage because of potential injury; and a client's likelihood of receiving a safe massage is better from a "therapist with credentials from the American Massage Therapy Association."1,2
In an initial phone interview, Dr. Gotlin told Massage Today that his true message was not made clear in the television segment, and that he was not given the opportunity to proofread the piece before it went to production3 -- a statement Stacie Overton, Director of Medical Programming for Ivanhoe, vehemently denies. "We fact-check everything we do," Overton said. "If he had a problem, I wish he had said something ... if [he thought the piece] was presented poorly."4
Dr. Gotlin indicated that the segment was originally intended to address what he perceives is a problem in the massage profession. "The impetus for this piece is the recent increase in storefront 'pay-by-the-minute' massage centers," he said. "For the hundreds of patients seen monthly for complaints of musculoskeletal pain ... [an] increasingly common modality tied to pain symptoms is storefront 'pay-by-the-minute' massages."5 But Overton denies the piece was ever intended to cover massage mishaps in storefront-type operations. "I would have never accepted that story," she said.4
When queried about his claim that 15 percent of massage patients need corrective treatment, Dr. Gotlin told Massage Today that his statistic was derived from unofficial, nonscientific assessments of thousands of patients from his private practice over the past two to three years. "This was a practice comment," he said.
However, transcripts of Ivanhoe's original interview, which were fact-checked and approved by Dr. Gotlin prior to production, show-- although he openly admits his conclusions are based on "trial and error" evaluations of his own patients -- that Dr. Gotlin never clarifies his statistical assessment is based on those same in-office patient evaluations; consequently, this omission resulted in an innacurate depiction of massage injuries.6,7,8
Moreover, Dr. Gotlin, who claims to see roughly five to six patients a week for injuries following massage, agreed that his patients usually have pre-existing injuries that are merely exacerbated -- not caused by -- massage.3 The feature never makes this point clear.
In reality, it is "rare for a well-trained massage therapist to give a bad massage," remarked AMTA President Laurel Freeman. "There are very few malpractice claims filed against massage therapists for injury."9 Moreover, the number of documented injuries is extremely low.
According to a study conducted by massage educator Keith Eric Grant, PhD, and published in the October 2003 issue of the Journal of Bodywork and Movement Therapies: "There are extremely few reported cases of injury related to massage within the indexed health care literature. While statements have occurred in newspapers that would seem to indicate that massage has a high potential and probability for causing injury, such anecdotal statements have no support in the medical literature or in insurance statistics."10
And a study published late last year in Rheumatolgy indicates that although "massage is not entirely risk free ... serious adverse events are probably true rarities."11
"I seriously question the judgment if not the ethics of [Gotlin's] pronouncements to the media," Dr. Grant said. "If Dr. Gotlin had clinical observations to report, doing so by a journal article or letter to the editor would have been a fully appropriate and useful contribution to the ongoing professional dialogue and development of the massage profession." Dr. Grant further noted that Dr. Gotlin's statements were made "in a manner potentially misleading to the public."12
Still, Dr. Gotlin stressed his support of massage therapy when properly indicated, and affirmed that his concern is for those who self-treat with massage prior to seeking appropriate medical care for pre-existing injuries. "For those who are without pain and wish the comforts of soft-tissue massage ... this is not the population I am speaking of," he said. "It is those who have complaints of neck or back pain accompanied by arm and/or leg pain, which manifests at night, or pain along with muscle weakness ... conditions which should undergo a medical evaluation before embarking on any therapy.
"Massage therapy may be an excellent modality choice if not contraindicated," he continued. "Many patients are not [told] to seek medical advice by the storefront massage therapist. In fact, there is usually no discussion of any related symptoms."5 Yet, Dr. Gotlin's support of massage therapy was not a point made central to the feature that aired.
James Waslaski, international lecturer on orthopedic massage, chronic pain and sports injuries, believes that massage often receives negative press because of ongoing "turf wars" between health care professionals, and affirms that "many advanced disciplines within [the massage] profession have a very low chance of making an existing injury worse.
"I do recommend that people become certified in advanced [massage] disciplines ... to assure that proper assessment is done prior to treatment. By referring out [to other qualified therapists], certain complicated conditions ... would not become exacerbated by massage treatments. In fact, many times for soft tissue injuries, muscle relaxants and cortisone injections will only mask the patient's symptoms instead of treating the underlying structural imbalance causing the pain," Waslaski said.13
Another of Dr. Gotlin's claims was that thin people should not receive deep-tissue massage. "The most common body habitus seen with complaints of increased symptoms with deep massage is the ectomorph. Those who are thin may suffer the greatest ill effects of deep-tissue massage, likely due to the close proximity of the massaging hands to inflamed nerves and muscles," he said.5
But according to Waslaski, "deep tissue massage can indeed be performed safely on thin individuals." Waslaski affirms that most orthopedic massage instruction stresses the importance in teaching massage to remain "always pain free," which may involve "superficial to deep, myofascial spreading routine, avoiding bony landmarks to increase blood flow to ischemic areas ... gentle trigger point techniques to referral pain patterns in short muscle groups and gentle stretching ... to assist the body back to a state of balance.
"In my opinion, muscle groups shorten because of repetitive use or poor postures," he continued. "It is our role to lengthen those short muscle groups in a pain free fashion. We should never cause pain in our treatments, and [must conduct] a thorough assessment of [the] patient prior to doing the treatment," Waslaski added.13
Freeman agrees. "Thin people have skin and muscles just like people who are heavier. The more important question is: 'What is the person's sensitivity level?'"9
Although Dr. Gotlin is on record saying that those seeking massage should ask if "the therapist [is] certified by the AMTA,"7 he amended his statement to Massage Today, stating instead that consumers should seek a massage therapist "who is certified/licensed by an organization such as the AMTA."5
He also wants the public to know that his intentions were noble: "The intent of ... my media pieces is to 'advise' consumers ... to increase awareness of the indications/contraindications and risk/benefit ratios for the many therapeutic options available," he said. "I am an advocate and believer in massage therapy."5
Although some may construe this report as a setback to the massage industry, Freeman emphasizes how far the profession has come over the past several years. "Massage has been growing at an incredible rate," she said. "In the last seven years, AMTA's consumer surveys have shown the percentage of American adults receiving massage jump from 8 percent to 21 percent; the number of articles written about massage have gone from 3,700 per year to over 15,000; and the massage profession is listed in the American Medical Association's Health Professions Career & Education Directory."9
Editor's note: Due to the transient nature of the Internet, some links may no longer be accessible.
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