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Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
February, 2011, Vol. 11, Issue 02
Chasing the Pain, Part 2
A Look at Depression
By Rita Woods, LMT
In my past article "Chasing the Pain", I reported that pain (especially leg pain) may be the result of medications your clients are taking. A thorough medical intake questionnaire that includes medications is imperative for customizing and evaluating your massage plan for each client.Identifying the cause of pain and plan of treatment involves more than subjective and objective observations.
You must begin to look beyond the obvious and consider a wider range of potential causes for their pain. This is especially true if you are not getting the positive results you had expected with your treatment plan. Today, I'm adding another perspective to chasing the pain: depression.
You've probably seen the TV commercial with the slogan: "Depression Hurts". It's an advertisement for a medication used to treat depression. Pain and depression are closely related. They share many of the same neurotransmitters and nerve pathways. Major depression and chronic pain can become a vicious cycle.
On average, 65 percent of depressed people also complain of pain. Chronic pain can lead to depression as it disrupts your daily activities, eating habits, personality and behavior and sleep patterns. In the U.S., 32 million people report pain lasting longer than one year, often without a known physical cause. In primary care practices, up to 80 percent of depressed patients present exclusively with physical symptoms that can include: headache, abdominal pain, and musculoskeletal pains in the lower back, joints, and neck.1
The following is a typical post I found when researching what people actually feel when they are depressed:
"I don't even know where to begin. I'm finding myself getting mad over the smallest things. I find myself crying afterwards because I feel I'm hurting my family. I don't think I'm a good husband or father and I don't understand why my family even wants me around... I would like to add I have this lower back pain that came from nowhere, meaning I didn't do anything physical to cause it, and it is pretty bad."
The low back pain described by this man is not uncommon in people suffering from depression. If he were to come into your massage practice hoping that you could ease or alleviate his low back pain, it would be helpful for you to know he suffers from depression.
Remember that some of the overlap between depression and chronic pain can be explained by biology as they share some of the same neurotransmitters (chemical messengers traveling between nerves). They also share some of the same nerve pathways. According to a Harvard Health publication, almost every drug used in psychiatry can also serve as a pain medication. This is a true mind-body connection.
Massage Therapy and Depression
For the purposes of this article, I will over-simplify that process and focus only on issues that fall within our scope of practice. As massage therapists, we do not deal with emotional and psychological issues but we know from research that massage can help lessen feelings of anxiety, stress and depression. The neurotransmitters, norepinephrine and serotonin (among others), help regulate mood and the perception of pain. Neurotransmitters follow both an ascending and descending pathway, some traveling through the brain and some through the spinal column.
When the regulation of these neurotransmitters fails many things can happen including depression and the sensation of pain. Even if there is no physical reason for the pain, the brain senses pain due to the disruption of the neurotransmitters following the nerve pathways. The NIH reports that clinical investigators have tested chronic pain patients and found that they often have lower-than-normal levels of endorphins in their spinal fluid.
Let's be clear, I'm not saying that all people with pain are automatically depressed, nor all people who are depressed have physical pain. But with the predominance of stress and depression in today's world, you will certainly have some clients suffering from pain that is related to their neurochemistry and not a physical injury. Your treatment plan should include types of massage geared at reducing stress chemicals and increasing the pain-relieving and mood-enhancing chemistry. Instead of chasing the pain, you should reevaluate your treatment plan if the client is showing no signs of improvement.
Swedish massage in particular may enhance well-being by stimulating the release of endorphins (natural painkillers and mood elevators) and reducing levels of certain stress hormones. Additionally, the researchers at the School of Medicine at UCLA found that participants who received a single Swedish massage session had a significant decrease in the hormone arginine-vasopressin (which plays a role in regulating blood pressure and water retention).
In a group of studies by the Touch Research Institute which included about 500 men, women, and children with depression or stress problems, researchers measured the stress hormone cortisol in participants before and immediately after massage. Massage therapy lowered levels by up to 53 percent. Massage also increased serotonin and dopamine, neurotransmitters that help reduce depression. Massaged subjects were less depressed and anxious and showed behavioral and stress hormone changes including a decrease in anxious behavior.
Once again, it's important to emphasize the importance of your client's intake form. Include questions about anxiety, stress and depression. Having this knowledge may help you establish a more successful treatment plan and achieve greater benefits for your client. January and February are typically the worst months for people who suffer from a specific type of depression called Seasonal Affective Disorder (SAD). So now is a good time to call your clients and remind them to make an appointment.
Click here for more information about Rita Woods, LMT.
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