resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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?
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Pediatric Footwear: Function Over Fashion
As practitioners, it is not uncommon for parents to bring us their children to treat or ask us questions related to the pediatric population. Children's feet tend to be a perplexing region for parents and practitioners alike.
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.
May, 2006, Vol. 06, Issue 05
A Study on Massage and Symptom Relief
By Tracy Walton, LMT, MS
This column is devoted largely to the rewards and challenges of working with people who have been diagnosed with cancer. To that end, I will discuss clinical practice, research and education, all of which are important to this work.In particular, because people have a keen interest in the research on massage and cancer, I've compiled research on the topic and made it available in a bibliography at http://tracywalton.com/id8.html.
The number of studies on this topic is growing, but the quality of research varies, as it does in any discipline. Some studies show good, solid research methods, and others suffer flaws that compromise the integrity of the investigators' findings. In this column, I'd like to share one of my favorites. The work by Janice Post-White and her colleagues, based at the University of Minnesota in Minneapolis and the United Hospital in Saint Paul, is wonderfully designed.1
The investigators studied 230 people in chemotherapy. They looked at immediate symptom relief just after a session, and at overall effects from a course of four weekly treatments. They compared massage therapy to three other types of care: Healing Touch (HT), a specific type of energy therapy derived from therapeutic touch, including both off- and on-body components;2 Caring Presence (P), in which a provider was present in the treatment room with the patient, but with no touch involved; and a control condition of Usual Care (UC), consisting of standard medical care provided to patients, but with no special intervention.
To best describe the design of the project, I ask you to imagine you were a patient recruited for it. After consenting to the study, you were randomized to one of three groups - MT, HT, or P - receiving a 45-minute session of the intervention each week over four weeks. Although you had free choice to join up with the study, and were free at any time to leave it, you did not get to choose your group assignment - it was chosen for you randomly. Your vital signs were taken before and after each session, and you were asked questions about your symptoms at those time points to determine the immediate effects of the intervention. At the beginning of the first session and the beginning of the fourth session in the series, researchers asked you additional questions about pain, nausea and mood, and questions about your use of other complementary therapies. You were asked to keep a log of your medication use, and it was collected from you at each weekly session.
One interesting feature of this study is that investigators used a "crossover design," meaning each research subject served as his or her own control. You went through two, four-week periods in this study - one week getting an intervention such as MT, HT or P, and one week as a "control subject," in which you completed the same kinds of measurements but received no intervention, just your usual medical care (UC). The order in which you spent time in the control and treatment conditions was random: some of you had the four weeks of treatment first; some of you had the control period first. A several-day "washout period" took place in between, to be sure the first period didn't influence the second one.
One thing I admire about this study is how researchers timed the sessions. Because the patients were in chemotherapy, they were subject to the ups and downs of strong medical treatment, which can follow a cyclical pattern after the drug is delivered. Symptoms such as nausea, anxiety, profound fatigue and pain can ebb and flow during chemotherapy, depending on how the patient responds to it. How someone feels depends a lot on when you ask. Unfortunately, this variability can significantly "confound" or muddy the outcomes of a research study. What if fatigue is measured at a particularly bad point in one chemotherapy cycle, but at a better point in another? It would make it hard to assess the true effects of massage on fatigue.
The authors anticipated this and made sure that the two sets of measurements, one over a four-week control period and one over a four-week treatment period, occurred at the same time point in identical chemotherapy cycles. Their care with this timing is one key to the solid design of this study.
After all this, what were their findings? Some highlights: They found that MT and HT reduced pain, improved mood and increased relaxation more than presence or the usual care control. These modalities also lowered respiration rate, heart rate and blood pressure. These were immediate effects of the sessions, but they were consistent across all four sessions. Only massage significantly lowered anxiety, and only HT significantly reduced fatigue. No intervention lowered nausea, but investigators found that the timing of the weekly sessions was such that the patients' nausea scores were already low, and it's difficult to significantly reduce a symptom that is low in the first place. This is called a "floor effect," and since nausea typically is worse in the few days following chemotherapy and then resolves, higher nausea scores didn't get picked up in the weekly sessions (the first massage right before the first infusion; the second a whole week later). Finally, over a four-week course of massage therapy, patients used less pain medication than those in the other groups, and less than they did during their control group experience.
Does this study "prove" that massage helps? In general, it's good to steer clear of that term until we have enough additional well-designed studies to provide convincing numbers. The field needs a large body of evidence for such a strong statement. Certainly, the findings suggest benefit and the authors cite other studies that corroborate their findings. The most consistent finding among studies on massage and cancer is its effect on anxiety, which is supported by this paper. In my own promotion of massage, whether speaking or teaching, I'm finally starting to feel the support of those numbers. And, if you're an individual in chemotherapy, finding symptom relief with massage, you feel supported no matter what the numbers show. You're not likely to stop what you're doing to wait for the data to catch up with your experience.
This is a wonderful study, worth reading closely. In the growing body of research on massage therapy, this is one of the largest, strongest works to date. I'm planning a research update, including this study, at the Atlanta AMTA convention this fall. I appreciate the dialogue that flows from this work.
Click here for more information about Tracy Walton, LMT, MS.
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