resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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?'
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?
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.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
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.
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.
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.
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.
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.
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).
October, 2006, Vol. 06, Issue 10
By Whitney Lowe, LMT
Osteoarthritis is the most common type of joint disease and involves degenerative changes at synovial joints in the body. It's a challenging condition to treat and is becoming an economic burden to the health care systems in many countries.In the U.S., for example, the number of adults with arthritis is projected to increase from 42.7 million in 2002 to around 65 million in 2030, due to the aging population.1
Synovial joints are the ones affected in osteoarthritis. Within the synovial joint are the articulating bones, articular cartilage, a fibrous joint capsule and synovial membrane, synovial fluid, and joint cavity. These structures work together to create smooth gliding movement where adjacent bones contact each other. Maintaining this surface is especially important in the weight-bearing joints, such as the hip or knee, as excessive compressive stress can lead to bone degeneration.
Osteoarthritis is divided into two categories: primary and secondary. Primary osteoarthritis develops gradually from excessive wear on the joints, but the specific factors that lead to the condition are not well understood. Repetitive stress to the joints of the hips, knees and hands in certain occupations could play a role in creating the problem for some clients.
Secondary osteoarthritis develops as the result of some other disease or pathological condition. Traumatic injury to the joint can initiate joint damage that leads to cartilage degeneration. In other cases, surgery, obesity or various activities are directly related to the condition's onset. The condition is prevalent in soccer players due to impact trauma, and in weight lifters because of their increased body weight.2,3 Greater weight and joint degeneration also can increase the likelihood of lower extremity postural distortions, such as genu varum (bow leg) and genu valgum (knock-knee). Both of these distortions lead to more joint wear and increased chance of developing osteoarthritis.
In some cases, inflammation from osteoarthritis stimulates bone spurs to form around the joints, causing further pain and dysfunction. The spurs are common in the interphalangeal joints of the fingers. They are called Heberden's nodes when they develop at the distal interphalangeal joints and Bouchard's nodes at the proximal interphalangeal joint.4 Spurs that develop from spinal osteoarthritis (also called spondylitis) can press on adjacent nerve roots and mimic intervertebral disc herniation.4
Osteoarthritis produces pain in the joints that is aggravated with movement. Due to continual use, pain usually is worse later in the day. Joint swelling might increase with activity. Pain sometimes arises from long periods of immobility or even from changes in weather, although the association between weather and arthritis symptoms still is not clear.5 Unlike systemic forms of arthritis, such as rheumatoid arthritis, there are no effects to organs or other remote tissues. The tissue damage is confined to the surfaces of the affected joints, although pain can be referred to other locations.
Osteoarthritis typically affects the fingers, spine, hips and knees. While it periodically occurs in other joints, it is not common in the shoulder, elbow, wrist or ankle. It does appear to have a hereditary pattern, but a direct congenital cause of osteoarthritis has not been established. There is a greater incidence in younger males and females over 45 years of age.6 Pain usually is worse in the later part of the day, and the client also might complain of swelling, heat, and crepitus in the joint. Reports of aggravated pain with changes in the weather are common. The client also might report an increase in symptoms as a result of long periods of immobility, especially if the condition is more advanced. Joint swelling is evident in many cases, but absence of visible swelling does not indicate absence of the condition.
Characteristics in Physical Examination
The affected joints might be tender to palpation due to increased swelling in the area. Tenderness is more common if the condition is advanced or if palpation presses the affected joint surfaces together. Bone spurs, if present, can sometimes be felt around the affected joint, especially in the fingers.
Active and passive motions can cause pain in any direction the joint is moved. However, pain can fluctuate with the time of day or the degree of aggravation of the joint. If the affected joint is a weight-bearing joint, pain is worse when active movement is performed while bearing weight. Edema, muscle spasm or bone spurs could all prematurely limit the available range of movement. The end feel for joint motions tends to be a bit leathery and a capsular pattern of restriction typically is evident. In some cases, pain and weakness is evident during resisted motions.
A Role for Massage
While cartilage degeneration cannot be reversed, massage and stretching can be used to reduce muscle spasm and decrease compressive forces associated with the joint disorder. These approaches also are helpful in reducing edema resulting from inflammation. Avoiding activities that increase joint irritation, compression or inflammation is important. Weight reduction, rest, supportive braces and some exercise can be helpful, especially for osteoarthritis in the weight-bearing joints. If osteoarthritis is suspected, it's advisable to have it confirmed by a physician through X-ray. It also would be helpful to consult further with the physician for the most appropriate role for massage in the treatment process.
Click here for more information about Whitney Lowe, LMT.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.