resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
East Meets West
Gung Hay Fat Choi. Welcome to the year of the Monkey. There will be fireworks for both January and February this year. What great celebrations.
Do Doctors Lie to Patients? (Do You Lie to Yours?)
In a previous column ["When Patients Lie (Bribe or Flatter)," Oct. 1, 2015], I discussed the issue of patients lying to doctors, and the many reasons why this can occur.
Percussion Therapy: An Experiment
My study of qi began more than 20 years ago — long before my study of TCM, points or pathways. It all started with an awareness in my hands and physical manifestations in the way of blockages while working on clients.
Yo San University Helps Make LA Communities Healthier
An element of healthcare training often overlooked is the residual benefit to communities served by Acupuncture and Oriental Medicine (AOM) schools nationwide.
Chiropractic Around the World: WFC Country Reports December 2015
The following country updates are reprinted with permission from the December 2015 World Federation of Chiropractic (WFC) Quarterly World Report. Information is excepted for space and edited to DC-specific style guidelines.
Diet, Nutrition and the Context of Risk (Part 1)
Food and supplement safety is a topic that often comes up when I speak to chiropractors for CE relicensing, even when it is not the advertised subject.
Billing and Coding for Moxibustion
Q: I am trying to locate a code for cupping and moxibustion, and have had various fellow acupuncturists indicate that they bill using the existing codes for heat, 97010 hot packs or 97026 infra-red for moxa and 97016 vasopneumatic device for cupping.
Lab Rats (Roaming the Streets)
The title of this article is an accurate description of American consumers (regardless of age) in the modern era.
Asking the Insurance Rep the Right Questions
One of the first or last questions a potential patient often asks is: "Do you take insurance?" An ill-informed or optimistic, "yes" can result in delayed or non-payment. Instead, just say: "Let me check if you are eligible first."
RAND Study Recruiting DCs
Dr. Ian Coulter, RAND / Samueli chair for integrative medicine and senior health policy researcher for the RAND Corporation, has issued a call for participation, recruiting doctors of chiropractic for a practice-based research study that will examine "the impact of evidence, outcomes, costs and patient preferences on the choice of treatment for chronic low back pain and neck pain."
Treating Pain: The Hypermobile Coccyx
When I write about the coccyx, I recognize that I am talking about a relatively small subset of patients. When I write for Dynamic Chiropractic, I am trying to reach 60,000 chiropractors.
From Antiquity to Modernity: Huang Qin Tang at Yale Medical School, Part 1
Traditional Chinese medicine is a coherent medical system with several unique characteristics: it originated almost 3,000 years ago; in its area of origin, it has been practiced without interruption since its inception.
Changing the Cultural View of Medicine
Many hospitals in the U.S. are incorporating integrative clinics that include Traditional Chinese Medicine. Cleveland Clinic has led the charge for adding a traditional Chinese herbal medicine clinic to their existing acupuncture program.
Ethics: The Glue That Holds Us Together
Kudos to the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) for creating a code of ethics for the nationwide profession and for deciding to make courses in ethics a requirement for certification renewal.
Is There a Neurological Basis and Correction for Macular Degeneration?
Macular degeneration, aka AMD (age-related macular degeneration), is a common eye disease and a leading cause of blindness in people age 50 years and older, according to the National Institutes of Health National Eye Institute.
Interprofessionalism: What it Means and Why You Should Care
Interprofessionalism in education and in practice is a growing trend across health care in the United States. The idea that team-based care and collaborative practice can improve health care has been around more than 50 years.
The Roots of Insomnia
One of the most common clinical presentations is insomnia. Next to digestive disorders, sleep disorders are one of the most common complaints the clinician will encounter in daily practice.
Forgotten Options for Musculoskeletal Health
Challenges with musculoskeletal health are of tremendous concern for many people today.
How to Humanize Your Content to Create Stronger Relationships
Content marketing is about building relationships, whether that is through updates on social media, offers on your website, blog posts, email campaigns, or even printed material. Now days a business needs to make a human connection.
The MRI: What to Do With the Results
As I wrote in my previous article on this topic, it is my goal for you, the doctor, to be an expert in interpreting MRI images yourself; and to be able to independently make decisions based upon a combination of clinical presentations and findings, followed by the MRI images.
The Clinical Versatility of Milk Thistle (Part 2)
Evidence is growing that the silymarin complex of flavonolignans from milk thistle can impact serum ferritin and iron overload in various clinical circumstances.
Window of the Sky Points
The acupuncture points known as Window of the Sky are a modern creation. There is no reference in Chinese medical texts for an acupuncture point category called Window of the Sky.
Enhancing Performance in Cross-Fit Athletes
Cross-fitness centers are expanding in number and increasing in popularity. To remain relevant to this growing portion of society, practitioners need to learn about the exercises and injuries common to this group.
Integrative Medicine Can Shape the Profession
As the AOM profession struggles to define the role of "integrative" medicine within their practices their schools and organizations, students, faculty, alumni and administrators at schools wrestle with discussions of how much, where, how, and what to "integrate."
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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