resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
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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