resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Code Connection: 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.
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.
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?'
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).
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.
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.
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.
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.
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.
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.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
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.
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.
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.
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.
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'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.
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?
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.
December, 2008, Vol. 08, Issue 12
Body Art: Tattoos and Piercings
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
A couple of years ago, I was teaching a class about massage and the parasympathetic effect. To make my point, I stood behind a student, put my hands on her trapezius and then began to do some gentle petrissage through her sweater.Chatting blithely away about blood vessel dilation, changes in breathing, and dropping blood pressure, I failed to notice that this poor, polite student was not enjoying her massage. She was wincing, tightening up and leaning away. When I finally noticed and asked her what was going on, she said she had just had a big tattoo put on her shoulders. The whole class gasped in sympathy.
On a related topic, a reader named Tamra sent me this note: "I was standing behind a person in the grocery store with surgical steel ball implants in her cervical area (bilaterally) from about C3 to C7, in what would be considered the lamina groove. I wondered as I was standing there: If she were my client and she had neck pain, what would I do? How would I treat her? I had no answers, only avocados."
I know that I am a good deal older than many of my peers in the massage profession, and I freely confess to being a bit of a fogey about body art. I was so grateful that the threat, "Whatever you have pierced, I'll have pierced. And then I'll show all your friends," worked on my children and I never had to shop for a navel ring. That said, for many people tattoos, piercings and other physical modifications are a mode of self-expression that is important and deeply meaningful. While, like anything, body art can be abused, it can also be very creative and empowering. In the words of Andy Barnett, a professional piercer and tattoo artist, "I want to adorn the body, not mutilate it."
Many of us have clients with various forms of body art. Under some circumstances this can require some adjustments in our work. This article offers a brief primer on tattoos and piercings, the challenges that they may pose for massage, and strategies that can help us be safe and effective practitioners in this context.
Tattoos are pictures drawn on the skin through shallow injections of colored ink. Tattoo artists use tiny needles and a rapidly pulsating machine to deposit the ink just under the skin. Standards for hygiene in licensed tattoo studios are high, so the risk of infection from contaminated equipment is minimal. With "garage artists," this is not always the case, meaning blood-borne infections like HIV, or hepatitis B or C can be spread this way.
The dyes in tattoo ink can be a problem for some people. While inks are safer than they used to be, a lack of regular oversight means that not all inks are hypoallergenic. Allergic reactions are rare, but not unheard of. Because they most often occur in reaction to any color in the red family, new tattoo clients may be counseled to begin using red in small amounts until they know how they'll react. Reactions can cause itching, blisters and bumps (called granulomas) around the edges of a tattoo.
A person with a new tattoo is usually counseled to cover it for a day, avoid submerging it in water for up to two weeks, and rub it frequently with ointment and then with unscented lotion to promote speedy healing. New tattoos involve compromised skin - an obvious contraindication for massage. After the initial tenderness subsides, many people experience intense itching for a few days. This is another caution for massage, which can make itching worse by drawing blood to an area. The safest course in this situation is to wait for any pain and itching to resolve before doing massage in an area with a new tattoo.
Piercings are self-evident, and the variety of body parts that are pierced continues to expand. I remember being both shocked and vastly curious the first time we had a massage student with a nipple ring. (In my own defense, I will point out that these were the days when it was daring to have more than one hole in an earlobe.)
Piercings involve using a special needle to penetrate the skin. Various types of instruments are then inserted into the opening and secured from both sides. The piercing heals when scar tissue forms a tunnel around the instrument. The young woman Tamra described had several long instruments that were inserted to reach horizontally under her skin across the back of her neck.
Depending on the site, piercings can take anywhere from a few weeks to several months to heal completely. At that time, jewelry can be removed and replaced easily. (There's the answer to Tamra's question, by the way: She can take the studs out of her neck to receive massage, if necessary.) Most piercing jewelry is made of surgical steel. Surface piercings, like those on the young woman with the nape studs, have a relatively high rejection rate, but they tend to be most successful when the jewelry is made of surgical-grade Teflon or acrylic, which can conform to the body's curvature. While piercings are healing, the person is advised to keep the area clean and avoid letting anything like hair or clothing catch on the jewelry.
The size of the jewelry is an important safety factor. If it is too short, it can be drawn into the skin, and if it is too long, it can create unnecessary friction as it rubs on nearby structures. Tongue studs that are the wrong size are notorious, for instance, for causing damage to teeth and gums. Other risks with piercings include the possibility of excessive scar tissue or keloids, or trauma if the jewelry is torn out.
Guidelines for massage in the context of piercings are clear: New piercings involve injured skin and must be locally avoided until the lesion has scarred over. On the other hand, older piercings pose no contraindications, and the jewelry can be removed to make massage more effective whenever necessary.
Many thanks to Tamra, who posed this interesting question, and to Andy Barnett of Frankie's Tattoo in Clearfield, Utah, who generously allowed himself to be interviewed for this article. For next time, the floor is once again open. We can continue in this vein with additional information about body art (implants, braiding, scarification, etc.), or we can pick up something entirely different. It's up to you: What's on your table?
Until then, many thanks and many blessings.
Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.
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