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Talking to Patients About Lumbar Facet Denervation (Medial Branch Neurotomy)
Lumbar facet denervation, more appropriately termed medial branch neurotomy (MBN), is a procedure that may be considered when patients suffer from recalcitrant non-radicular axial back and/or leg pain.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
Low Back Pain in Professional Golf: A Common Muscular Relationship
Every sport creates its own unique demands on the body. Some sports require such a myriad of body positions that assessing pathology is often difficult and unpredictable.
Turning a Blind Eye to History – and Reality
The American Medical Association is taking the Supreme Court's Feb. 25, 2015 decision exactly as it always does – by turning a blind eye to history, legal precedent and reality.
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
Applying the Thin Skull Principle
The "thin skull" principle, also known as the "you take your victim as you find them" principle, is a legal principle that can be summed up by the following statement.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
Optimism = Compassion = Trust
A randomized clinical trial recently published online in JAMA Oncology examined how patients viewed their doctor based upon how the practitioner presented bad news to the patient.
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
Sleep, Less Sleep or No Sleep?
I had a dream I wasn't getting enough sleep. It was a very realistic dream, even though I was probably slightly awake and not really deep dreaming. Most likely I had been dozing, caught in that twilight of sleep and wakefulness.
A House Divided?
The American Chiropractic Association's House of Delegates voted on 30 resolutions at its annual business meeting in Washington D.C., but two in particular took immediate center stage due to their controversial nature.
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
A View From the ER
The University of Western States has inked an innovative agreement with local nonprofit health system Legacy Health whereby UWS sports-medicine fellows can experience observational clinical rotations in emergency-room settings within the Legacy system.
Functional Hip Impingement (Part 1)
Every time I sit down to write an article, I realize how much more there is to know about musculoskeletal pain. I also learn something new every time. (I want to give special thanks to Lucy Whyte Ferguson for assisting with this article.)
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
January, 2005, Vol. 05, Issue 01
Medical Massage and More, Part II
By Ralph Stephens, BS, LMT, NCTMB
In November, I shared my definition of medical massage, why I like the term "medical massage," and the importance of maintaining our status as first door providers (www.massagetoday.com/archives/2004/11/11.html).This generated some interesting responses. I want to share two of them. A physical therapist turned massage therapist wrote:
I find it amusing that as other health care professional like chiropractors, dentists, physical therapists, and even some MDs are fighting to get out of the insurance/government-controlled system and get back to cash practices, the massage profession is fighting to get in. Hoping for status, I guess, or recognition by the "gods of allopathy," or maybe ego gratification. I hope not just lust for money. There is no higher status than a first-door provider. Why not try learning our stuff - and maybe professionalism? A massage therapist, quite concerned about the egotism in medical massage, wrote:
I am one medical massage advocate that does not look down on relaxation therapists as a class and hope we never fit the Western medical model. It is just as much an art and skill to provide a high quality relaxation massage on the entire body, as it is to provide a high quality medical massage on the rotator cuff. The key words being "high quality." It is the individual's choice which area they want to specialize in. I do make a clear distinction between the two. If you look at them objectively, they share the same foundational techniques (strokes); however, they have very different intents.
Relaxation massage should intend to elicit the general parasympathetic response. It should soothe, nurture, promote and maintain wellness. If we had a health care system (we do not, we have a sickness care system), relaxation massage would be one of the premier modalities of wellness care. Relaxation massage therapists should be respected and well-paid primary providers of wellness health care; however, because I hold relaxation massage in high esteem, I believe relaxation therapists should know their anatomy, strokes, contraindications, and be very well trained, in general. It's not "just a massage"; it is wellness health care, and it should not be practiced by people with only a few weeks of training.
Medical massage exists because accidents and injuries do happen. Since wellness is not practiced in general, sickness occurs on many levels, including at the musculoskeletal level. Medical massage requires additional training, beyond the level of how to give a good full body massage. One must be able to address pain, injuries, dysfunctions, postural distortions, etc. Having knowledge about medical procedures and protocols is essential when working in a hospital, clinic, or other medical facility. So medical massage differs from relaxation massage in intent, direction (focus), scope, and quantity of training. Medical massage builds upon the foundation of relaxation massage.
However, the medical massage therapist should never lose sight of the wellness paradigm and always treat the whole person, not just the symptom. They should address the cause of carpal tunnel syndrome (in the neck and shoulder, for example) not just the symptom at the wrist. Of course, the first few appointments might focus on symptomatic relief for patient comfort, but the goal is to eliminate the cause. In the case of carpal tunnel syndrome, treatment should not be restricted to only the forearm by the prescription of a physician.
While medical massage therapists can work well with allopathic sickness providers, they should be there to provide an alternative, when appropriate, to more invasive procedures like surgery and drugs. Medical massage should also help with rehabilitation and recovery from surgeries and other injuries. If medical massage becomes controlled by the allopaths and insurance companies, it will most likely only be used like drugs to treat symptoms and not allowed to treat causes. Treating causes cures conditions, which allopaths hate because there is not as much money to be made in curing people as there is made treating symptoms.
Once they control massage, it will soon be eliminated from allopathic protocols, again. Drugs and technology phased out massage, or "manual medicine," during the 1950s. Massage has come back and now competes with their cash flow. The pharmaceutical cartel always tries to get control of a competitive procedure or discipline and co-op it. This is why I reject the Western medical model (sickness care) and hope we never get sold out to it. If we do, history shows it will be by the leadership of the profession. More on scope of practice in March.
Try this: When treating tennis elbow (lateral epicondylitis) and golfer's elbow (medical epicondylitis), remember that the involved muscles run all the way down to the hand and fingers. By examining and treating the entire muscle, you will get much better and faster results than just treating the injured tendons at the elbow where the symptoms manifest. Adding active movement of the muscles (flexion - extension of the hand) as you massage them will increase your therapeutic impact. Stretching both flexors and extensors of the forearm, for either condition, using Active Isolated Stretching - Mattes Method© should be done before and after massage. And don't forget to address the superficial fascia, preferably first.
Click here for more information about Ralph Stephens, BS, LMT, NCTMB.
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