resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
A Simple Protocol for Holiday Stress
It's winter, a time when we should be deep in reflection, eating warming foods and sleeping long hours. Following nature's rhythms, we restore our bodies and minds in preparation for the renewal of spring.
Molecular Motors: Tiny Machines Behind the Rhythm of Life
In the clinic, we aim to restore healthy patterns of movement for qi that has gotten trapped or misdirected, or may have even collapsed. We may be focused on freeing stagnation, releasing heat or redirecting counterflow qi, but it often comes down to helping re-establish a flow of sorts.
Chiro School Reunion: Whatever Happened to...?
I opened the door to the closet slowly, carefully, since I knew it contained a large number of precariously stacked file boxes. It also held numerous outdated gizmos with electrical cords of various lengths that could trip or strangle a person.
Herbs for Digestion: The Power of Bitter
Many cultures (and indeed herbal clinicians) around the world have long respected the role of bitter herbs and foods for promoting digestion. For example, aperitifs – drinks consumed before a meal to stimulate appetite and digestion – were originally derived from bitter herbs.
Branding: Set Your Practice Apart
Dr. Brad started his practice seven years ago on a shoestring budget. He created his generic logo in five minutes using a website because he didn't have the time to figure out how to make something special.
What We Can Learn From Spine Surgery
Patients with lumbar stenosis presumably present for conservative care to improve their quality of life and avoid surgery. However, providing clear guidance to these patients can be difficult for a number of reasons.
Meshing TCM With Environmental Pediatrics: Where's the Overlap?
Pediatrics has a long history within Chinese medicine dating back to the late Han dynasty (i.e., the late 200s CE), with the two primary areas of emphasis being herbal medicine and xiao er tui na (pediatric massage).
Overuse Injuries in Young Athletes (Pt. 2)
Most overuse injuries are benign, but there are some high-risk injuries that, if unrecognized or inappropriately treated, can result in significant loss in time from the sport or even require leaving the sport.
A First for the Profession: CCE Accredits First Chiropractic Residencies
The Council on Chiropractic Education (CCE) has awarded accreditation to all five chiropractic residency programs currently administered at Veterans Administration facilities, "the first residency programs in the nation ever to be awarded this distinction, a significant advancement in the evolution of chiropractic education," according to a VA press release announcing the milestone.
End of an Era Looms at NYCC
New York Chiropractic College recently announced that Dr. Frank Nicchi will retire in August 2017 after 36 years with the college, the past 17 as president.
Little Sticker, Big Impact
It's the end of an election year. Hilary Clinton and Donald Trump were the subject of conversation for everyone, everywhere for the entire 2016 calendar year. I don't think any of us can deny that this election affected us all very deeply on a personal level.
All Fiber Is Not Created Equal
Sometimes the best place to start is at the end. So, the conclusion of this article is that all fiber is good ... but some fiber is better. Let's break it down. There are two main types of fiber: soluble fiber and insoluble fiber.
DVT: Know the Signs and You Could Save a Life
I lost a friend several months ago. He died from a pulmonary embolism (PE) secondary to a deep-vein thrombosis (DVT) that originated in his lower leg. Bobby was in his mid-60s, soft-spoken and had a big heart.
Can a Multivitamin Reduce Breast Cancer Recurrence?
There is a great deal of controversy regarding the value of multivitamin supplements in cancer prevention. However, with respect to preventing breast cancer recurrence, an important study was published in the Journal of Breast Cancer Research and Treatment in 2011 by Kwan ML, et al.
6 Steps to Make 2017 Your Best Year Yet
People often ask me what defines success. Success, for me, is simple: doing exactly what you want to do in life. Whether it's the kind of practice you run, your life at home, your hobbies or something else, it's achieving anything you put your mind to.
A Letter to the Profession from the New President at AAAOM
Volunteering for a national, nonprofit organization brings with it such highs, lows, and accomplishments, as well as a steep learning curve.
Southwest Acupuncture College Brings It to Division 1 Athletes
When Michael Phelps' photograph with the distinctive round marks left by cupping went viral, the Division 1 student athletes treated through the Dal Ward Athletic Center at the University of Colorado (CU) could relate.
A Q & A About Updated Codes
Yes, indeed there was an update to ICD-10 on Oct.1, 2016. This is a regular update to the diagnosis coding system and this type of update will occur every Oct. 1, just as it did when the ICD-9 system was in place.
Assessing Core Stability and ROM: 5 Basic Checks
One of the first steps in addressing core stability is assessing static posture, ranges of motion, and motion of the pelvic bones, sacrum, femurs, lumbar spine and thoracic spine.
News in Brief
New President / CEO Takes Office at Yo San University. Electroacupuncture for Constipation?
Dedicated to Defending Chiropractic
Whether you're a veteran DC or a first-trimester student, the name George McAndrews should be part and parcel of your professional vernacular, as familiar as the word chiropractic.
2016: A Year in the Life of Acupuncture
Happy Holidays, may you, your family and friends have peace, joy and blessings throughout this special time of year. As 2016 comes to a close, we can look back and celebrate the many events and accomplishments for the profession of acupuncture.
