resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Flexion-Intolerant Lower Back Pain (Pt. 3): Mobilization & Soft-Tissue Treatment
What is the biggest challenge to the chiropractor in treating discogenic pain? You have to completely reframe the purpose of your manipulation. It is rarely about unlocking a stuck segment at the disc involvement level; it is not about putting a joint back in alignment.
Leaving a Lasting Legacy: Donna Liewer
For the past 31 years, Donna Liewer has been on a personal mission "to comfort the afflicted and afflict the comfortable." In her role as executive director of the Federation of Chiropractic Licensing Boards, Liewer has accomplished that and much, much more.
Resilience is the New Longevity
Sometimes we must enter a room through one door and not another, even though they both lead into the same space. I am talking now of the recent cachet with the concept of "resilience" regarding health, chronic pain and longevity.
AAAOM – The Beginning of the End (Part II)
In 2012, the AAAOM board members met in Chicago for their annual meeting. The goal was to come to a consensus on a long list of issues the AAAOM needed to work on including a functional board and budget.
Green Tea Catechins Lower PSA, Other Biomarkers in Men With Localized Prostate Cancer
A 2006 study (Cancer Research) was the first human investigation to show that green tea catechins (GTC) are highly effective in reversing premalignant prostate lesions (high-grade prostate intra-epithelial neoplasia), an established precursor to prostate cancer.
Risk Factors for Heel Problems
Heel pain and gait disability are common occurrences in adults, often the result of thinning heel pads and a lifetime of exposure to heel-strike shock. One condition experienced by many people is plantar fasciitis.
Successful Strategies in Integrating Acupuncture and Shiatsu in a Hospital Oncology Program
Colleagues from the Network of Researchers in Public Health in CAM recently published an article of interest to our Traditional Asian Medicine community.
The Healing Properties of Light: An Interview With Researcher Anna Cocliovo
This interview is with Anna Cocliovo, a light researcher and Acupuncturist in Arizona. During my own research in light, I came across the article she published for the American Journal of Acupuncture and sought her out as a result.
Are You Guilty of Paternalism in Your Approach to Patient Care?
Einstein is purported to have said, "When a man sits with a pretty girl for an hour, it seems like a minute. But let him sit on a hot stove for a minute and it's longer than any hour. That's relativity." In some way, everything is relative to one's point of view.
What is a Discipline in Medicine?
In my now prolonged dialogue with physicians, one question emerges with enough regularity to deserve mention and naming: what is a discipline?
Steven Rosenblatt: Birthing A Cross-Cultural Acupuncture Profession
The existence of a cross-cultural acupuncture profession in the United States, one that is legalized, licensed, supported by formalized, academic training and inclusive of non-Asian practitioners, is an important part of the medical landscape in this country and is responsible for improving the lives of hundreds of thousands of Americans.
Why DCs Need to Understand the Principles of "Inclusive Design"
In the past few columns, I've written about the negative effects of prolonged sitting at work. I've attempted to make the point that prolonged sitting (or prolonged standing) takes a toll on workers. Now let's discuss a related issue: the concept of "inclusive design."
Stress in the Modern Age: Impact on Homeostasis and What You Can Do (Part 1)
In 1926, Hans Selye first used the word stress in a biological context, referring to the nonspecific response of the body to any demand placed upon it.
Epigenetics: The Western Science Supporting Essence
Since the days of Darwin, western medicine has touted that our genes were set in stone, that our genetics were our destiny. We were told that the diseases that ran in our family were likely coming to us as well.
Collaboration for a Cause
The Patient Protection and Affordable Care Act strongly encourages the formation of multidisciplinary practitioner teams called Patient Centered Medical Homes (PCMHs) and Accountable Care Organizations (ACOs).
AAAOM – Making Promises They Can't Keep
When the AAAOM first formed in 2007, their mission was clear: to support the profession through education, resources and legislative advocacy. The first years of the organization were filled with promise and hope.
News in Brief
Hamm Elected New President of the ACA; WFC / ACC 2014 Education Conference: Call for Papers; F4CP Recognizes Standard Process as $1 Million Supporter; Texas Chiro. College Begins Search for New President; League of Chiropractic Women Hosts Women's Success Summit.
Chiropractic Prevents ADHD? Research Shows...
Now that I have your attention, let me tell you what the latest study actually states. As you may have noticed, research over the past few years has begun to reveal that acetaminophen (the primary ingredient in Tylenol) is not as safe as once thought.
One and Done: Keeping Patients From Vanishing After Just One Appointment
What happened to my 3:30 p.m. ROF? They may have rescheduled, but there are two common answers no one wants to hear: 1) "She called to cancel. I tried to get her to reschedule, but she refused." 2) "She no-showed.
Monoculture of the Mind: Part II
Cases are built within boundaries. Such bounds may be a program, event, activity or individuals. In this instance, a medical case has boundaries that include clinical interactions that are comprised of history, signs, symptoms, diagnoses, treatment plans and treatments.
Creating Child-Friendly Clinics with ABT
The Zurich Dojo was scattered with toy ducks, dolls, trains, exercise balls and teddy bears during my recent pediatric workshop.
October, 2011, Vol. 11, Issue 10
Massage and Diabetic Peripheral Neuropathy
By Rita Woods, LMT
You can use your massage skills and talents to work on clients with diabetic and chemotherapy induced peripheral neuropathies. The degree of success is dependent upon the stage/severity of the neuropathy, client compliance with their own medical care and the "homework" you give them, and your understanding and use of the correct massage therapy protocol.
