resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
The X Factor in Clinical Research: The Patient
It was the great baseball legend, former New York Yankees catcher Yogi Berra – he of countless aphorisms, each with a mind-bending twist – who once declared, "You can observe a lot by watching."
Managing Today's Fertility Patient
I recently received an email from one of my fertility patients: "Got my lab results back. FSH is 11, AMH is 0.7. My doctor said these numbers aren't good. I guess I'm infertile. Just as a thought. Just set up an appointment to speak with an adoption agency."
Lime Jello on Morphine
Taste is in the eyes... actually the mouth... of the beholder. My food preferences have changed, lightening from the food of my youth. My parents loved heavy eastern European cuisine and I loved it as a child. Now I enjoy leaner, healthier whole foods.
Healing With TCM at San Quentin State Prison
For the prisoners at San Quentin State Prison, life-sentences are the reality of every day life. It is not often that prisoners get the opportunity to use alternative medicine to deal with common ailments they encounter behind bars such as, depression, anxiety and pain.
Help Patients Achieve Optimal Vitamin D Levels
Much research has been done on vitamin D levels and their impact on health; optimal levels have been correlated with a reduced risk of developing numerous conditions.
Managing Patient Expectations About Acupuncture
Last year, I attended the Pacific Symposium in San Diego for the first time in six or seven years. It was the 25th anniversary of this event, and on one evening there was a panel discussion with the title; "What is Qi?."
Blaming the Gluteus Medius, Overlooking the Deltoid
The gluteus medius (Gmed) is commonly written about, strengthened and blamed for many conditions, and rightfully so. After all, the Gmed plays a role in pelvic stability, hip motor control and lower-quarter dynamic movements.
Saying No to Medicine
An interesting article recently appeared in Men's Journal titled "When to Say No to Your Doctor." The article begins with the summary statement above and effectively arms readers with information that will help them "take more responsibility for your own health care, because you can't be sure anyone else is.
Jingei Diagnosis: An Effective and Powerful Diagnostic
I graduated from the Kotatama Institute under the direction of Drs. Masahilo and Katsuharu Nakazono in 1984. As a student, I was exposed to the practice of most of the various theories and modalites of Oriental Medicine.
Pulse Diagnosis: What We Know
I am still finding pearls of wisdom from the books and papers that I inherited from my pulse diagnosis mentor Jim Ramholz.
Web Marketing: Content Is King
Google's sweeping updates to its search algorithms over the past few years have brought a paradigm shift in how you can optimize your chiropractic website to gain maximum marketing leverage.
Calcium Helps Prevent Colorectal Cancer
Over the past 25 to 30 years, studies have suggested calcium may confer protection against colorectal cancer.
Simple Ways To Find True Happiness
Patients in our clinics are always seeking happiness. As their health advocate, we need to ensure we inform them that in order to find happiness, they have to make sure to identify what makes them happy in the first place.
Transparency and Accountability: Q&A With the CCE
Every profession needs an organization dedicated to upholding the quality and integrity of its degree programs and educational institutions.
The Wonders of Light Therapy: An Interview with Wes Burwell
I first met Wes Burwell in 2011 when he was teaching a class on light. Since then, every time I hear him speak, his understanding of the benefits, function and capacity of light has evolved.
Talking to Patients About Healthy Aging
I've noticed that a particular category of patients seems to make up more and more of my practice – they work out, but still experience lots of degenerative joint disease (DJD) issues.
5 Ways to Occupy Occupational Health
Despite the progress that has been made to better protect workers, occupational health and safety remains a priority area for many national governmental organizations due to the widespread problem of occupationally related morbidity and mortality.
The Tao of Gender
If you think gender is as simple as having a new client check off the "male" or "female" box on your intake form, we hope this article will expand your understanding and thus the reach of your health care.
To The Finish Line With the Help of TCM
When acupuncturist Eddy De Smedt pursued a career in Traditional Chinese Medicine, he knew he wanted to make a difference.
AOMA Strengthens Leadership Team
AOMA Graduate School of Integrative Medicine, a leading college of acupuncture & herbal medicine, announced the appointment of Donna LaPoint Hurta, MBA as the new VP of Finance & Operations this Fall.
Understanding and Identifying Pediatric Growth-Plate Fractures
In general, fractures in children heal well with little intervention as long as the alignment is good. Fractures involving the growth plate, however, are a different issue. In fact, growth-plate injuries are the primary reason for the subspecialty of pediatric orthopedics.
June, 2009, Vol. 09, Issue 06
Dry Eyes, Dry Mouth: Sjogren's Syndrome
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
My February article, "Bariatric Surgery," about working with clients who have had various forms of bariatric surgery really seemed to hit a cord. Here are some of your responses:
"I read with interest your article on bariatric surgery. I especially am thankful that you mentioned colon massages. I learned abdominal massage in massage school and improved on it by working with other massage therapists to get greater sensitivity in that area. Now I can feel the colon and surrounding tissue, the peristalsis and what's going on in the rest of the abdomen, as well as helping clients to be more knowledgeable about their own bodies. I understand that there are massage therapists who would rather not address this area, don't have time to do so, or don't feel that they know enough. I would suggest then, to just practice with your colleagues and get the colon massages for yourself. You never know when you may be of assistance to a client with a chronic backache, who really only has a colon ache."
