resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
Animal Acupuncture: A Case Study in the Treatment of Traumatic Injury in the Equine
The rise of animal acupuncture in the U.S. began in the early 1970's as a result of the work by members of the National Acupuncture Association in Westwood, Calif.
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.
Integrating Art with Clinical Practice for Patients with PTSD: The Artemis Project
Are you restricted by those one-on-one clinic dynamics? Why not join colleagues and clients in experimental group settings? Three of us volunteered to do just that in Austin on behalf of women veteranss from all branches of the service.
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 Challenges of Integrating Eastern and Western Medicine
My Masters thesis was titled, "The Challenges of Integrating Eastern and Western Medicine," which highlighted several reasons why it is hard for these two worlds to mix.
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.
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.
Marijuana, Apathy and Chinese Medicine, Part 1
This article was written in response to the unheeded acceptance of marijuana as a harmless substance that potentially does good when used for the medical relief of pain.
Term Limits: What's in a Word?
It was the French historian and philosopher Voltaire who once declared the Holy Roman Empire was neither holy nor Roman nor an empire.
5 Tips for Using Pinterest to Market Your Practice
Pinterest is a very popular, but often under-utilized, social media platform where people can bookmark, or "pin," fun and interesting things from all across the internet.
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.
PCOM Granted Regional Accreditation
Pacific College of Oriental Medicine (PCOM) recently announce it has received regional accreditation from the Western Association of Schools and Colleges (WASC). This achievement reflects five years of hard work on the part of faculty, staff, and students.
Medicine is Clumsy, Don't You Be
All medical systems have clumsiness in them. If the technique isn't, the practitioner is. Everyone in every form of medicine is striving to improve. That is why we call it practice.
How Much Do You Know About the Benefits of Birds Nest?
Edible bird's nest is the nest made by the Swiftlet bird of Southeast Asia that is usually prepared as a soup and prized in Chinese culture as a healthful delicacy.
The Acupuncturist's Problem
I want share with you some observations and insights into what seems to be the most common problem my colleagues in the acupuncture profession struggles with. If you also struggle with this problem, I hope you get a valuable "aha" moment from reading this.
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.
The Tide is Rising in the Acupuncture Profession
Former President Ronald Regan said, "When the tide rises all boats float." The tide is rising for the acupuncture profession. Many forces outside the profession are helping the tides to rise.
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.)
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.
January, 2005, Vol. 05, Issue 01
Verruca Vulgaris: Warts!
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
Happy New Year! I am writing this in early December when the challenges of the holiday season are still in front of me, and the New Year appears to be far, far away, but I realize that soon we will be looking back at 2004 with nostalgia.I hope it has been a wonderful transition for all of you.
My last article on herpes simplex generated a fair amount of feedback: Some readers wanted more information on the prodromic stage of the infection, specifically, how to protect themselves before the lesions are visible. There is no easy answer to this question.
The best I can offer is that because herpes is a much less stigmatized infection than it used to be (we have way more serious sexually transmitted infections now!), people are more likely to tell us the truth on client intake forms about their condition. When we know someone has a history of herpes, it is fair and even responsible to ask them to reschedule their appointments, particularly if they know they are prodromic or in the midst of an episode. Outside of that, we are limited to using standard precautions and taking excellent care of our health and our hands. Ultimately, this is very effective. In my years of teaching this material to thousands of people, I've met maybe two who thought they might have picked up a herpes infection from a client.
Other readers wanted more information about what therapists with active lesions can do. Again, it depends mainly on you and your clients' comfort levels. Topical and oral antiviral medications can shorten the length of a herpes outbreak, but they don't prevent them and they don't reduce communicability of an active lesion. If a therapist has an active lesion, covers it to the best of his/her ability, and shares that information with the client, then the client should be able to decide if the appointment needs to be rescheduled.
One thing that didn't generate a lot of discussion was my request for you to let me know what you'd like to read about next. In the absence of a consensus, I will proceed with everybody's favorite viral infection, warts.
