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Elevated Shoulder? Check the QL
As you know, posture reveals a great deal about the body. Posture is a unique mental and physical landscape revealing compensations and adaptations to life. It's a classic mind-and-body story.
How to Humanize Your Content to Create Stronger Relationships
Content marketing is about building relationships, whether that is through updates on social media, offers on your website, blog posts, email campaigns, or even printed material. Now days a business needs to make a human connection.
Billing and Coding for Moxibustion
Q: I am trying to locate a code for cupping and moxibustion, and have had various fellow acupuncturists indicate that they bill using the existing codes for heat, 97010 hot packs or 97026 infra-red for moxa and 97016 vasopneumatic device for cupping.
The MRI: When and Why to Order One
As I lecture around the country to both chiropractors and medical specialists, it's clear one of the main disconnects between the two professions is that of an accurate diagnosis.
The Future of Functional Neurology
Functional is the hot buzzword in health care these days; witness the rising popularity of functional medicine, functional testing and yes, functional neurology.
Changing the Cultural View of Medicine
Many hospitals in the U.S. are incorporating integrative clinics that include Traditional Chinese Medicine. Cleveland Clinic has led the charge for adding a traditional Chinese herbal medicine clinic to their existing acupuncture program.
Do You Teach Patients How to Breathe Properly?
Spinal manipulation often produces quick results in terms of pain alleviation and improved range of motion. Unfortunately, once the patient is no longer in pain, they may discontinue therapy, only to be plagued by the same complaint at a future date.
Preventing ACL Injuries in Female Athletes
For female athletes, the key to optimal athletic health lies in preventing ACL injuries. In medical terms, the anterior cruciate ligament (ACL) is the primary restraint to the anterior displacement of the tibia on the femur at all angles of the knee flexor.
Integrative Medicine Can Shape the Profession
As the AOM profession struggles to define the role of "integrative" medicine within their practices their schools and organizations, students, faculty, alumni and administrators at schools wrestle with discussions of how much, where, how, and what to "integrate."
News in Brief
A Winner in and Out of the Office; Ready for the "Have-A-Heart" Campaign? New Integrative Medicine Journal.
The Roots of Insomnia
One of the most common clinical presentations is insomnia. Next to digestive disorders, sleep disorders are one of the most common complaints the clinician will encounter in daily practice.
Osteoporosis Isn't Always the Case
What is your diagnosis? The patient is a 58-year-old female with back pain. I am sure all of you see the compression fracture at L2; however, there are some findings that suggest this is not a compression fracture due to osteoporosis.
Yo San University Helps Make LA Communities Healthier
An element of healthcare training often overlooked is the residual benefit to communities served by Acupuncture and Oriental Medicine (AOM) schools nationwide.
Window of the Sky Points
The acupuncture points known as Window of the Sky are a modern creation. There is no reference in Chinese medical texts for an acupuncture point category called Window of the Sky.
We Get Letters & Email
In the Dec. 1, 2015 issue, we have Donald Petersen reporting on "the adapting chiropractic practice," which includes multidisciplinary practice as an option; a ChiroPoll indicating 59 percent of DCs are seeing at least 21 patients per day and 27 percent are seeing more than 40.
Asking the Insurance Rep the Right Questions
One of the first or last questions a potential patient often asks is: "Do you take insurance?" An ill-informed or optimistic, "yes" can result in delayed or non-payment. Instead, just say: "Let me check if you are eligible first."
Sell Out: Using Research for the Wrong Reasons
The above chorus is from the ska band Reel Big Fish's 1997 hit song, "Sell Out," from their album, "Turn the Radio Off." In the song, the singer sarcastically relates the plight of a musician who is tired of "flipping burgers" and is willing to get "lots of money" by playing "what they want you to hear" in order to get a recording contract.
Interprofessionalism: What it Means and Why You Should Care
Interprofessionalism in education and in practice is a growing trend across health care in the United States. The idea that team-based care and collaborative practice can improve health care has been around more than 50 years.
Spine Surgery: A Tale of Greed and Corruption
All too often, where there's substantial money to be made, greed and corruption inevitably follow.
Percussion Therapy: An Experiment
My study of qi began more than 20 years ago — long before my study of TCM, points or pathways. It all started with an awareness in my hands and physical manifestations in the way of blockages while working on clients.
Ethics: The Glue That Holds Us Together
Kudos to the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) for creating a code of ethics for the nationwide profession and for deciding to make courses in ethics a requirement for certification renewal.
Top 10 Fitness Trends for 2016
The American College of Sports Medicine (ACSM) published its annual fitness trend forecast in the November / December 2015 issue of ACSM's Health & Fitness Journal.
From Antiquity to Modernity: Huang Qin Tang at Yale Medical School, Part 1
Traditional Chinese medicine is a coherent medical system with several unique characteristics: it originated almost 3,000 years ago; in its area of origin, it has been practiced without interruption since its inception.
The Amazing Clinical Versatility of Milk Thistle (Part 1)
Most of us know that the standardized extract from the seeds of milk thistle (Silybum marianum) is probably the best-proven herb for protecting the liver from chemical and inflammatory damage.
Forgotten Options for Musculoskeletal Health
Challenges with musculoskeletal health are of tremendous concern for many people today.
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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