resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
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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