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A Simple Protocol for Holiday Stress
It's winter, a time when we should be deep in reflection, eating warming foods and sleeping long hours. Following nature's rhythms, we restore our bodies and minds in preparation for the renewal of spring.
Assessing Core Stability and ROM: 5 Basic Checks
One of the first steps in addressing core stability is assessing static posture, ranges of motion, and motion of the pelvic bones, sacrum, femurs, lumbar spine and thoracic spine.
Overuse Injuries in Young Athletes (Pt. 2)
Most overuse injuries are benign, but there are some high-risk injuries that, if unrecognized or inappropriately treated, can result in significant loss in time from the sport or even require leaving the sport.
End of an Era Looms at NYCC
New York Chiropractic College recently announced that Dr. Frank Nicchi will retire in August 2017 after 36 years with the college, the past 17 as president.
All Fiber Is Not Created Equal
Sometimes the best place to start is at the end. So, the conclusion of this article is that all fiber is good ... but some fiber is better. Let's break it down. There are two main types of fiber: soluble fiber and insoluble fiber.
Little Sticker, Big Impact
It's the end of an election year. Hilary Clinton and Donald Trump were the subject of conversation for everyone, everywhere for the entire 2016 calendar year. I don't think any of us can deny that this election affected us all very deeply on a personal level.
Southwest Acupuncture College Brings It to Division 1 Athletes
When Michael Phelps' photograph with the distinctive round marks left by cupping went viral, the Division 1 student athletes treated through the Dal Ward Athletic Center at the University of Colorado (CU) could relate.
Herbs for Digestion: The Power of Bitter
Many cultures (and indeed herbal clinicians) around the world have long respected the role of bitter herbs and foods for promoting digestion. For example, aperitifs – drinks consumed before a meal to stimulate appetite and digestion – were originally derived from bitter herbs.
DVT: Know the Signs and You Could Save a Life
I lost a friend several months ago. He died from a pulmonary embolism (PE) secondary to a deep-vein thrombosis (DVT) that originated in his lower leg. Bobby was in his mid-60s, soft-spoken and had a big heart.
A Letter to the Profession from the New President at AAAOM
Volunteering for a national, nonprofit organization brings with it such highs, lows, and accomplishments, as well as a steep learning curve.
Chiro School Reunion: Whatever Happened to...?
I opened the door to the closet slowly, carefully, since I knew it contained a large number of precariously stacked file boxes. It also held numerous outdated gizmos with electrical cords of various lengths that could trip or strangle a person.
Can a Multivitamin Reduce Breast Cancer Recurrence?
There is a great deal of controversy regarding the value of multivitamin supplements in cancer prevention. However, with respect to preventing breast cancer recurrence, an important study was published in the Journal of Breast Cancer Research and Treatment in 2011 by Kwan ML, et al.
News in Brief
New President / CEO Takes Office at Yo San University. Electroacupuncture for Constipation?
Another Chance to Make a Difference
Just a few months ago, "the worst natural disaster to strike the United States since Hurricane Sandy" hit Louisiana. During this storm, one area experienced 31 inches of rain in 15 hours as almost 7 trillion gallons of water rained down in just one week across the state.
6 Steps to Make 2017 Your Best Year Yet
People often ask me what defines success. Success, for me, is simple: doing exactly what you want to do in life. Whether it's the kind of practice you run, your life at home, your hobbies or something else, it's achieving anything you put your mind to.
Meshing TCM With Environmental Pediatrics: Where's the Overlap?
Pediatrics has a long history within Chinese medicine dating back to the late Han dynasty (i.e., the late 200s CE), with the two primary areas of emphasis being herbal medicine and xiao er tui na (pediatric massage).
Branding: Set Your Practice Apart
Dr. Brad started his practice seven years ago on a shoestring budget. He created his generic logo in five minutes using a website because he didn't have the time to figure out how to make something special.
Molecular Motors: Tiny Machines Behind the Rhythm of Life
In the clinic, we aim to restore healthy patterns of movement for qi that has gotten trapped or misdirected, or may have even collapsed. We may be focused on freeing stagnation, releasing heat or redirecting counterflow qi, but it often comes down to helping re-establish a flow of sorts.
A Q & A About Updated Codes
Yes, indeed there was an update to ICD-10 on Oct.1, 2016. This is a regular update to the diagnosis coding system and this type of update will occur every Oct. 1, just as it did when the ICD-9 system was in place.
What We Can Learn From Spine Surgery
Patients with lumbar stenosis presumably present for conservative care to improve their quality of life and avoid surgery. However, providing clear guidance to these patients can be difficult for a number of reasons.
Dedicated to Defending Chiropractic
Whether you're a veteran DC or a first-trimester student, the name George McAndrews should be part and parcel of your professional vernacular, as familiar as the word chiropractic.
A First for the Profession: CCE Accredits First Chiropractic Residencies
The Council on Chiropractic Education (CCE) has awarded accreditation to all five chiropractic residency programs currently administered at Veterans Administration facilities, "the first residency programs in the nation ever to be awarded this distinction, a significant advancement in the evolution of chiropractic education," according to a VA press release announcing the milestone.
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 previous articles by Rita Woods, LMT.
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