resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. After two treatments for back pain, a patient presents for a third session complaining of rapid breathing and wheezing that is made worse during cold weather.
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
June, 2004, Vol. 04, Issue 06
By Keith Eric Grant, PhD, NCTMB
There's nothing like a bit of personal involvement to motivate learning.With a disposition to burning the candle at both ends, a semi-addiction to exercise, and a tendency toward upper-respiratory allergies, I'm all too prone to catching a head cold from a school-bound offspring or world-traveling colleague. Generally, it's not the respiratory symptoms that impact me most, but the mental fog, tendency to nod off, and general malaise that comes with them. It's the immune system chemicals called cytokines, believed to result in the systemic response, that are the focus of this article. What's particularly fascinating about cytokines is that they show up in the literature on infections, allergies, exercise, stress responses, fibromyalgia, and chronic fatigue syndrome.
The local response to infection or tissue injury involves the production of cytokines, which are released at the site of inflammation. Cytokines facilitate an influx of lymphocytes, neutrophils, monocytes and other cells, which participate in the clearing of antigens and healing of tissue. The local inflammatory response is accompanied by a systemic response, known as the acute phase response.6
Similar to explicit tissue injury, strenuous exercise is also accompanied by an increase in circulating proinflammatory and inflammation-responsive cytokines.7 This effect is observed both from long events, such as marathons, and from shorter, intense episodes of eccentric exercise. The cytokine response following exercise is also affected by nutritional factors such as carbohydrate loading or restriction.6
Cytokines are potent mediators of immune activity. These chemicals carry messages from one cell group to another and invoke the most powerful of whole-body defense responses. The cytokines include the interferons and interleukins, which cause many of the symptoms of bacterial and viral infections - fever, headache, generalized aching, fatigue, weakness, and clouded consciousness.3 Injection of proinflammatory cytokines has reproduced many of these acute phase symptoms.
Cytokine production also responds to stress. It is now well established that the central nervous, endocrine and immune systems interact with each other; psychological stress can down-regulate the immune response by affecting the interplay of these systems. The interactions are complex, involving both the hypothalamic-pituitary-adrenal axis (HPA) and the autonomic nervous system.4
It's been proposed that cytokines, reacting to partial protein production by latent viral infections, could be a mechanism involved in chronic fatigue syndrome.4 The viruses could be partially reactivated; that is, viral proteins could be produced at levels high enough to cause a low-grade infection, but too low to be seen using current laboratory assays.5 Stress is also thought to play a role in viral reactiviation.
Cytokines may also play an important role in the more systemic effects of allergic rhinitis, symptoms that include fatigue and difficulty concentrating. One possibility is that allergy stimulates the release of cytokines, which have been shown to produce achiness and fatigue, as well as cognitive impairment. It may also interfere with adrenergic and cholinergic activity in the central nervous system, thereby impairing attention.1
In my December 2002 article, "Flushing Out Myths" (www.massagetoday.com/archives/2002/12/08.html) I advanced the opinion that post-massage reactions similar to flu might be due to an induced response of normally subclinical fibromyalgia; a concept advanced by Leon Chaitow.2 I noted: "I tend to think of a body's neurochemical system on the edge of its ability to adapt being pushed temporarily beyond the edge by accommodating to the work being done. This reaction may be exacerbated by effects of athletic overtraining or by a genetic metabolic predisposition." The post-massage production of proinflammatory cytokines would be a possible mechanism leading to this result. Chaitow has also noted the involvement of cytokines in fibromyalgia.
The possibility of inducing a proinflammatory response should caution us not to probe too deeply, too fast into the unknown client. It is better to start a first session moderately and then adjust based on following up the client's response. On the other hand, since the immune response is impacted by stress, reducing perceived stress and its effects within the musculature may help the client's body to cope with the otherwise unmanageable. Sometimes our lesser effort is more. It's all in the intention and the attention we bring.
Editor's note: Due to the transient nature of the Internet, some links may not be operational.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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