resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Functional Hip Impingement (Part 1)
Every time I sit down to write an article, I realize how much more there is to know about musculoskeletal pain. I also learn something new every time. (I want to give special thanks to Lucy Whyte Ferguson for assisting with this article.)
Low Back Pain in Professional Golf: A Common Muscular Relationship
Every sport creates its own unique demands on the body. Some sports require such a myriad of body positions that assessing pathology is often difficult and unpredictable.
Turning a Blind Eye to History – and Reality
The American Medical Association is taking the Supreme Court's Feb. 25, 2015 decision exactly as it always does – by turning a blind eye to history, legal precedent and reality.
The Challenges of Integrating Eastern and Western Medicine
My Masters thesis was titled, "The Challenges of Integrating Eastern and Western Medicine," which highlighted several reasons why it is hard for these two worlds to mix.
PCOM Granted Regional Accreditation
Pacific College of Oriental Medicine (PCOM) recently announce it has received regional accreditation from the Western Association of Schools and Colleges (WASC). This achievement reflects five years of hard work on the part of faculty, staff, and students.
Talking to Patients About Lumbar Facet Denervation (Medial Branch Neurotomy)
Lumbar facet denervation, more appropriately termed medial branch neurotomy (MBN), is a procedure that may be considered when patients suffer from recalcitrant non-radicular axial back and/or leg pain.
Term Limits: What's in a Word?
It was the French historian and philosopher Voltaire who once declared the Holy Roman Empire was neither holy nor Roman nor an empire.
Medicine is Clumsy, Don't You Be
All medical systems have clumsiness in them. If the technique isn't, the practitioner is. Everyone in every form of medicine is striving to improve. That is why we call it practice.
The Acupuncturist's Problem
I want share with you some observations and insights into what seems to be the most common problem my colleagues in the acupuncture profession struggles with. If you also struggle with this problem, I hope you get a valuable "aha" moment from reading this.
A House Divided?
The American Chiropractic Association's House of Delegates voted on 30 resolutions at its annual business meeting in Washington D.C., but two in particular took immediate center stage due to their controversial nature.
5 Simple Steps to Create an Effective Marketing Calendar
In the educational experience of most healthcare practitioners, business and marketing are overlooked topics.
Optimism = Compassion = Trust
A randomized clinical trial recently published online in JAMA Oncology examined how patients viewed their doctor based upon how the practitioner presented bad news to the patient.
5 Tips for Using Pinterest to Market Your Practice
Pinterest is a very popular, but often under-utilized, social media platform where people can bookmark, or "pin," fun and interesting things from all across the internet.
Applying the Thin Skull Principle
The "thin skull" principle, also known as the "you take your victim as you find them" principle, is a legal principle that can be summed up by the following statement.
A View From the ER
The University of Western States has inked an innovative agreement with local nonprofit health system Legacy Health whereby UWS sports-medicine fellows can experience observational clinical rotations in emergency-room settings within the Legacy system.
The Tide is Rising in the Acupuncture Profession
Former President Ronald Regan said, "When the tide rises all boats float." The tide is rising for the acupuncture profession. Many forces outside the profession are helping the tides to rise.
How Much Do You Know About the Benefits of Birds Nest?
Edible bird's nest is the nest made by the Swiftlet bird of Southeast Asia that is usually prepared as a soup and prized in Chinese culture as a healthful delicacy.
Sleep, Less Sleep or No Sleep?
I had a dream I wasn't getting enough sleep. It was a very realistic dream, even though I was probably slightly awake and not really deep dreaming. Most likely I had been dozing, caught in that twilight of sleep and wakefulness.
Integrating Art with Clinical Practice for Patients with PTSD: The Artemis Project
Are you restricted by those one-on-one clinic dynamics? Why not join colleagues and clients in experimental group settings? Three of us volunteered to do just that in Austin on behalf of women veteranss from all branches of the service.
Animal Acupuncture: A Case Study in the Treatment of Traumatic Injury in the Equine
The rise of animal acupuncture in the U.S. began in the early 1970's as a result of the work by members of the National Acupuncture Association in Westwood, Calif.
September, 2006, Vol. 06, Issue 09
Dealing With Psoriasis
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
I was surprised to hear so little in response to my last piece on MRSA (methicillin resistant staphylococcus aureus); I had fully anticipated a lively discussion of this health threat to follow my article.Instead, the silence was deafening. I didn't get any suggestions for a topic for this article either, so I made an executive decision to pick up a topic of interest, at least to me: psoriasis.
