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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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
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.
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.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
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.
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.
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.
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."
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
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.
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.
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.
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."
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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