resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Uncle Sam Needs You (Part 2)
Where chiropractic care has been used in the military health services, it has been deemed very successful.
CMT & Stroke Risk: Myth vs. Fact
By now, most of you have probably heard that the American Heart Association recently published a statement regarding the association between cervical dissection (CD) and cervical manipulative therapy (CMT).
The Wonders of Light Therapy: An Interview with Wes Burwell
I first met Wes Burwell in 2011 when he was teaching a class on light. Since then, every time I hear him speak, his understanding of the benefits, function and capacity of light has evolved.
Healing With TCM at San Quentin State Prison
For the prisoners at San Quentin State Prison, life-sentences are the reality of every day life. It is not often that prisoners get the opportunity to use alternative medicine to deal with common ailments they encounter behind bars such as, depression, anxiety and pain.
Correcting Pelvic Rotation Around the Long Axis: Adjustment Protocol
The pelvis can be considered a ring that can misalign on the sacrum rotating around the long axis. The following is a description of an adjustment that helps to correct sacroiliac rotation around the long axis.
Essential Orthopedic Testing: Tests That Involve Standing on One Leg
Since these tests have a common mechanism of performance (standing on one leg), there are differential diagnostic concerns during testing. The tests cannot be completely isolated from each other for performance.
The Case for Immunization
As long as I have been a chiropractor, I have seen many in this profession oppose vaccinations. Indeed, it has often been taken as a "given" that to be a principled chiropractor requires a curmudgeon's willingness to hold aloft that banner of opposition.
Lime Jello on Morphine
Taste is in the eyes... actually the mouth... of the beholder. My food preferences have changed, lightening from the food of my youth. My parents loved heavy eastern European cuisine and I loved it as a child. Now I enjoy leaner, healthier whole foods.
Communication 101: Please Explain Yourself!
Twice this past week, I overheard conversations about chiropractic. As you can imagine, it is a topic my ears naturally pick up. In both cases, a patient was talking to a friend about their experience with a chiropractor.
Sports Science: What's in That Drink?
Athletes frequently ask me what the best liquid is to drink during exercise – water or a sports drink? Water provides the necessary hydration, but unfortunately, it lacks the key nutrients to aid in performance and recovery.
Pulse Diagnosis: What We Know
I am still finding pearls of wisdom from the books and papers that I inherited from my pulse diagnosis mentor Jim Ramholz.
To The Finish Line With the Help of TCM
When acupuncturist Eddy De Smedt pursued a career in Traditional Chinese Medicine, he knew he wanted to make a difference.
Managing Patient Expectations About Acupuncture
Last year, I attended the Pacific Symposium in San Diego for the first time in six or seven years. It was the 25th anniversary of this event, and on one evening there was a panel discussion with the title; "What is Qi?."
The Tao of Gender
If you think gender is as simple as having a new client check off the "male" or "female" box on your intake form, we hope this article will expand your understanding and thus the reach of your health care.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 2)
As mentioned in part 1, using a flexion-distraction table is a great way to unlock this particular fixation. You have found the stuck segment. You have determined whether it is unilateral, midline or bilateral.
Managing Today's Fertility Patient
I recently received an email from one of my fertility patients: "Got my lab results back. FSH is 11, AMH is 0.7. My doctor said these numbers aren't good. I guess I'm infertile. Just as a thought. Just set up an appointment to speak with an adoption agency."
Jingei Diagnosis: An Effective and Powerful Diagnostic
I graduated from the Kotatama Institute under the direction of Drs. Masahilo and Katsuharu Nakazono in 1984. As a student, I was exposed to the practice of most of the various theories and modalites of Oriental Medicine.
The Heart Protector
On the physical level, the Pericardium is a double-layered sac of fibrous tissue that envelops the Heart. The space between the layers is filled with serous fluid that protects the Heart from external shock or trauma and lubricates to allow for normal Heart movement.
AOMA Strengthens Leadership Team
AOMA Graduate School of Integrative Medicine, a leading college of acupuncture & herbal medicine, announced the appointment of Donna LaPoint Hurta, MBA as the new VP of Finance & Operations this Fall.
Commingling Money: 12 Questions for the ACA About the CHAMP / NCLAF Merger
The American Chiropractic Association recently announced it was merging the National Chiropractic Legal Action Fund and the Chiropractic Health Advocacy and Mobilization Project into a single entity that will support both legal and legislative actions.
Dr. George Goodman and His Legacy to Logan University
Those who knew him called him a revered leader, a visionary and one of chiropractic's biggest advocates. George A. Goodman, DC, Logan University's sixth and longest-serving president, passed away on Sept. 9. He was 70 years old.
Chiropractic Research in Review
Predicting Pain With Disability in Office Workers; Traction Approaches for Discogenic Cervical Radiculopathy; Intra-Articular Gas Bubbles Following Manipulation; Nonresponsive Chronic Ankle Sprains: Think Tendon Rupture.
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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