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Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
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.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
March, 2009, Vol. 09, Issue 03
Hospice Massage: Easing the Pain of a Life-Limiting Illness, Part 1
By Ann Catlin, LMT, NCTMB, OTR
A couple of years ago, I had the privilege of spending a few days at a residential hospice in Washington, D.C. called Joseph's House; I was there to conduct a workshop for the staff. While I was there to teach, in the process I learned so much about dying with dignity. You see, Joseph's House takes in and cares for homeless men and women with terminal illness. Witnessing the impact of touch on the lives of these men and women was profound and has stayed with me ever since. Anxiety was eased, relationships were deepened and spirits were lifted for those receiving the touch and those giving it. I recall gently massaging the legs and arms of a young man who, it was believed, was only days away from dying. As I watched him fully receive my touch with a look of peace, I felt blessed to be doing this humble work. Those who entered the doors of Joseph's House were given the gift of living well with dignity in their final days.
I believe that is the essence of hospice care to help the dying person live well and to support quality of life. A paramount concern in hospice care is alleviating pain. As massage practitioners, we have much to contribute to easing pain and suffering on many levels. The complex nature of pain is holistic, meaning it is related to the whole person: the body mind and spirit. By acknowledging only the physical component of pain, we are disregarding a significant part of the pain experience that may have as much impact on the quality of life as the physical discomfort. The dimensions of pain obviously include the physical, however the psychological, emotional, social and spiritual dimensions equally impact the quality of life as well.
Dimensions of Pain
The dimensions of pain include:1
Massage: Why it Works
The American Massage Therapy Association (AMTA) defines massage as "a manual soft tissue manipulation, and includes holding, causing movement, and/or applying pressure to the body." The intention of applying massage is, according to the AMTA to positively affect the health and well-being of the client.
A hands-on complementary approach for those in eldercare, hospice and palliative care enhances quality of life. Combining sensitive massage techniques, focused touch, one-on-one attention and specialized communication skills can be highly effective for those in later life stages. The concepts and techniques of this hands-on approach are effective as a non-pharmacological tool in alleviating discomfort associated with the dimensions of pain. What follows is an exploration of the effects of massage along with some of the rationale for why massage may be important tools in alleviating pain for individuals with life-limiting illness.
Physiological Effect: Physical sensation of pain is reduced. Massage has been shown to affect the nervous system through stimulation of sensory receptors. The gate control theory refers to the idea that pain impulses pass through a "gate" to reach the nerve fibers leading from the spinal cord to the thalamus in the brain. Pain impulses are transmitted by large and small diameter nerve fibers. Massage stimulates the large-diameter fibers, preventing the small diameter fibers from transmitting signals, suppressing the sensation of pain.2
Massage stimulates production of endorphins. Endorphins are opiate-like compounds produced by the body that relieve pain and produce feelings of euphoria.2 Massage decreases cortisol levels. Cortisol is a stress hormone that is produced by the adrenal glands during prolonged stress. When cortisol levels are lowered it enhances sleep quality and the immune system.2
Behavioral Effect: Physical tasks are performed with greater comfort (i.e. transfers, dressing, ambulating). When the burden of pain is eased the individual may increase his or her involvement in self-care and participate more actively in daily life and level of function is improved.
Emotional Effect: Positive feelings and mood is enhanced. Massage has a generalized effect on the autonomic nervous system, resulting in changes in mood and an induced relaxation response.2 Massage seems to increase serotonin levels. Serotonin is a neurochemical that regulates mood; feelings of calm; and subdues anxiety and irritability.3
Cognitive Effect: The cycle of pain and fear may be interrupted, resulting in more positive thought patterns. One hypothesis4 states that pain has three phases: the anticipation phase; the sensation phase; and the aftermath phase. The person suffering from chronic or intermittent pain may experience fear in the anticipation phase stemming from unpleasant past painful experiences. When the pain experience is eased with massage and one-on-one focused attention, those associations may lose their grip on the belief system of the person.
Social Effect: Touch and massage is a medium that enhances the relationship between the ill person and caregivers.
Bush5 reports that substantial evidence points to the fact that the experiences of touch are laden with psychosocial as well as physiologic implications. It is a viable means of improving both verbal and non-verbal communication. Human touch creates a way for the dying person to interact and connect with others, decreasing feelings of isolation and loneliness.
Spiritual Effect: Human touch enhances spiritual well-being. Nelson6 reports that when individual felt cared for by staff during and after receiving complementary approaches, the burden of disease (i.e. physical, emotional) seemed less and allowed them to feel like they had more of a desire to participate in life.
The unconditional gift of touch acknowledges the individual's worth regardless of the condition of the body or mind easing suffering on all levels. Hospice organizations are offering massage therapy as a complementary service more than ever before. We truly hold within our hands the means to make a meaningful difference in the quality of life at life's end.
Click here for more information about Ann Catlin, LMT, NCTMB, OTR.
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