What Is It?
The word psoriasis comes from the Greek root psora, which means "the itch." It's mainly a skin condition, although in some circumstances other systems can be involved as well. Psoriasis is quite common in this country, affecting 6 to 7 million Americans. It's most common in Caucasians. About 150,000 new cases are diagnosed every year.
How Does It Work?
Under normal circumstances, superficial skin cells are replaced roughly every 28 to 32 days. (Hmmm, a 28- to 32- day cycle. What does that make you think of?) What we see with psoriasis is that, in certain areas, skin cells replicate at a vastly accelerated rate: instead of a month-long turnover cycle, they are replaced every 4 to 6 days. The consequence is a patchy pile-up of keratinized epithelial cells, often with a silvery scale: these are the plaques of the most common form of psoriasis.
What we don't understand is why this happens. A genetic link might seem to be part of the picture, because the incidence of psoriasis is higher within families. Immune system anomalies are clear as well, and some experts classify psoriasis as an autoimmune disease - a situation in which immune system mechanisms are directed against healthy tissue by mistake. Psoriasis frequently appears with some other autoimmune disorders (ankylosing spondylitis, for instance), and it runs in cycles of flare and remission; both of these characteristics are common in autoimmune disorders.
Types of Psoriasis
Plaque psoriasis (Fig. 1) is the most common form of this disorder. It frequently appears over joints: knees and elbows are common. Some people have one small lesion that appears in the same place for a few weeks every year or so; others have huge lesions that might cover their back or trunk, scalp, hands or feet. Even when the condition goes into remission, the skin might sustain enough damage to appear permanently discolored and scarred. Other forms of psoriasis are less common, but good to know about:
Psoriasis doesn't usually involve dangerous complications, unless the lesions bleed and get infected, or unless a person with erythrodermic psoriasis has a fluid-loss crisis. However, about 10 percent of the people with psoriasis are at risk for a painful and possibly extreme form of arthritis, called psoriatic arthritis. If a client has psoriatic arthritis, treat it in the same way you would treat rheumatoid arthritis: avoid it when it's hot and inflamed and work for joint mobility and pain reduction when the joint is not actively inflamed.
We understand a lot about the process of how psoriasis develops, but this still is a basically idiopathic (of unknown origin) disease. Consequently, the treatment options for psoriasis are largely hit-and-miss efforts to control symptoms. Many people with psoriasis develop tolerance for medical interventions, and so, must constantly be looking for the next option.
Allopathic interventions include topical skin creams to reduce itching and help clear up plaques. Oral medication can work with controlled exposure to UV radiation to help this process. In very extreme cases, patients might be prescribed chemotherapeutic drugs to limit skin cell replication. All of these can help to control the frequency and severity of psoriasis outbreaks, but none of them are a permanent cure for the disease.
The newest strategy involves a group of drugs called TNF Blockers. TNF (tumor necrosis factor) is an immune system mediator associated with inflammation. Blocking its activity keeps the inflammatory process (and accompanying proliferation of extra skin cells) under control.
Alternative psoriasis treatments also vary widely. A search for "psoriasis cure" brings up dozens of products claiming to heal this disease. They range from herbal clay applications, to aromatherapy, to visiting the Red Sea so that a species of fish can nibble at the lesions (I am not making this up!).
Personally, I am open-minded to seeing dietary adjustments and herbal or homeopathic applications for psoriasis management, but I retain a healthy skepticism of any product that claims to "permanently cure" this condition.
In the olden days (as in, the days of Hippocrates), doctors were instructed to rub olive oil into psoriasis lesions. We know now that when psoriasis is acute, these are areas where cells already are hyperactive. Increasing energy or circulation to these sites might not be the best plan. However, it's important to point out that psoriasis is not contagious! Clients with psoriasis can benefit from bodywork that includes the whole body, as long as the stimulus doesn't increase itching or irritation. Herbal or aromatherapeutic agents could be useful in this context as well. If you have found an application you have seen to improve psoriasis symptoms, please share it with me and other Massage Today readers.
For Next Time
Gentle readers, let me remind you that this is your column! I am at your disposal to gather information on the pathology topics you want to read about. Please go through your client history notes and find one that makes you curious - and let us all know: what's on your table?
Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.
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