Neuropathies are characterized by a progressive loss of nerve fiber function. Diabetic peripheral neuropathy or (DPN) can be defined as "the presence of symptoms and or signs of peripheral nerve dysfunction in people with diabetes after exclusion of other causes." This is by far the most common form of neuropathy and one that you are likely to see in your massage practice. Symptoms include pain, tingling, a burning sensation, numbness or loss of feeling, pins and needles feeling and even muscle weakness. This neuropathy usually starts in the toes (in the most distal peripheral nerves) then progresses to the foot, then up the ankle and so on. The hands can be affected in the same way. This condition is almost always bilateral, involving both feet and or both hands. While DPN can involve organs and other body systems, our goal here, staying within our scope of practice, is to normalize function in the feet and hands using appropriate massage therapy techniques. It's important to understand some processes to help hone your skills and to help educate your clients about why it is important to follow their doctors orders. Understanding the why of something often encourages participation and compliance.
First, let's look at the condition itself. The feet of a person with long-term or poorly treated diabetes will often look discolored in a mottled pattern, bluish, shiny/tight or swollen. The client may or may not have been diagnosed with diabetes. Often, it's the neuropathy that causes them to go see their doctor. Early stages usually show no outward physical signs but more advanced stages may show blue toes. This can (and usually does) eventually turn to gangrene where the tissue dies and turns black. The first sign of gangrene can look like a small poppy seed sized black spot. This tissue cannot be regenerated and amputation is the end result of this progression. Naturally, the goal is to begin working on these feet before the condition gets to that point. Following is a case study provided by Charlotte Versagi, LMT, using the massage protocol. This was her first and most dramatic case that eventually led to the saving of hundreds of toes and feet.
The client was a 55-year-old male construction worker with severe diabetes and bilateral cold/blue feet with numbness and tingling. He could barely stand to have his feet touched and his feet were so painful from neuropathy that he could barely get his feet into his work boots in the morning and almost cried when he pried his boots off at night. When he went to the doctor, he was told, "you should plan on an amputation sometime in the near future." There was no mention of any treatment option, no additional medication proposed, just "plan on amputation."
He came to Charlotte asking what she could do. She started the protocol, very slowly, very lightly and called in his wife to teach her. After a few weeks, they were going in "to the bone" as the protocol suggests. He came once per week. His wife was performing the protocol twice a day. He rubbed his own feet whenever he could. In four months, he had almost no pain, had full function and his feet were warm to the touch and normally colored. The doctor retracted his statement about amputation. It should be noted that the client was following a strict diet and taking his medication as directed and was compliant with all aspects of his diabetes care.
Glucose in the body undergoes a series of chemical reactions. If you consume normal amounts of sugars (fructose, sucrose, any form of "sugar" including honey) the early stages of the chemical reactions form an equilibrium reaction. This is called a reversible reaction and allows the body to function optimally. On the other hand, if too much sugar is consumed, these reactions are not reversible and a cascade of events take place by joining the glucose molecule with a protein or fat in an abnormal process which is pathological in nature. This process is called glycation and involves every fundamental process of cellular metabolism. Eventually, through a series of reactions, you wind up with advanced glycation end products or AGEs. These are bad things and cause nothing but harm and damage.
Glycation has been implicated in many diseases and inflammatory processes. It affects the cardiovascular system in a very big way. Tissues that have a slow turnover (more permanent) in the body are most affected by glycation. So the cardiovascular system, connective tissue and skin, nerve tissue and renal tissue are major targets. Inside a blood vessel are elastin fibers to which AGE molecules will attach, thus decreasing the diameter (or caliber) of the blood vessel. There is also a lot of collagen in the arterial walls that can cross-link with the AGE molecules further compromising the blood vessels ability to function properly. Each time there is a glucose spike and AGE molecules are formed, distal circulation is compromised and the blood vessels themselves become occluded beginning with the small capillaries. Unable to supply the surrounding tissue and nerves with nutrients and oxygen the resulting oxidative debt turns toes blue and causes nerves to malfunction sending signals to the brain of pain, tingling, burning and numbness. In addition to the mechanical damage, it is believed these toxic AGE molecules (and other toxins) also trigger the release of substances that further damage the adjacent nerves.
The most important factor to getting DPN under control is to first stop the sugar spikes. Clients must maintain their glucose at a balanced level. No great highs or lows. (They know what level their doctor wants them to maintain.) With diet and medication under control, the massage therapy protocol (coming next article) can truly help save toes and feet from amputation and relieve some or all of the pain and misery of the neuropathy. The next article will discuss chemotherapy induced peripheral neuropathy and give the detailed step-by-step massage therapy protocol for peripheral neuropathy as developed by Charlotte Michael Versagi who has graciously allowed me to share it, in its entirety, with Massage Today readers.
Editor's Note: For additional information, see Step-By-Step Massage Therapy Protocols for Common Conditions by Charlotte Michael Versagi with contributions by Rita D. Woods. Published by Lippincott Williams & Wilkins, 2011. To find this book and more on medical protocols, visit www.charlottemichaelversagi.com or www.darienlourde.com.
Click here for more information about Rita Woods, LMT.
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