"I started receiving weekly massage therapy shortly after my surgery and continued through the summer of 2008. I found it invaluable to assist me in keeping in touch with my changing body. My massage therapist did Swedish, deep tissue, and stretching. We would also talk about my experience of losing weight and having the band in my body. He was a real support to me through this process. Bottom-line: Massage can be very helpful to someone going through this process."
Roger Bartman, LMT
For this article, I am answering the request of a reader (Hi Karen in Virginia!), whose client has a relatively common autoimmune disorder called Sjogren's syndrome. Sjogren's syndrome is usually manageable, but in rare cases it can be a serious and potentially threatening condition.
Sjogren's Syndrome: What is it?
Sjogren's syndrome, named for Swedish doctor Henrik Sjogren who first identified this pattern in the early 20th century, is an inflammatory condition that usually affects the eyes and mouth, but can have impact on many tissues throughout the body. Most experts agree that Sjogren's syndrome is an autoimmune disorder with a strong genetic component. In this situation lymphocytes invade and rogue antibodies attack two major sets of glands: the lacrimal glands that produce tears, and the salivary glands. In some cases, antibodies may attack other tissues as well--especially in joints and blood vessels--but this is relatively rare.
Sjogren's syndrome has some features in common with other autoimmune diseases. While some people experience this as a chronic, low-grade, slowly progressive condition, others find that it runs in a cycle of extreme and severe flares followed by periods of remission. Like most other autoimmune conditions, Sjogren's syndrome is more common in women than in men by a ratio of about 9-to-1. It usually affects women between 45 and 55 years of age, but it has been documented in patients both older and younger. Statistics on its incidence in the United States vary; it may affect anywhere from 400,000 to 3 million people. Sjogren's syndrome often appears with other autoimmune disorders: about half of those with Sjogren's syndrome may also be diagnosed with rheumatoid arthritis, scleroderma, or lupus.
Signs, Symptoms, and Complications
Signs and symptoms of Sjogren's syndrome revolve around inflammation of tear and salivary ducts, leading to a decrease in important secretions. Without adequate lubrication the eye can feel gritty and painful, it can become vulnerable to bacterial or viral infection, and the cornea can be permanently damaged.
Inadequate production of saliva makes it difficult to swallow, especially dry food. Teeth become vulnerable to cavities and infection, the tongue may develop fissures, and the mouth is generally more vulnerable to a fungal infection called thrush.
Some people experience similar drying effects in other areas, notably the nasal sinuses, vaginal canal, and the skin in general. While nosebleeds and dry skin are irritating, even more severe manifestations of Sjogren's syndrome can lead to joint pain, a type of gastroesophageal reflux disease, and inflammation of the blood vessels (vasculitis) that can contribute to kidney damage, lung damage, and nervous system damage ranging from mood swings to strokes.
Treatment Options for Sjogren's Disease
Sjogren's disease is often categorized as secondary (occurring as part of some other autoimmune disease) or primary, occurring as a freestanding condition. Secondary Sjogren's syndrome is treated symptomatically, but only as a side-issue to the underlying pathology.
Primary Sjogren's syndrome may be benign, mild and non-progressive, but it may be systemic and potentially threatening. Benign and systemic cases are also treated according to symptoms, but specialists now recognize that Sjogren's syndrome has the potential to cause serious problems and it requires careful and thorough follow-up to manage its progression and the tissue damage that it can cause.
Treatment options usually begin with artificial tears, aggressive oral hygiene care, and medications that promote the production of saliva. Room humidifiers can help with dry mouth and irritated nasal sinuses. If these are insufficient, other strategies include medications that suppress immune system activity, steroidal and non-steroidal anti-inflammatories, and drugs that address organ-by-organ problems that systemic Sjogren's syndrome might involve.
What about massage?
When a client's Sjogren's syndrome is connected to other autoimmune disorders, the therapist must gather information about these conditions before making choices about massage. Lupus, scleroderma and rheumatoid arthritis all affect the connective tissues, and bodywork practitioners need to be sure that their work is not exacerbating symptoms or problems. It is generally suggested to save rigorous mechanical types of bodywork for periods of remission with autoimmune diseases. During flares most clients are better off with reflexive or energetic types of bodywork that invite stability rather than challenge homeostasis.
Most people who have primary Sjogren's syndrome experience this as a mildly annoying but manageable condition that doesn't significantly impact their quality of life. In these situations choices about massage are not specifically influenced by this condition. However, in those rare cases where it is associated with very severe symptoms, then accommodations for bodywork may be necessary.
For next time: it's up to you, readers. If anyone is interested in more information about Sjogren's syndrome partners (lupus, scleroderma, rheumatoid arthritis), let me know. Alternatively, I've sensed some interest in the role of massage in the context of cosmetic surgery. Do you work in a plastic surgery office? Have you seen massage as a post-operative strategy to reduce swelling after liposuction or facelifts? Do you have clients who use botox as a cosmetic intervention? What do you find about massage in that setting?
Use this column as a way to share your wisdom with your colleagues and let me know: 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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