resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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).
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 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.
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.
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?
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.
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.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
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?'
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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