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Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
It's Time to Wake Up
It is time for this profession to wake up and tell someone about the healing benefits of acupuncture. This is the time for Asian Medicine. Its popularity, growth and unusual acceptance is nothing short of amazing.
The Ethics of Herbal Prescribing
While teaching ethics classes, I often encounter licensed acupuncturists who are surprised that our use of herbs and supplements has a specific section in the material. It is often an aspect within ethics that clinicians don't think of in practice.
Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
Patient Retention Techniques
When talking about techniques to grow your business, we tend to focus on the "large" aspect of the patient base, that is, on strategies to attract new patients. However, it is important to remember that "loyal" is equally, if not more, important.
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
ASA Ready to Impact Profession
The American Society of Acupuncturists (ASA) is a 501(c)6 (pending), not-for-profit collaboration among state based, acupuncturist professional associations.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
Online Marketing Basics: Website Creation
The various online marketing options make it a challenge, especially when all you want to do is help your patients feel better. With such a broad topic, I'm going to share some basics you should know about website creation.
Exercise Recommendations for Healthy Aging
Aging is inevitable, but how you age is not. Common physical signs of aging include decreased muscle mass, decreased muscular power, increased body fat, and decreased aerobic (lung) capacity.
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
Fish Oil: A Key Component to Positive Clinical Outcomes
Patients seem to be presenting with more complex problems, and many are responding to care more slowly or have completely unexpected results. Why?
Relationship Marketing: A Modern Approach
Remember when you used to get real letters in the mail? Not the automated type, but the real deal, hand written with a personal message just because someone was thinking about you? You know what I'm talking about.
Teaching Qi Gong to Children
Many of us have come to embrace Qi Gong or Tai Chi practice as a regular part of our lives. Qi Gong has been a stabilizing factor in my life for the last twenty years.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 1
All humans, by the very nature of being human, will experience moments of trauma and suffering. What, then, makes the difference in how the individual who experiences trauma, suffering, and spiritual loss reacts to such experiences?
What to do When Today Sucks
Have you ever had one of those days when nothing went the way it should have? The patient with migraines got worse instead of better from a treatment similar to one you've effectively used on him before.
Acupuncture Treatment of Trauma in the Canine
From 1972 until 1976, John Ottaviano and I were treating dogs at five different veterinary clinics in the Los Angeles county area. Usually, we were at a clinic for seven to eight hours.
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
Healing the Core: AWB Nepal Earthquake Relief Project
With almost 9,000 people killed during the earthquakes in April and May, another 23,000 suffering injuries, hundreds of thousands left homeless when entire villages collapsed, and many sacred sites destroyed, no one in this country of approximately 28 million has been left untouched by the disaster.
An Unexpected Superfood: All About Eggs
About 40 years ago, excessive dietary cholesterol was labeled a public health concern. Specifically, it was thought that there was a causal link between consumption of cholesterol-laden foods and increased risk of heart disease.
Integrative Sports Medicine
One of the most rewarding and challenging clinical scenarios is the treatment of athletes.
Peaching to the Choir: How to Extend Our Reach Beyond the CAM Community
Professional conferences offer unique opportunities to network, be exposed to cutting-edge innovators, share your interests and work, and be inspired.
Learning the Transformative Language of the Channel System: The Sinew Channels
The Chinese medical classics describe the energetic terrain of the body in much detail. The acupuncture channel systems, as presented in the Ling Shu illustrate the various expressions our qi energy can take.
July, 2004, Vol. 04, Issue 07
Spotlight on Research
By Michael Devitt
Editor's note: This periodic column keeps you abreast of the latest research documenting the benefits of massage and bodywork. Published research is summarized, with references to the full study text provided; abstracts of research are reproduced with minimal edits.
If you would like your research abstract or summary published in Spotlight on Research, please contact us at .
New Study Reviews Effectiveness of Massage Therapy: Researchers Draw Interesting Parallels Between Massage and Psychotherapy
Massage therapy is one of the fastest growing forms of alternative medicine in the country.A 1998 study found that visits to massage therapists increased 36 percent between 1990 and 1997.1 More recently, a study published by the National Center for Complementary and Alternative Medicine this May2 found that massage was the ninth most popular form of alternative medicine in the country, with an estimated 5 percent of the adult American population using massage therapy at least once in the past 12 months.
While the use of massage continues to rise, so has interest in massage research. While several meta-analyses of massage studies have been conducted in the past, each of them has been limited in scope, preferring to look at specific patient groups or types of massage. A new meta-analysis, published in a peer-reviewed scientific journal earlier this year,3 has taken a fresh look at the effectiveness of massage therapy in the adult population, and has concluded that it offers a wide range of physical and psychological benefits similar to those seen using other forms of care.
