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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.
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.
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.
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.
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.
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.
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?'
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.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
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.
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.
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.
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).
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.
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.
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.
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.
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.
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.
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
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.
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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