resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
A View From the ER
The University of Western States has inked an innovative agreement with local nonprofit health system Legacy Health whereby UWS sports-medicine fellows can experience observational clinical rotations in emergency-room settings within the Legacy system.
Animal Acupuncture: A Case Study in the Treatment of Traumatic Injury in the Equine
The rise of animal acupuncture in the U.S. began in the early 1970's as a result of the work by members of the National Acupuncture Association in Westwood, Calif.
Talking to Patients About Lumbar Facet Denervation (Medial Branch Neurotomy)
Lumbar facet denervation, more appropriately termed medial branch neurotomy (MBN), is a procedure that may be considered when patients suffer from recalcitrant non-radicular axial back and/or leg pain.
Integrating Art with Clinical Practice for Patients with PTSD: The Artemis Project
Are you restricted by those one-on-one clinic dynamics? Why not join colleagues and clients in experimental group settings? Three of us volunteered to do just that in Austin on behalf of women veteranss from all branches of the service.
A House Divided?
The American Chiropractic Association's House of Delegates voted on 30 resolutions at its annual business meeting in Washington D.C., but two in particular took immediate center stage due to their controversial nature.
The Challenges of Integrating Eastern and Western Medicine
My Masters thesis was titled, "The Challenges of Integrating Eastern and Western Medicine," which highlighted several reasons why it is hard for these two worlds to mix.
Optimism = Compassion = Trust
A randomized clinical trial recently published online in JAMA Oncology examined how patients viewed their doctor based upon how the practitioner presented bad news to the patient.
Applying the Thin Skull Principle
The "thin skull" principle, also known as the "you take your victim as you find them" principle, is a legal principle that can be summed up by the following statement.
Marijuana, Apathy and Chinese Medicine, Part 1
This article was written in response to the unheeded acceptance of marijuana as a harmless substance that potentially does good when used for the medical relief of pain.
Term Limits: What's in a Word?
It was the French historian and philosopher Voltaire who once declared the Holy Roman Empire was neither holy nor Roman nor an empire.
5 Tips for Using Pinterest to Market Your Practice
Pinterest is a very popular, but often under-utilized, social media platform where people can bookmark, or "pin," fun and interesting things from all across the internet.
Turning a Blind Eye to History – and Reality
The American Medical Association is taking the Supreme Court's Feb. 25, 2015 decision exactly as it always does – by turning a blind eye to history, legal precedent and reality.
PCOM Granted Regional Accreditation
Pacific College of Oriental Medicine (PCOM) recently announce it has received regional accreditation from the Western Association of Schools and Colleges (WASC). This achievement reflects five years of hard work on the part of faculty, staff, and students.
Medicine is Clumsy, Don't You Be
All medical systems have clumsiness in them. If the technique isn't, the practitioner is. Everyone in every form of medicine is striving to improve. That is why we call it practice.
How Much Do You Know About the Benefits of Birds Nest?
Edible bird's nest is the nest made by the Swiftlet bird of Southeast Asia that is usually prepared as a soup and prized in Chinese culture as a healthful delicacy.
The Acupuncturist's Problem
I want share with you some observations and insights into what seems to be the most common problem my colleagues in the acupuncture profession struggles with. If you also struggle with this problem, I hope you get a valuable "aha" moment from reading this.
Sleep, Less Sleep or No Sleep?
I had a dream I wasn't getting enough sleep. It was a very realistic dream, even though I was probably slightly awake and not really deep dreaming. Most likely I had been dozing, caught in that twilight of sleep and wakefulness.
The Tide is Rising in the Acupuncture Profession
Former President Ronald Regan said, "When the tide rises all boats float." The tide is rising for the acupuncture profession. Many forces outside the profession are helping the tides to rise.
Functional Hip Impingement (Part 1)
Every time I sit down to write an article, I realize how much more there is to know about musculoskeletal pain. I also learn something new every time. (I want to give special thanks to Lucy Whyte Ferguson for assisting with this article.)
Low Back Pain in Professional Golf: A Common Muscular Relationship
Every sport creates its own unique demands on the body. Some sports require such a myriad of body positions that assessing pathology is often difficult and unpredictable.
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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