In the analysis, researchers began with 144 studies that fit their definition of massage, which was defined as "the manual manipulation of soft tissue intended to promote health and well-being." To qualify for inclusion, each study had to have been conducted on adults; studies on infants, or those employing therapeutic touch, ice massage, self-massage or massage with mechanical devices were eliminated. In addition, each study had to (a) compare a massage therapy group with at least one non-massage therapy control group; (b) randomly assign subjects to groups; and (c) report data sufficient enough for a between-groups effect to be generated on at least one variable being studied.
Thirty-seven studies met the above criteria and were used in the meta-analysis. The studies involved a total of 1,802 participants, including 795 who received massage therapy. The average number of participants per study was 48.7; the average age of a participant was 40.6. In some studies, massage was delivered only once; in others, it was performed multiple times. On average, participants received 21.7 minutes of massage therapy per treatment application. Sixty-five percent of the studies reported using a trained massage therapist (or therapists) to provide care; 22 percent reported using a "minimally trained" person or persons; and 14 percent did not indicate the level of training by the person (or persons) administering massage.
Nine specific effects were measured in the studies. In studies in which patients received a single application of massage therapy, anxiety state, blood-pressure levels, heart rate, negative mood, and immediate assessment of pain and cortisol levels were examined. In multiple-application studies, trait anxiety, depression and delayed assessment of pain were investigated. In the single-application studies, massage therapy (MT) produced "statistically significant" positive results for three effects compared to patients receiving a placebo or a different therapy.
According to the researchers: "... the average participant receiving MT experienced a reduction of state anxiety that was greater than 64 percent of participants receiving a comparison treatment. MT was also more effective than comparison treatments in reducing blood pressure and heart rate. The average MT participant experienced a reduction in blood pressure that was greater than 60 percent of comparison group participants, whereas for heart rate, the reduction resulting from MT was greater than 66 percent of comparison group participants."
In a surprise finding, massage did not reduce cortisol levels significantly, a result that differed from conclusions obtained in previous studies. In addition, massage therapy did not exhibit any effect on the immediate assessment of pain or a patient's negative mood. Despite these contrasting results, the scientists noted that "the significant finding for the cardiovascular variables suggests that future research should examine whether MT might have an enduring effect on blood pressure such that it could be used in treating hypertension."
In the multiple-application studies, "some of MT's largest and most interesting effects" were observed. While massage didn't appear to affect one's immediate assessment of pain, "a significant effect" was found for delayed assessment of pain. Specifically, patients who received a course of massage therapy and were assessed several days or weeks after the last treatment session "exhibited levels of pain that were lower, on average, than 62 percent of comparison group participants," a finding that lends credence to the theory that massage may promote the reduction of pain by allowing restorative sleep to take place more easily.
The most significant effects of massage therapy were seen when measuring anxiety and depression levels. According to the researchers, "The average MT participant experienced a reduction of trait anxiety that was greater than 77 percent of comparison group participants, and a reduction of depression that was greater than 73 percent of comparison group participants." So great were these reductions that the scientists considered massage therapy almost as effective as traditional psychotherapy in the treatment of anxiety and depression.
Massage: The Psychotherapy of the 21st Century?
The results of the meta-analysis dealt a blow to some commonly held beliefs about the effectiveness of massage therapy. For instance, the failure of massage to provide a significant effect on the immediate assessment of pain "contradicts the theory that MT provides stimuli that interfere with pain consistent with gate control theory." In addition, while the reductions in blood pressure and heart rate supported existing beliefs that massage promotes a response in the parasympathetic nervous system, the authors noted that "if this theory is true, it would also be expected that a significant reduction in cortisol levels would have occurred, which did not."
One new theory the researchers put forth was that massage therapy "may provide benefit in a way that parallels the common-factors model of psychotherapy." In this model, the specific mode of psychotherapy delivered is secondary to other factors, such as a client's positive expectation for treatment, a therapist who is warm and has a positive regard for the client, and the relationship between the therapies and the client.
"The same model can be extended to MT, given the possibility that benefits arising from it may come about more from factors such as the recipient's attitude toward MT, the therapist's personal characteristics and expectations, and the interpersonal contact and communication that take place during treatment, as opposed to the specific form of MT used or the site to which it is applied," the authors suggested.
Given the proposed similarities between massage therapy and psychotherapy, one might think that the benefits derived from massage are, in layman's terms, "all in your head." As the researchers asserted in their conclusion, this is hardly the case, but it does lead to intriguing possibilities for future massage research.
"The idea that MT has significant parallels with psychotherapy, and that perspectives gained from psychotherapeutic research should be applied to future research, is not meant to suggest that MT delivers effects entirely by psychological means," the scientists explained. "Clearly MT is at least partially a physical therapy, and some of its benefits almost certainly occur through physiological mechanisms. In fact, one of the most interesting aspects of MT is that it may deliver benefit in multiple ways."
"... However, whether researchers wish to study MT as a physical therapy, as a psychological one, or as both, new research should examine not merely the effects resulting from MT, but also the way in which these effects come about," they advised. "It is only by testing MT theories that a better understanding of this ancient practice will result."
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