resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Workers' Back Pain: Causes, Costs & Solution
You will want to share two important papers published in the past several months. Why? When read separately, each provides valuable information relevant to your patients, community and practice; together, they tell a compelling story.
Getting Paid by Medicare Is Getting a Major Adjustment
The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law to implement a new approach to clinician payments and replace the Sustainable Growth Rate formula.
Treating Peripheral Neuropathy: Multi-Faceted Approach Including Laser Therapy
Peripheral neuropathy affects at least 20 million people in the United States1 and nearly 60 percent of all people with diabetes suffer from diabetic neuropathy. Many suffer from the disorder without ever identifying the cause.
Dysautonomia: The Medical Condition You May Already Be Treating
TCM practitioners have spent thousands of years healing patients without knowing or needing the names of their diseases as defined by allopathic medicine. We have syndrome names that are both poetic and efficient.
First Annual ICD-10 Updates Take Effect
Yes, there was an update to ICD-10 codes on Oct. 1. It was a regular update to the diagnosis coding system and will take place every Oct. 1, just as it did when the ICD-9 system was in place.
Pediatric Asthma: A Case Study
I have had very good success with pediatric asthma, combining acupuncture with Chinese herbal products. Treatment is given over four to eight months, twice monthly, with herbal formulas rotated every month.
Upgrade to "Parker 2.0" in Las Vegas
Continuing your education and refining your practice: two key elements of a successful chiropractic career. Parker Seminars promises both as it celebrates its 65th anniversary in Las Vegas next February, according to Parker University President, Dr. William Morgan, and seminar consultant Dr. Mark Sanna.
Going Beyond Just Feeling Good
We all know that most patients come to us for some pain complaint: neck pain, back pain, sciatica, carpal tunnel, etc. We also all know that acupuncture is a great first-line care for these issues, as well as supporting overall health and wellness.
National Board Apologizes for Testing Issues
The National Board of Chiropractic Examiners (NBCE) has issued a formal apology following a series of computer-based testing malfunctions that impacted two separate examinations (March and June 2016) and caused "widespread confusion and frustration" to the nearly 1,500 examinees taking the tests.
ITB Syndrome: Treat the Tensor Fascia Latae
Iliotibial band syndrome is usually the result of repetitive knee flexion, such as in runners or cyclists. Pain may be experienced in the knee and/or the hip. The patient may express a sense of the hip dislocating, popping or snapping.
Integrative Cancer Care: Chiropractic for Chemotherapy-Induced Hiccups
Hiccups (singultus) are a frequent occurrence during cancer treatment. The cause of the hiccups may be the chemotherapy drug itself, such as Cisplatin; or the prophylactic use of corticosteroids such as Decadron, which is used to prevent nausea and/or vomiting.
Four Ways to Attract Patients
Acupuncturist A has been in practice for six years and has struggled since day one. She spends as much time and money on marketing as she can, but since her practice is slow, her budget isn't that big.
Decoding the Mystery of Medical Insurance Acceptance
In the constantly evolving profession of acupuncture, one of the least understood areas is medical insurance acceptance. The profession is filled with controversy surrounding this topic: Is it ethical?
Update from the International AIDS Conference
The 21st International AIDS Conference in Durban, South Africa, brought together more than 15,000 of the world's leading scientists, activists, funders, policy makers, and consumers from 153 countries.
U.S. Olympians Have a DC in Their Corner
It's probably old news to you that doctors of chiropractic play an increasingly prominent role in treating athletes, from youth sports participants to weekend warriors, to elite / professional competitors.
Treatment Success at the Won Institute
According to the World Health Organization's 2003 report titled, "Acupuncture: Review and Analysis of Controlled Clinical Trials," acupuncture has been shown to improve many physical, emotional, and mental conditions.
Natural Cancer Prevention: Pomegranate for the Prostate
In recent years, the ingestion of pure pomegranate juice (8 ounces per day) has been shown in clinical studies with human subjects to slow, and to some degree, reverse, the progression of prostate cancer – the second leading cause of cancer death in North American men.
Power to the Patient
Against a backdrop of splintered political parties, polarizations within nations, civil unrest, and distrust of established government (such as the growing anti-Washington, D.C. sentiment) comes the not-so-surprising finding that health care authorities and practitioners (with perhaps the exception of insurers) are turning over more and more powers to the individual patient.
Using the Lens of Chinese Medicine
One of the most common medications I see in clinical practice on a daily basis is fluoxetine or Prozac. Consequently, I hear many complaints concerning the side effects of this medication and am frequently asked by patients to help manage these side effects with acupuncture and Chinese medicine.
