resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
After two treatments for back pain, a patient presents for a third
session complaining of rapid breathing and wheezing that is made worse
during cold weather.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
May, 2005, Vol. 05, Issue 05
Spotlight on Research: Trager Approach Shows Promise in Treating Chronic Headaches
By Michael Devitt
This periodic column keeps you abreast of the latest research documenting the benefits of massage and bodywork. Published research is summarized, with references to the full study text provided; abstracts of research are reproduced with minimal edits.If you would like your research abstract or summary published in Spotlight on Research, please contact us at .
Named after an Illinois medical doctor, the Trager approach is one of several mind-body techniques used frequently by massage therapists in the course of care. A combination of massage, mobilization and relaxation, the Trager approach relies on gentle, rhythmic rocking motions and stretching techniques that promote easy and free movement and sensations throughout the body. A typical Trager session can last from between 60 and 90 minutes, and includes not only stretching and movements, but also a form of mental exercise called "Mentastics" that helps clients remember and recreate the experiences felt during the actual Trager session.
The Trager approach is usually employed to treat musculoskeletal conditions such as low back pain. In a study published in a recent issue of Alternative Therapies in Health and Medicine, however, scientists looked at the role Trager could play in the treatment of another debilitating condition: chronic headaches. The study found that the Trager approach reduced both the frequency and duration of headaches, with the added benefit of helping people cut back on the amount of drugs they needed to treat headache pain.
In the trial, 29 men and women were randomly assigned to either a medication/Trager group, a medication/attention-control group, or a medication-only control group. All of the subjects had been diagnosed with some form of chronic headache, and all were taking some type of headache medication to relieve the condition.
Patients in the Trager group were treated by a Trager practitioner once a week for six weeks. A typical Trager session lasted approximately one hour and consisted of three parts: 1) a brief, current patient history; 2) a series of movements performed by the practitioner with the patient lying on a padded table, on joint and soft-tissue areas of the patient such as (but not limited to) the head, neck, upper back and shoulders, designed to increase range of motion, ease tension, and encourage both site-specific and general relaxation; 3) teaching the client simple movements designed to help recall and recreate the movements achieved while the practitioner worked on the client, and encouraging the client to practice these movements between treatment sessions.
In the attention control group, subjects met with a physician once a week for approximately 20 minutes, during which time the physician examined the person's head and neck and recorded any pertinent findings or changes. The physician also discussed any headaches the subject experienced in the past week, and asked about medication intake, headache changes and overall well-being. Patients in the medication-only group had no scheduled visits with a health care provider during the six-week treatment period.
For two weeks prior to the start of the study and throughout the six-week treatment period, participants were required to keep a headache diary that documented the frequency, duration and intensity of headaches, and use of headache-related medications. Each participant also completed a modified headache quality of life (HQOL) questionnaire.
Compared to the attention and medication-only groups, patients in the Trager group experienced significant mean decreases in the number of headache episodes per week. Trager patients reported a 27.5 percent reduction in weekly headache frequency, while attention patients experienced only a moderate (3.7 percent) reduction in headache episodes. In the medication-only group, however, the frequency of headaches actually increased by 13.5 percent.
Significant differences were also seen in the area of headache duration. In Trager patients, the length of headaches decreased an average of 0.6 hours; in attention patients, average headache duration decreased 0.3 hours. As with headache frequency, headache duration for patients in the medication-only group increased by an average of 1.3 hours per week.
Perhaps most strikingly, "statistically significant differences" in medication use were seen between groups. In the Trager group, biweekly medication usage decreased an average of 44 percent per patient from baseline through the treatment phase of the study. Medication use among patients in the attention group decreased an average of 19 percent. Patients in the medication-only group, on the other hand, showed an average 25 percent increase in biweekly medication use.
Each of these factors appeared to have an impact on the participants' quality of life. Not surprisingly, patients allocated to the Trager group "showed a significant improvement in HQOL," a result the researchers deemed "encouraging." Interestingly, improvements in headache quality of life scores were similar between patients in the attention and Trager groups. While these scores were not significantly different, the authors noted, "[the] improvements for each of these groups were significantly better than the control group."
The investigators admitted some limitations to their study design, most notably the small number of participants (33 randomized subjects, including four people who withdrew prior to completing the treatment phase). They also observed that while the attrition rate for their study was relatively low, dropout rates of other headache trials have approached 50 percent, a situation that must be taken into account when planning future studies. Finally, the authors noted that different participants took different types of headache remedies. "In the ideal situation," they wrote, "the medication used by all participants would be the same pharmaceutical preparation, and a clearly defined increase or decrease of specific drug type would be measured."
Limitations notwithstanding, the scientists suggested that the improvements seen in headache patients given the Trager approach "support the potential efficacy of Trager in treating chronic headache."
They also recommended that the results of the current trial be used as the framework for a larger, more ambitious study. As the scientists wrote in their conclusion: "In this first randomized trial evaluating the efficacy of Trager in treating chronic headache, we have demonstrated that the Trager approach decreased both headache frequency and medication usage, and that both Trager and physician attention improved the HQOL measurements in chronic headache patients ... the patient improvement in frequency, HQOL, and medication usage while under the care of the Trager practitioner implies that properly focused attention, combined with Trager's manual approaches, is an effective and promising treatment for chronic headache.
"... Demonstration of equivalence between the Trager method and the attention control group in a randomized, controlled, pilot study such as this, is the first step in scientifically assessing the efficacy of alternative treatments. Thus, this pilot study has provided data for the design feasibility of a larger, phase III multi-site trial."
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