resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
Essentials of Assessment: The Squat
The squat is a simple, fast and functional tool to evaluate patient symmetry and function. As simple and easy as it is to implement, it can yield considerable amounts of valuable, clinically relevant information.
Recording and Appropriate Billing of Timed Physical Medicine Services
There is a common misunderstanding about timed therapy services and although you do have some knowledge of timed service documentation, based on your comment on the 8-minute rule, your understanding is correct, but incomplete.
How to Find and Fix TL Nerve Impingements
The thoracolumbar junction (TLJ) and the peripheral sensory nerves that exit from it are frequent, important and rarely recognized sources of lower back, pelvic and hip pain. Let's outline a clear exam protocol for diagnosing the problem.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
Musculoskeletal Disorders Take Center Stage
Looking for the latest on the musculoskeletal pain epidemic and the increasing premium placed on preventive strategies including chiropractic? Check out The Impact of Musculoskeletal Disorders on Americans – Opportunities for Action.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
Vitamin D Fails to Help Knee OA? The Proper Perspective
The March 8, 2016 issue of JAMA includes a study about vitamin D supplementation for osteoarthritis of the knee. This is a really weird study.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
Business Lesson #1: Adapt or Else
My wife and I recently enjoyed an excellent meal at a restaurant recommended by some friends. We often have concerns about restaurant recommendations, as many have been disappointing.
The IME System: A Current Public Health Risk and Solutions That Are Working
I strongly believe in the independent medical examination (IME) system. There are far too many doctors in every profession who are not following E&M protocols and never claim MMI (maximum medical improvement) has occurred for their patients, which has caused financial stress for many private and public carriers.
The Power of Eccentric Exercise: Hamstring Injury Prevention and Rehab
For almost 20 years, I've worked with professional athletes who make a living by running really fast. It goes without saying that hamstring injury (HSI) prevention and rehabilitation is a big part of what they expect from a sports chiropractor.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
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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