Six Things Every DC Should Know About the Zika Virus
The Zika outbreak continues to spread across the continental United States and U.S. territories. We offer this brief overview on this important public health problem for the practicing doctor of chiropractic.
October, 2005, Vol. 05, Issue 10
Searching for Medical Massage
By Keith Eric Grant, PhD, NCTMB
I suppose I share a personality trait with a notable orange cat that once graced my life. Upon hearing a fence-top "discussion" among others of his kind, he would head toward the fray, rather than away from it.Only this trait can explain my entering into the current fray on the definition of medical massage.
If we are to call an area of massage "medical," then it seems it should have connection to those who practice medicine and the treatments they provide. To be both relevant and comprehensive, medical massage should both fall within medical interest in massage and be broad enough to span the scope of such interest. Because medicine directs its efforts toward the treatment of dysfunction, medical massage also would be expected to produce measurable outcomes within the context of such treatment. Where integrated with medical efforts aimed at preventative intervention, preventative use of massage also would be medical massage. Outcomes might be directly observable based on patient reports, or on third-party diagnostics such as laboratory blood analysis.
These thoughts gave me a sufficient focus to search the PubMed database (January 1997 through August 2005) for indexed articles with massage in the title and without the terms cardiac or carotid as a keyword; using the latter terms often retrieved massage in a medical context outside of our interest.4 Prior to 1997, the number of articles with online abstracts dropped off sharply, motivating the limit on how far back to search. What I retrieved for my efforts was 463 articles, from which I was able to visually select 172 as addressing the use of massage in the context of specific medical treatment. Of the initial 463, I first eliminated those not identifiable as relevant to massage as we mean the term. I next excluded articles simply introducing massage to another professional audience or describing the setup of a massage or CAM program. I also eliminated papers on sports recovery facilitation apart from injury treatment.
For each of the remaining articles, I attempted to identify the patient population that was targeted and the goals of the treatment. In Table 1, I've presented a summary of the populations served and in Table 2, the goals of the treatments provided. For several of the articles, either the population, treatment or both fell into multiple categories, such as children who are burn patients being treated for pain and discomfort as well as stress, anxiety and depression. Thus, my totals for treatment populations and treatment goals are both greater than 172.
While this survey of PubMed articles is far from being a complete and rigorous characterization, it clearly indicates the medical application of massage extends over a range of treatment needs and uses techniques from simple touch to highly clinical. The goals involve changes that are physical, neurochemical, emotional and behavioral. For me, a picture emerges from which I draw several conclusions.
First, the con-siderations of whether massage is medical and whether it is clinical-orthopedic are separate. Medically oriented massage draws on a diversity of skills and techniques. Similarly, orthopedic techniques can be used in a medical context or in, for example, the context of sports facilitation and maintenance. That a technique is not tissue-specific does not imply the absence of assessable outcomes. The only conclusion we can draw as to technique is that the practitioner should be working within his or her training.
A second conclusion is that those practicing medical massage will need to communicate and integrate within the medical environment, including having knowledge of terminology, privacy requirements, record-keeping and facility protocols. Dunn and Williams note, for example, changed expectations for physical privacy, uninterrupted time and presence of monitoring equipment and wires while working in hospitals compared to individual practice.2 This area of communication and protocols for medical integrations defines the single core area of training and knowledge pervasive to the medical use of massage.
Finally, a practitioner working in a medical context will need to know the needs of the specific population served on physical, emotional and social fronts. Renee Gecsedi points out, for example, the need for specific knowledge in working with cancer patients.3 "LMT's need information about a patient's cancer diagnosis, comorbidities, type of treatment and response to treatment to safely provide massage therapy. Nurses play an important role in conveying this information and [other] information LMT's [require] about any special considerations, such as the presence of neutropenia or thrombocytopenia. Safe and effective massage therapy to patients with cancer only is achieved when the patient, healthcare providers and LMT collaborate effectively."
Applications in gynecology and urology, while outside the current scope of practice in many states, were within the discussion of practice submitted for consideration to the British Columbia Health Professions Council in a relatively recent comprehensive review of health professions. In its reply, the HPC noted that norms on and availability of training are, as yet, inadequately developed.1 Lacking clearly identified areas of application and norms for the corresponding knowledge and skill requirements, likely are the greatest deficit we encounter toward medically-orient massage. We still need to work with other health care provides to create norms and guidelines for most applications.
To the extent medical massage is definable separately from massage in general, it is defined by its integration into a medical context and by its focus on treatment outcomes. We have a great diversity of opportunities for practice, and equally great opportunities to benefit our fellow inhabitants on this blue-green planet by realizing the full potential of massaging "medically."
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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