resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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.
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?
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.
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.
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.
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.
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.
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.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
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.
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).
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.
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.
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.
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?'
Code Connection: 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.
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.
October, 2009, Vol. 9, Issue 10
Your Clients With Lyme Disease
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
I am writing this in high summer, which is prime tick season. Consequently, in this installment, we will examine one of the most mysterious and frustrating conditions associated with summertime activities: Lyme disease. This comes about thanks to the comments of Joy Sablatura in response to my article about Sjogren's syndrome.
One of the things that I have a passion about is educating the public about Lyme disease. So often it is diagnosed as the symptoms that it presents with, such as arthritis, fibromyalgia, chronic fatigue, Bell's Palsy, Parkinson's, Sjogren's, lupus, multiple sclerosis, ALS, ADD, bipolar disorder, anxiety, meningitis or IBS. Reading about Sjogren's makes me wonder how many people with that diagnosis have Lyme as the causative agent? I think it's possible that the Lyme spirochete invades the joints, crosses the blood brain barrier, and spirals into the organs and tissues, causing inflammation. This is why the antibodies attack tissues and organs: They are trying to get to the spirochetes, which are masters of disguise and know where to hide in the body.
Lyme Disease History
In 1974 a group of children in Lyme, Conn., were diagnosed with juvenile rheumatoid arthritis. Because this supposedly noncontagious condition occurred in such concentration in an isolated area and over a short period of time, intensive research was conducted. The conclusion was that the diagnosis of juvenile rheumatoid arthritis was incorrect. Instead, these children had a bacterial infection that had settled in their joints. A scientist named Willy Burgdorfer isolated the spirochete, now called Borrelia burgdorferi. He found it in highest concentrations in the midgut of deer ticks. Burgdorfer's discovery in 1982 began a process of surveillance that continues today. The incidence of Lyme disease rises yearly. About 19,000 cases were diagnosed in 2006, the most recent year for which statistics are available.
Borrelia-carrying ticks have been found all over the Northeast, the mid-Atlantic, parts of the Midwest and in specific areas of the West coast. However, Lyme disease has been diagnosed throughout the country, because the people who have the infection often travel after their tick bite.
It is important to emphasize that a person with Lyme disease cannot transmit it directly to another person. This is a vector-borne infection. In most cases, it is a tick that carries the bacteria from one host to another, but theoretically it could also be spread through contaminated blood products or organ transplants. Humans are not the only species affected; dogs can also get Lyme disease. Of course, deer and mice are the reservoirs of bacteria that infect the ticks to begin with.
Process of the Disease
Lyme disease infection begins with exposure to a tick that carries the bacteria. Only a few species do this in the U.S., which is why the infection is associated with geographic areas where the ticks are common. Deer ticks are very small when they are in the nymph stage and when they haven't taken a blood meal: They are roughly the size of a period in 12-point font. Adult and fully fed ticks are much larger. For an excellent array of tick photos, see www.cdc.gov/ncidod/dvbid/lyme/ld_transmission.htm. Ticks are slow feeders. The risk of transmission within the first 24 hours of having a tick attach are quite low. This is why it is important to do thorough tick-checks every day when spending time in areas where they are common.
Lyme disease usually moves in three stages, although its progression may vary from one patient to another:
Stage 1: Early symptoms generally appear between 7 to 30 days after an initial tick bite. They include a circular red rash (a "bulls-eye" rash) that is hot and itchy, but not raised from the skin, accompanied by high fever, fatigue, night sweats, headache, stiff neck and swollen lymph nodes. If no rash appears, these early symptoms may be mistaken for flu, mononucleosis or meningitis. Many people with Lyme disease have no memory of a bulls-eye rash or this acute phase of the infection.
Stage 2: Systemic symptoms emerge during this phase. These include irregular heart beat and dizziness, chronic headaches, facial paralysis, numbness, tingling, forgetfulness and poor coordination, along with debilitating fatigue.
Stage 3: Many Lyme disease infections eventually involve extreme inflammation of one or more large joints, especially knees, elbows and shoulders. Most patients don't have the infection in more than three joints at a time. The inflammation can be extreme enough to damage the joint permanently, especially if it is left untreated.
Lyme disease presents multiple challenges both to the people who have it and to the health care providers who are charged with treating it. One of the most frustrating aspects of this disease is that it can be so difficult to identify. Blood tests for antibodies are often misleading, and they give no information about the timeline of the disease. In other words, a positive blood test only demonstrates a history of exposure. It doesn't explain whether current symptoms (which can be subtle and nonspecific) are related to that exposure.
Further, a certain percentage of people infected with Lyme disease don't respond to the typical 30-day prescription of antibiotics. They have what is sometimes termed "chronic Lyme disease" and are often resistant to treatment. Some experts theorize that the bacterial infection triggers an autoimmune response in these patients. In the meantime, the arthritis and central nervous system consequences of the infection can be debilitating.
Finally, the symptoms of Lyme disease are so unpredictable that it is often missed. People who are diagnosed with multiple chemical sensitivity, fibromyalgia, chronic fatigue syndrome, multiple sclerosis or lupus might be interested to pursue the possibility of Lyme disease. Even a disease as serious as amyotrophic lateral sclerosis (Lou Gehrig's disease) can be misdiagnosed when Lyme disease generates similar neurologic symptoms.
Massage therapists who work in areas where Lyme disease is common should know what deer ticks look like and proper removal techniques. With tweezers, grasp the tick as close to the skin as possible, pull up with steady pressure, then disinfect the puncture site. Never put noxious chemicals or a hot match head on the tick, as this may cause it to regurgitate; exactly what you don't want to have happen.
Clients who have been diagnosed with Lyme disease may have any number of infection-related problems that can be addressed with massage. Tendon, bursa and joint pain may be relieved, but of course therapists must avoid irritating inflamed areas. Headaches can be addressed, along with other neurological issues like facial paralysis and neuropathy, as long as sensation is intact and the client can give good feedback about comfort. Perhaps more than anything else, massage therapists can be receptive, supportive givers of comfort to clients who live with a frustrating and often very threatening condition.
Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.