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House Calls With Dad
My father was a chiropractor and he did house calls. On Wednesday nights, while my mother attended the weekly women's meeting at the Odd Fellows and Rebekahs hall in our small town, dad loaded up the portable adjusting table, fired up the Pontiac and drove off to treat a few patients in their homes. I went with him.
Correcting Rib Dysfunction: Improve Patients' Pain, Posture and Breathing
As chiropractors, we tend to focus on the spine, and rightly so. Many problems our patients face can be corrected by manipulating the correct spinal level.
Gather & Grow
I recently attended a faculty seminar held by one of the acupuncture schools. There was a facilitator who led us through some very interesting experiences. The attendees were a diverse group with varying opinions.
AOM Residency at NUNM
Imagine you're a recent acupuncture graduate, worried about making enough income as you forge your new career and seek more in-depth training in a particular treatment style.
Near-Infrared Therapy for Diabetic Neuropathy
The pain experienced by people with diabetes is a symptom of diabetic neuropathy. The impact on quality of life is significant. Pain makes walking difficult, sleep troublesome, and eventually contributes to a decrease in social interaction.
VF Works / DMX Works Epilogue: Almost Two Decades Later, the Lawsuits Continue
An article in the March 8, 1999 edition of Dynamic Chiropractic examined whether then-VF Works / Nu-Best Franchising was selling its franchises illegally to doctors of chiropractic.
4 Things Every DC Should Know About Levels of Care & Prevention
As health practitioners, we help people with their health problems and assist them with health promotion and disease prevention.
Treating the Lower Pelvis (Pt. 2): Midline Structures and Fascia
My previous article [October 2016 issue] outlined evaluation and treatment of pelvic issues involving the sacrotuberous ligament and the pubic symphysis. Now let's discuss two case studies that illustrate how to address additional problematic areas of the pelvis.
Spiritual Initiation: Opening Your Higher Healing Abilities
People drawn to the field of acupuncture and Oriental Medicine tend to be those who march to the beat of a different drummer.
Advancing the "Whole Organ" Spine Model
Historically, the human spine has been organized by body region utilizing specific anatomical landmarks and transition zones.
Paperwork Done Wrong, Done Right
I was visiting a doctor's office recently and a member of his staff brought a stack of forms to his private office and laid them on the doctor's desk. She informed him he needed to complete the forms for patients and a few third parties.
The Acupuncture Channel System (Part 2)
The primary channels (main channels) are introduced in chapter 10 of the Ling Shu, these channels are referenced in many chapters throughout the Su Wen and the Ling Shu. The primary channels have become the main channel system used in TCM.
News in Brief
The American Association of Acupuncture and Oriental Medicine (AAAOM) board members recently met with the Korean Customs Service, which is similar to the FDA, to discuss herbal safety and importation issues.
ICA Goes on the Vaccine Offensive
Have you watched the vaccination documentary, "Vaxxed: From Cover-Up to Catastrophe," by Andrew Wakefield MD, director, and Del Bigtree, producer? This is the documentary Robert DeNiro was pressured to remove from his Tribeca Film Festival.
Waist Circumference: A Conversation Starter
New estimates suggest more than two-thirds of Americans are either overweight or obese. The medical significance of this statistic is astounding.
Helping Patients With Parkinson's Disease
Parkinson's disease (PD), a long-term degenerative disorder of the central nervous system that mainly affects motor function, has a slow onset over time.
TCM & the Caregiving Population: Treatment Considerations & Our Vital Role
Informal caregiving is increasingly a reality for many Americans who find themselves providing unpaid care for a loved one or a family member with a long-term, terminal, or chronic illness.
The Large Intestine Official
The large intestine (AKA colon) is the great eliminator, or as J.R. Worsley called it, "The Drainer of the Dregs." Dregs are defined as the remnants of liquid with its sediment left in a container, or the basest, least valuable portion of anything.
Reader Beware: Consider the Source
The aftermath of last year's presidential elections brought a running conversation on the role played by "fake news" that was largely presented via social media.
A Brief History of Acupuncture and Oriental Medicine Doctoral Programs
A doctorate in acupuncture and Oriental medicine has been a goal of the profession since its beginnings in the late 1970s. At that time, however, the maturity of the educational institutions and the regulatory environment made it a goal with only a distant completion date.
Latest Cassidy Study on Stroke Risk Published
The latest study to investigate whether a unique association between chiropractic manipulation and risk of cervical artery dissection / stroke exists has yielded similar encouraging findings, with the authors noting "no excess risk of carotid artery stroke after chiropractic care" and no significant risk difference between patients receiving care from a DC or a primary care medical provider.
Chiropractic in Texas Is Under Attack
The profession of chiropractic faces an unprecedented challenge in Texas, an attack that is more aggressive, sustained and dangerous than anything previously seen. The medical lobby has launched a coordinated, multi-front assault.
Getting Unstuck: Healing From Trauma With TCM, Qigong & Movement
We all come into this world vulnerable, with seeds to grow into our strength. Some of us — through a combination of good fortune (i.e., family and culture we are born into, constitutional inheritance, or ability to learn) grow with minimal interruption from traumatic injuries and experiences.
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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