Another Chance to Make a Difference
Just a few months ago, "the worst natural disaster to strike the United States since Hurricane Sandy" hit Louisiana. During this storm, one area experienced 31 inches of rain in 15 hours as almost 7 trillion gallons of water rained down in just one week across the state.
July, 2008, Vol. 08, Issue 07
Giant Cell Arteritis
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
My previous column looked at polymyalgia rheumatica (PMR), an idiopathic condition affecting mainly Caucasian women from 50 to 80 years old and characterized by sudden onset of muscle and joint pain, especially around the shoulders and hips.This month, we will address a very different condition, giant cell arteritis (GCA), which has a very different etiology and symptomatic profile, but occurs so often in the same people affected by PMR that many researchers wonder if the two conditions might be connected.
What Is It?
Giant cell arteritis, also called granulomatous arteritis, is a condition in which medium and large-sized arteries become inflamed. This inflammation might be body-wide, but symptoms often center around the face and head, so synonyms for this condition are temporal arteritis and cranial arteritis.
GCA usually affects a specific population: Caucasian women between the ages of 50 and 80. (Men can have it, too, but they account for a small percentage of diagnoses.) In this group, the incidence of the condition ranges from 0.5 to 27 per every 100,000 people. The further north, the higher the incidence. Scandinavia has the highest rate of GCA in Europe, while Mediterranean countries have a low rate.
The causes of GCA are not well-understood. Most experts agree it probably is a combination of genetic predisposition and dysfunctional immune response that might be triggered by a pathogenic exposure.
A high overlap exists between people who have GCA and people who have had polymyalgic rheumatica. Statistics vary, but about 15 percent to 25 percent of those with PMR have GCA and vice versa. This raises the question about whether these two conditions truly are freestanding, or if they indicate different stages of progression in immune system anomalies.
The vessels most at risk are the superficial temporal arteries, the ophthalmic arteries, and more rarely, the aorta, subclavian and brachial arteries. The inflammation permeates disconnected patches of the tunica media of these arteries, and biopsies reveal characteristic abnormal "giant cells" that give the condition its name.
What Are the Signs and Symptoms?
The most predictable sign of GCA is a slow or sudden onset of a headache in a new pattern. It usually is restricted to the temporal-occipital area of one side, but it can be diffuse and bilateral. The pain feels superficial rather than deep. Sometimes, simply stroking the hair on the affected side can elicit symptoms.
The headache seen with GCA might be preceded by "prodromic" symptoms that resemble polymyalgia rheumatica: general muscle and joint pain, especially at the shoulders and hips. The jaw might become extremely painful, leading to problems with chewing and swallowing. Loss of appetite, weight loss and fever also might be present, but these are not consistent for every patient.
Perhaps the most alarming symptom of GCA is a change in vision including blurring, double vision or complete vision loss in one eye. It's important to act on this symptom immediately, as the vision loss with GCA might be permanent.
How Is It Diagnosed?
GCA is diagnosed through several measures. Blood tests look at the erythrocyte sedimentation (SED) rate and levels of C-reactive protein as indicators of inflammation. These tests are informative, but not conclusive; a biopsy of the temporal artery is necessary to confirm the diagnosis. This is a simple procedure that can be performed in an outpatient setting, but because the complications of GCA are so serious, treatment might be initiated before the results of the biopsy are obtained.
What Are the Complications?
The most common complication of GCA is permanent vision loss. This usually is the result of a condition called anterior ischemic optic neuropathy. In other words, the optic nerve is damaged because of ischemia. This occurs in up to 50 percent of all people diagnosed with GCA. In addition, inflammation of the major blood vessels can cause blood clots in the brain (leading to transient ischemic attack or stroke) or the larger arteries can weaken and bulge (aortic aneurysm).
How Is It Treated?
High-dose steroidal anti-inflammatories are the first recourse for someone with GCA. The sooner this regimen is begun, the better the chance of saving the patient's vision, so it's worth being aggressive. Low-dose aspirin often is recommended as well, to reduce the risk of forming dangerous clots in inflamed arteries.
The steroid prescription for GCA typically is a long-term commitment: two years or more, tapering off when inflammatory markers in the blood come back to normal ranges. The consequences of prolonged steroid use, especially for mature women, can be serious. They include bone loss (which might be mitigated with medications to increase bone density), hypertension, muscle weakness, cataracts, hyperglycemia, risk of diabetes, immune system suppression and thin skin with easy bruising.
What About Massage?
A client in her 50s or older who reports a headache in a new pattern, especially with vision changes, should go to a doctor before going to a massage therapist. A client with polymyalgia rheumatica must be vigilant about visual disturbances, as this is considered a medical emergency. Because the vision problems with GCA can be permanent, it's important to begin anti-inflammatory therapy as quickly as possible.
A client being treated for GCA might be a candidate for massage, but here the concerns shift to the consequences of long-term steroidal anti-inflammatory use: bone density loss, skin damage, hypertension and other side effects. Furthermore, these medications can interfere with pain responses (their job, after all, is to suppress inflammation!), so the practitioner must be conservative to avoid the risk of overtreatment.
For Next Time
The table is clear and I have no specific requests in the pipeline. So, dear readers, I leave it up to you. What would you like to talk about? What's on Your Table?
Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.
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