resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. 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.
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
May, 2006, Vol. 06, Issue 05
Client Sensitivities to Aroma
By Shellie Enteen, RA, BA, LMBT
Following the publication of my article on treating fibromyalgia (FM) with essential oils, several readers contacted me with questions about what to do when clients appear to have difficulty with scents.Of course, this is a topic that has relevance for a broader population than those with FM.
I do not believe that sensitivity to aroma is a result of, or indicator for, FM, and so I would not consider aromatherapy a general contraindication for that diagnosis. In fact, Lynne K. Matallana, president of the National Fibromyalgia Association (NFA), has said the following:
"The National Fibromyalgia Association suggests that individuals who suffer with the symptoms of fibromyalgia implement a self-management program which incorporates both Western and complementary approaches to health care. Some people with FM are very sensitive to medicines and prefer to use more natural health care options. Dealing with the constant pain and fatigue of fibromyalgia can be quite stressful and finding ways to help relieve stress can also help to reduce the overall symptoms of this chronic illness. Since fibromyalgia involves an increase in neurological sensitivity, both physically and emotionally, practices that are calming can bring a sense of relief. To accomplish these goals, we suggest aromatherapy alone or in combination with massage and other relaxation techniques. The use of fragrant herbs or oils can help promote sleep, calm the mind, decrease muscle pain, increase circulation, relieve headaches and promote a general sense of well-being. To find credible information on aromatherapy, you can contact NAHA (National Association for Holistic Aromatherapy), www.naha.org."
It's important to know there are misconceptions about aromatherapy that have been communicated by people who have an agenda or have had insufficient education, or both. An agenda could involve the sale of essential oils, or it might arise from a competitive point of view from a practitioner of another modality. I can assure you there are wonderful scientists in the field of aromatherapy who are very up-to-date on contraindications, toxicity and safety issues, and the latest information from research being conducted throughout the world. The NAHA Web site has sections devoted to "frequently asked questions," safety and research. You can rest assured that the information you find there is credible.
People contact essences on a daily basis in food, as well as in cleaning and cosmetic products. Thus, it is not surprising that most of the research on essential oils has been conducted by the food and cosmetic industry, the largest users of essential oils. Issues of toxicity and sensitivity are important with distribution and accountability on such a large scale.
On the topic of sensitivity in general, I once heard a teacher who also sold essential oils falsely advise her students, "No one is allergic to true essential oils." There are times when a person can have sensitivity to the chemicals in synthetic fragrances and do well with true essential oils, but the truth is that a person can be allergic to anything. And there are essential oils that are known sensitizers. It's wise to consult a book such as The Aromatherapy Practitioner Manual, Vols. I and II, by Sylla Shepard Hanger, and learn possible contraindications for essential oils, particularly before using them on the skin. A proper client intake form should have a question about sensitivity to aromas and a place to list allergies. Case notes should list the essential oils (and the number of drops) used in a treatment, so the client has access to that information if a reaction occurs.
I have been fortunate; in more than 15 years, I have known only one client who appeared to have a reaction to a blend I used. What does a reaction look like? It can be a skin rash, a digestive response, nasal congestion/sneezing, or in this case, a headache. The good news is that once the client removes the blend and avoids additional exposure, the reaction goes away. There have been no cases of anaphylactic shock associated with the use of essential oils on the skin in the current research literature. So, while there is a chance of temporary discomfort resulting from an aromatherapy treatment, there will be no serious, lasting damage due to the application of diluted essential oils during a massage.
I interpret sensitivity to aromas as an aversion to inhaling fragrance. If this type of sensitivity were present, a way to add essential oils to the treatment would be to choose aromas that are commonly experienced on a daily basis and use them in high dilution. If they are not known allergens for the client, the citrus oils - orange, grapefruit, lemon, mandarin, lime, tangerine and bergamot - might easily be tolerated in high dilution (two or three drops to an ounce of carrier oil.) Citrus oils have an uplifting, encouraging effect, but also are soothing and relaxing. The essence of common cooking spices enhances circulation, bringing warming and a feeling of protection. Rosemary, thyme, ginger, cinnamon, nutmeg and even black pepper in high dilution (one drop per ounce of carrier oil) could be acceptable. And finally, a common wood aroma, such as pine or cedar, might be considered if these are not known allergens. Naturally, if the client refuses all aromas, you will have to do without this tool.
Please see prior articles on my columnist page (www.massagetoday.com/columnists/enteen) for more information on the properties and use of relaxing and stimulating essential oils. In future articles, I will explore some of the other misconceptions about aromatherapy. As always, I welcome your questions and comments!
Click here for previous articles by Shellie Enteen, RA, BA, LMBT.
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