Definition and Etiology: Common warts, or verruca vulgaris, are caused by an infection with a type of human papilloma virus (HPV). This is a pathogen that targets keratinocytes in the skin, leading to an excessive pile-up of the hard, crusty proteins that make us waterproof. (Some varieties of HPV cause genital warts, which may lead to cervical cancer; it is not the same virus that causes verruca vulgaris.)
Common warts can affect anyone, but they are especially prevalent among teenagers. They are often discussed as a contagious disorder because any skin that flakes off around a wart, or any blood that seeps from around an irritated wart, may carry the virus. However, bear in mind that this is a slow and lazy pathogen, and a massage therapist would have to work hard to "catch" someone else's warts.
Warts do not typically create a strong or aggressive immune system response as other infections usually do. This allows them to grow for months or even years if they are not removed by other means. That said, they are notoriously tenacious, and many self-administered remedies (specifically with salicylic acid) may miss some infected cells deep in the lesion, leading to secondary rings of warts around the original site of infection.
Signs and Symptoms: Warts look like hard, cauliflower-shaped growths on the skin. They are especially common around joints on knuckles, fingers, elbows, and knees. They can also grow on the plantar surface of the foot (these are plantar warts), where they protrude upward into the soft tissues, causing pain and making it difficult to walk. It is important to be able to distinguish between plantar warts and callus, which can have a similar appearance. Some key differentiating factors:
When we have a client who we think has plantar warts, it is not appropriate to say, "Oh, look, you have a plantar wart." It is appropriate, however, to give some good advice about having the area checked by a dermatologist or podiatrist before the person tries to remove it with a pumice stone or a pair of clippers, since this is an excellent way to turn one mildly annoying plantar wart into several large, painful, and even crippling growths on the feet.
Treatment: Warts are usually self-limiting - that is, they eventually go away by themselves - but this can take weeks, months, even years. More often, people try varieties of methods to eradicate them, including salicylic acid, liquid nitrogen, lasers, scalpel excisions, and a newly proven technique:wrapping the wart in duct tape (It's almost all you need sometimes.)*
But where warts get really interesting is when they disappear in response to more subtle triggers. Warts are highly suggestible - so much so that our literature is laden with stories of how people have rid themselves of warts.
The plot of Tom Sawyer turns on his swinging a black cat over an unconsecrated grave at midnight, all to cure his warts so Tom can take Becky to the picnic.
Other folk remedies include rubbing the wart with a rooster comb and then burying it; wrapping a horsehair around the wart and sleeping on it; "selling" the warts to a loving relative; and, of course, the time-honored potato cure. These instructions came verbatim from one of my students: "Cut a potato into six pieces. Bury each piece in a different place, and never tell anyone where you buried them. Your warts will fall off in two weeks, because mine did."
All this points to a remarkable connection between belief systems and immune system activity. If a person at any level believes that having her Russian grandmother chant and then spit on her warts (another cure shared by a student) will work, it works! The branch of medicine called psychoneuroimmunology specifically addresses the often-mysterious links between mental and emotional state and immune system status. The study of warts may provide a "way in" to explore this highly promising field.
Massage and Warts: Massage therapists should consider warts to be local contraindications. Massage won't make them go away (unless the client thinks it will!), but the flaking skin or any crusting around the wart may carry some virus that may spread. Minimizing direct contact with the wart is adequate; however, this again is a slow and lazy pathogen that doesn't easily or aggressively spread from one person to another.
For next time: I've had a few general requests to address topics specific to our aging population: Alzheimer's disease and Parkinson's disease, in particular. Other readers have been interested in amyotrophic lateral sclerosis, or Lou Gehrig's disease. What would you like to read about? Let me know: What's on your table? All my best wishes for a healthy and happy 2005!
*Focht DR, Spicer C, Fairchok MP. The efficacy of duct tape vs cryotherapy in the treatment of verruca vulgaris (the common wart). www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=
Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.
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